The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients

Youngjoo Park; Haejung Lee

doi:10.7469/kjan.2015.27.6.718

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Park and Lee: The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients

Original Article

Korean J Adult Nurs 2015;27(6):718-727.

Published online: December 2015

DOI: https://doi.org/10.7469/kjan.2015.27.6.718

The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients

Youngjoo Park¹, Haejung Lee^2,

^¹College of Nursing, Graduate School, Pusan National University, Yangsan

^²Collegeof Nursing, Pusan National University, Yangsan, Korea

Corresponding author: Lee, Haejung College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 626-870, Korea. Tel: +82-51-510-8344, Fax: +82-51-510-8308, E-mail: haejung@pusan.ac.kr

Received 5 October 201510 December 2015 Accepted 11 December 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify the levels of physical activity and its relationships with depression, health-related quality of life (QoL), sleep disturbance, and physiological indicators in hemodialysis patients.

Methods

The participants in this study were 139 patients undergoing hemodialysis in the hospitals in Busan andYangsan-si. Data were collected using hematologic tests and questionnaires that contained items about individual characteristics, International Physical Activity Questionnaires (IPAQ), Center For Epidemiological Studies Depression Scale (CES-D), a 12-item Short-Form Health Survey (SF-12), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using descriptive statistics, one way ANOVA, and correlation.

Results

Mean age of the participants was 59.91±12.63 and mean physical activity levels were 1,660.35±1,654.17. Patients who performed higher physical activities during their daily activities reported lower levels of depression (F=4.16, p=.018) and higher levels of QOL (PCS: F=5.00, p=.008, MCS: F=8.66, p<.001) than those of the others who did not perform physical activities.

Conclusion:

This study showed that the levels of physical activity among hemodialysis patients was significantly associatedwith their depression and QOL. Developing strategies for enhancing physical activity is warranted to improve depression and QOL among hemodialysis patients.

Keywords: Renal dialysis, Motor activity, Depression, Quality of life, Dyssomnias

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Table 1.

Characteristics of the Participants (N=139)

Characteristics	Categories	n (%) or M±SD
Age (year)		59.91±12.63
	64 ≤	(59.0) 82
	65 ≥	(41.0) 57
Gender	Male	87 (62.6)
Gender	Female	52 (37.4)
Occupation	Yes	16 (11.5)
Occupation	No	123 (88.5)
Monthly income (10,000 won)	100 ≤	89 (64.0)
Monthly income (10,000 won)	100 ＞	50 (36.0)
Marital status	Married	84 (60.4)
Marital status	Living alone	55 (39.6)
Religion	Yes	86 (61.9)
Religion	No	53 (38.1)
Level of education	Middle school ≤	55 (39.6)
Level of education	High school ≥	84 (60.4)
Number of family	0	32 (23.0)
	1	52 (37.4)
	2	22 (15.8)
	3 ≥	33 (23.7)
Hemodialysis period (year)		4.56±4.55
	1 ≤	36 (25.9)
	2~5	65 (46.8)
	5 ≥	38 (27.3)
DM	Yes	73 (52.5)
DM	No	66 (47.5)
HT	Yes	70 (50.4)
HT	No	69 (49.6)

Table 2.

Physical Activity, Depression, Quality of Life, and Sleep Disturbance of the Participants (N=139)

Variables	Categories	M±SD	n(%)	Min	Max
IPAQ	Inactive	1,600.54±1,654.17	55 (39.6)	0.0	5,940.0
	Minimally active		55 (39.6)
	HEPA		29 (20.9)
Depression	16 ≤	16.7±9.4	81 (58.3)	1.0	44.0
Depression	16 ＞	16.7±9.4	58 (41.7)	1.0	44.0
SF-12:PCS	39.2 ≤	39.2±9.1	63 (45.3)	17.1	55.6
SF-12:PCS	39.2 ＞	39.2±9.1	76 (54.7)	17.1	55.6
SF-12:MCS	46.6 ≤	46.6±11.2	70 (50.4)	18.8	69.1
SF-12:MCS	46.6 ＞	46.6±11.2	69 (49.6)	18.8	69.1
Sleep Disturbance	5 ≤	7.8±4.4	47 (33.8)	0.0	19.0
Sleep Disturbance	5 ＞	7.8±4.4	92 (66.2)	0.0	19.0

IPAQ=international physical activity questionnaire; Inactive= 600; ＜ Minimally active=600~3000; HEPA= 3000 ＞ (MET-min/week); CES-D=Center for Epidemiological Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; HEPA=health enhancing physical activity.

Table 3.

Differences in Depression, PCS, MCS, Sleep Disturbance, and Physiological Indicators according to Physical Activity (N=139)

Variables	Categories	Inactive	Minimally active	HEPA	F	p
Variables	Categories	n (%) & M±SD	n (%) & M±SD	n (%) & M±SD	F	p
Psychometric index	Depression	19.09±9.33	16.11±9.42	13.14±8.37	4.16	.018
	SF-12: PCS	36.24±8.90	40.88±9.24	41.45±7.90	5.00	.008
	SF-12: MCS	42.19±10.94	48.26±11.18	51.65±8.81	8.66	＜.001
	Sleep disturbance	8.64±4.59	7.44±3.87	6.72±4.86	2.05	.132
Physiological Indicators	Phosphorous	4.79±1.68	5.08±1.36	5.61±1.40	2.79	.065
	Potassium	5.04±0.94	5.14±0.85	5.73±0.84	6.11	.003
	Calcium	8.96±1.08	8.85±1.18	9.01±0.99	0.24	.785
	BUN	60.09±20.60	61.59±16.28	71.00±17.57	3.60	.030
	Cr	8.84±3.25	9.17±2.75	13.88±16.41	4.38	.014
	Albumin	4.03±0.49	4.08±0.40	4.08±0.25	0.21	.807
	Hemoglobin	10.19±0.94	10.55±1.37	10.36±1.07	1.30	.273

IPAQ=International Physical Activity Questionnaire, Inactive= 600, ＜ Minimally active=600~3,000, HEPA= 3,000 ＞ (MET-min/week), CES-D=Center For Epidemiological Studies Depression Scale, PSQI=Pittsburgh Sleep Quality Index, SF-12: PCS=Physical Component Summary Score, SF-12: MCS=Mental Component Summary Score, HEPA=health enhancing physical activity.

Table 4.

Relationships of Physical Activity with Depression, Quality of Life and Sleep Disturbance (N=139)

Variables	X1	X2	X3	X4	X5
IPAQ (X1)	1
CES-D (X2)	-.213	1
PSQI (X3)	-.091	.486	1
SF-12: PCS (X4)	.189	-.299	-411	1
SF-12: MCS (X5)	.252	-512	-.274	.108	1

IPAQ=International Physical Activity Questionnaire; CES-D=Center For Epidemiologic Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; p .05, ＜ p .01. ＜

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