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The cross-lagged association between depressive symptoms and health-related quality of life in patients receiving maintenance hemodialysis: a three-wave longitudinal study

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Abstract

Purpose

To examine the cross-lagged relationship between depressive symptoms and health-related quality of life (HRQoL) in patients receiving maintenance hemodialysis.

Methods

A longitudinal, observational study was conducted in two public hospitals in Shanghai, China. The sample consisted of 204 patients at baseline (T1). Of these, 144 completed the 12-month follow-up survey (T2), and 135 completed the 24-month follow-up survey (T3). Depressive symptoms were assessed using the depression subscale of the Hospital Anxiety and Depression Scale, and HRQoL was assessed using the Kidney Disease Quality of Life 36 short form. Cross-lagged path analysis was used to examine the temporal relationship between depressive symptoms and domains of health-related quality of life.

Results

Lower levels of three out of five domains of HRQoL (physical functioning, burden of kidney disease, and symptoms of kidney disease) at T1 were associated with increases in depressive symptoms at T2. Moreover, higher depressive symptoms at T2 were associated with decreases in four domains of HRQoL (mental functioning, burden of kidney disease, symptoms of kidney disease, and effects of kidney disease) at T3.

Conclusions

Patients who had poor HRQoL were more likely to report more subsequent depressive symptoms, which in turn predict lower HRQoL over time. It indicates a need to break this cycle in patients receiving maintenance hemodialysis.

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Data availability

The data is available from corresponding author upon reasonable request.

Code availability

The code is available from corresponding author.

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Funding

This study was supported by National Natural Science Foundation of China (No. 71874111), Shanghai Municipal Health Bureau Foundation (No. 201740116) and Basic Research Funds at Sun Yat-sen University (No. 53000-18841201). The funding agencies are not responsible for the opinions presented in the manuscript. The funding bodies had no influence on the conduct of the study or the interpretation of the results.

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Authors and Affiliations

  1. School of Nursing, Sun Yat-sen University, Guangzhou, China

    Jieling Chen

  2. Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China

    Lingling Liu, Jing Chen & Yanqing Jie

  3. The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China

    Marques S. N. Ng

  4. Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China

    Vivian W. Q. Lou

  5. Department of Nephrology, Zha Bei District Center Hospital of Shanghai, Shanghai, China

    Bibo Wu

  6. Department of Nephrology, Shanghai Shi Bei Hospital, Shanghai, China

    Weijie Jiang

  7. School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China

    Jingfen Zhu & Yaping He

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  1. Jieling Chen
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Correspondence to Yaping He.

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Chen, J., Liu, L., Chen, J. et al. The cross-lagged association between depressive symptoms and health-related quality of life in patients receiving maintenance hemodialysis: a three-wave longitudinal study. Qual Life Res 30, 3463–3473 (2021). https://doi.org/10.1007/s11136-021-02866-6

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