Effects of acceptance of disability on death or dialysis in chronic kidney disease patients: a 3-year prospective cohort study

BMC Nephrology

Research Article

Tzung-Yi Tsai¹  How-Ran Guo²  Mei-Ling Yen³  Hsin-Hung Chiang⁴  Hanoch Livneh⁵ 

[1] Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, No. 2, Minsheng Rd., Dalin Township, County 62247, Chiayi, ROC, Taiwan;Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan;Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan;Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan;Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan;College of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan;Rehabilitation Counseling Program, Portland State University, Oregon, USA;

关键词: Acceptance of disability;    Chronic kidney disease;    Dialysis;    Mortality;    Taiwan;   

DOI  :  10.1186/s12882-015-0197-z

 received in 2015-04-20, accepted in 2015-11-25,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAcceptance of disability (AOD) is a useful construct that assesses the ability of a patient to psychologically cope with chronic diseases, but its effect on long-term outcomes of patients with chronic kidney disease (CKD) remains unclear. This study aimed to evaluate the relation between AOD level and clinical outcomes in a cohort of CKD patients in Taiwan.Methods262 CKD patients without dialysis at a hospital in Taiwan were consecutively recruited, from 2010 to 2011, and followed up for 3 years. At enrollment, demographic and clinical data were obtained, including baseline level measurement of AOD, using the Acceptance of Disability Scale-Revised (AODS-R). During follow-up, the authors assessed the effect of AOD on progression to dialysis and all-cause mortality by using Cox proportional hazard regression analysis.ResultsOf the patients included in the analyses, 145 (55.3 %) whose total scores of AOD were below the median (86.00) were regarded as having low AOD at enrollment. At the end of 3-year follow-up, 25 have died and 57 initiated dialysis. Participants with low AOD were more likely to have the composite end-point of progression to dialysis or death (adjusted hazard ratios [AHR] = 1.89, 95 % confidence interval [CI]: 1.18-3.20). In addition, CKD stage at IV or above and hemoglobin level were found to be associated with the occurrence of the composite end-point.ConclusionAOD was associated with an increased risk for poor clinical outcomes, thus suggesting that prompt awareness and management of the psychological reactions may improve clinical outcomes of patients with CKD.

【 授权许可】

CC BY   
© Chiang et al. 2015