Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis

Jieun Cha; Myungsun Yi

doi:10.7469/kjan.2014.26.6.693

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Cha and Yi: Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis

Original Article

Korean J Adult Nurs 2014;26(6):693-702.

Published online: NaN December 2014

DOI: https://doi.org/10.7469/kjan.2014.26.6.693

Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis

Jieun Cha¹, Myungsun Yi²

^¹Department of Nursing, Daegu Health College, Daegu

^²College of Nursing ․ The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Corresponding author: Cha, Jieun Department of Nursing, Daegu Health College, 15 Youngsong-ro, Buk-gu, Daegu 702-722, Korea. Tel: +82-53-320-1446, Fax: +82-53-320-1470 E-mail: jecha1446@dhc.ac.kr

Received 24 September 20141 December 2014 Accepted 2 December 2014

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 examine the relationships between treatment belief, personal control, depressive mood, and health-related quality of life in patients with hemodialysis based on self-regulation theory.

Methods

Data were collected from 220 patients at 27 local hemodialysis clinics in Seoul during 2013 and 2014. The Revised Illness Perception Questionnaire, the Hospital Anxiety and Depression Scale, and Medical Outcomes Study Short Form-12 were used to measure outcome variables. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple regression using the ‘enter’ method.

Results

Treatment belief and personal control scored 3.58 and 3.54 out of 5 points respectively, on average. Treatment belief and personal control of kidney disease were negatively correlated with depressive mood and positively correlated with health-related quality of life. According to the regression analysis, treatment belief, monthly income, and personal control were discovered to account for 21.8% of the variance in depressive mood, where as depressive mood, monthly income, treatment belief, and age were found out to account for 40.6% of the variance in health-related quality of life.

Conclusion

Our study demonstrated significant positive relationships between treatment belief and illness outcome in hemodialysis patients. Interventions aimed to provide the necessary information and trust to maximize the effectiveness of treatment need be developed to improve patients outcomes.

Keywords: Cognition, Renal dialysis, Psychological adaptation, Quality of life

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Table 1.

Differences of Depressive Mood and Health-related Quality of Life according to General Characteristics (N=220)

Characteristics	Categories	n (%)	Depressive mood		Health-related quality of life
Characteristics	Categories	n (%)	M±SD	t or F (p)	M±SD	t or F (p)
Gender	Male	155 (70.5)	7.33±4.23	1.13	425.48±164.12	-1.51
Gender	Female	65 (29.5)	6.63±4.03	(.259)	460.77±141.00	(.131)
Age (year) (M±SD 48.0±9.2)	＜30^a	36 (16.4)	5.56±3.54	2.79	488.89±128.24	3.11
	30~39^b	86 (39.1)	7.52±4.26	(.041)	451.16±160.37	(.027)
	40~49^c	75 (34.1)	7.68±4.11	b, c＞a^†	403.00±163.68	a＞c, d^†
	50~65^d	23 (10.4)	6.26±4.47		403.26±151.75
Marital status	Married	120 (54.5)	7.18±4.10	0.23	447.50±153.72	0.80
	Unmarried	62 (28.2)	7.26±4.24	(.796)	427.42±158.74	(.449)
	Divorced/Widowed	38 (17.3)	6.71±4.37		413.16±171.51
Education level	≤High school	128 (58.2)	7.42±4.43	-2.82	411.72±169.53	1.26
Education level	≥College	92 (41.8)	6.71±3.78	(.005)	469.57±134.60	(.211)
Monthly income (10,000 won)	＜200	103 (46.8)	8.37±4.54	4.25	375.49±159.92	-5.69
Monthly income (10,000 won)	≥200	117 (53.2)	6.02±3.50	(＜.001)	489.10±136.51	(＜.001)
Job	Yes	113 (51.4)	6.14±3.87	-3.68	484.51±159.64	4.93
Job	No	107 (48.6)	8.16±4.25	(＜.001)	384.58±139.90	(＜.001)
Religion	Yes	138 (62.7)	6.98±4.08	-0.67	438.41±149.15	0.30
Religion	No	82 (37.3)	7.37±4.35	(.507)	431.71±173.12	(.762)
Dialysis period (year) (M±SD 8.7±6.9)	＜5	78 (35.5)	7.31±3.93	0.65	466.99±140.70	2.77
	5~10	56 (25.5)	6.57±4.09	(.522)	433.48±155.09	(.065)
	＞10	86 (39.1)	7.31±4.44		409.30±171.29
Primary disease	DM	34 (15.5)	8.09±4.07	1.88	394.85±125.19	2.00
	HTN	64 (29.1)	7.67±4.07	(.134)	418.36±161.17	(.115)
	GN	72 (32.7)	6.35±3.96		467.01±153.76
	others	50 (22.7)	6.88±4.67		441.50±174.79
TPL waiting	Yes	100 (45.5)	6.52±4.14	-1.97	462.25±157.69	2.28
TPL waiting	No	120 (54.5)	7.63±4.16	(.050)	413.96±155.80	(.024)

^† LSD test; DM=diabetes mellitus; HTN=hypertension; GN=glomerulonephritis; TPL=transplantation.

Table 2.

Descriptive Statistics of Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)

Variables	M±SD	Range
Treatment belief
1. There is very little that can be done to improve my kidney disease. (R)	2.90±1.07
2. My treatment (dialysis, medication, dietary treatment, etc.) will be effective in curing my kidney disease.	3.71±0.85
3. The negative effects of my kidney disease can be prevented (avoided) by my treatment (dialysis, medication, dietary treatment, etc.).	3.65±0.91
4. My treatment (dialysis, medication, dietary treatment, etc.) can control my kidney disease.	3.71±0.84
5. There is nothing which can help my condition. (R)	3.92±0.95
Total	17.89±3.29	5~25
Personal control
1. There is a lot which I can do to control my symptoms.	3.12±0.96
2. What I do can determine whether my kidney disease gets better or worse.	3.56±0.94
3. The course of my kidney disease depends on me.	3.64±0.90
4. Nothing I do will affect my kidney disease. (R)	3.63±0.99
5. I have the power to influence my kidney disease.	3.60±0.85
6. My actions will have no affect on the outcome of my kidney disease. (R)	3.70±0.96
Total	21.25±4.05	6~30
Depressive mood	7.12±4.18	0~21
Health-related quality of life	435.91±158.15	0~800

R=reverse coded item.

Table 3.

Correlations between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)

Variables	Depressive mood		Health-related quality of life
Variables	r	p	r	p
Treatment belief	-.37	＜.001	.36	＜.001
Personal control	-.35	＜.001	.25	＜.001
Depressive mood		-	-.58	＜.001

Table 4.

Influencing Factors on Depressive Mood (N=220)

Predictors	Depressive mood
Predictors	β	t (p)
Treatment belief	-.23	-3.23 (.001)
Monthly income	-.23	-3.16 (.002)
Personal control	-.21	-2.97 (.003)
	Adj. R²=.218, F=13.22, p＜.001.

β=standardized coefficients beta; Adj. R

² =adjusted R

² .

Table 5.

Influencing Factors on Health-related Quality of Life (N=220)

Predictors	Health-related quality of life
Predictors	β	t (p)
Depressive mood	-.45	-7.55 (＜.001)
Monthly income	.16	2.58 (.011)
Treatment belief	.15	2.37 (.019)
Age	-.12	-2.34 (.020)
	Adj. R²=.406, F=22.41, p＜.001

β=standardized coefficients beta; Adj. R

² =adjusted R

² .

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