Prevalence of depression in patients with end-stage renal disease undergoing hemodialysis in Saudi Arabia: A cross-sectional study
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Keywords

prevalence
depression
hemodialysis
end-stage renal disease
ESRD
cross-sectional study
nursing
Saudi Arabia

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Sallam, L., Alsharif, F., Abaalalaa, S., Alakeely, R., Abdullah, Z., Alkhamis, Z., Sindi, N., & Sharif, L. S. (2022). Prevalence of depression in patients with end-stage renal disease undergoing hemodialysis in Saudi Arabia: A cross-sectional study. Belitung Nursing Journal, 8(4), 296–303. https://doi.org/10.33546/bnj.2080
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Abstract

Background: A hemodialysis is a treatment option for patients with End-Stage Renal Disease (ESRD). However, patients undergoing hemodialysis three times per week may experience psychological issues, including depression, which are highly prevalent among patients. Unfortunately, most healthcare providers fail to recognize the symptoms of depression due to overlap with other somatic symptoms; thus, depression remains undiagnosed.

Objective: This study aimed to estimate the prevalence of depression and compare the differences in depression symptoms according to the sociodemographic characteristics of patients with ESRD undergoing hemodialysis.

Method: A descriptive, cross-sectional study was conducted from August to October 2021 with a total of 132 hemodialysis patients using the Beck Depression Inventory (BDI II) questionnaire to examine symptoms of depression at multiple health centers in Jeddah. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Post-hoc analysis using Conover tests were used for data analysis.

Results: The prevalence of depression in hemodialysis patients was 51.5%, 25.8%, 15.9%, and 6.8%, with minimal, mild, moderate, and severe symptoms, respectively. Depression exhibited a significant relationship with sex (p = 0.034), with females showing higher mean depression scores than males. Additionally, depression scores were statistically significant across the different levels of education (p = 0.019), with the mean depression scores significantly highest in subjects who had only primary school level of education. Furthermore, the most common symptoms associated with depression were found to be energy loss and fatigue.

Conclusion: Depression prevalence was relatively low among patients with ESRD undergoing hemodialysis, and a loss of energy and fatigue were the most common symptoms correlated with depression. Hence, nurses should be trained on how to routinely use psychological screening scales among patients with ESRD undergoing hemodialysis.

https://doi.org/10.33546/bnj.2080
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Copyright

Copyright (c) 2022 Lujain Sallam, Fatmah Alsharif, Sarah Abaalalaa, Rawan Alakeely, Zahraa Abdullah, Zahra Alkhamis, Najla Sindi, Loujain S Sharif

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declare no conflicts of interest concerning the research, authorship, and publication of this article.

Acknowledgment

The authors would also like to thank the health care centers in Jeddah for their collaboration and for allowing us to reach hemodialysis patients. Finally, special thanks to our parents for their love, support, and continuous encouragement.

Authors’ Contributions

Conceptualization, SA and ZK; methodology, LSS, RA; software, ZA; validation, LS; formal analysis, SA, RA, ZK, and ZA; investigation, RA; resources, SA, NS; data curation, ZK; writing-original draft preparation, LS; writing-review and editing, FS, LSS; visualization, ZA; supervision, LS, LSS and FA; project administration, SA, ZK, RA, ZA, and LSS. All authors agreed to be accountable for all contents of the study and agreed with the final version to be published.

Data Availability

The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request.


References

Abdi, A., Dalvand, S., Vahedian-Azimi, A., Gheshlagh, R. G., & Kurdi, A. (2018). Prevalence of depression among Iranian patients under hemodialysis: A systematic review and meta-analysis. Journal of Nephropathology, 7(4), 224-232. https://doi.org/10.15171/jnp.2018.47

Agrawaal, K. K., Chhetri, P. K., Singh, P. M., Manandhar, D. N., Poudel, P., & Chhetri, A. (2019). Prevalence of depression in patients with chronic kidney disease stage 5 on hemodialysis at a tertiary care center. JNMA: Journal of the Nepal Medical Association, 57(217), 172-175. https://doi.org/10.31729%2Fjnma.4408

Al Awwa, I. A., & Jallad, S. G. (2018). Prevalence of depression in Jordanian hemodialysis patients. Iranian Journal of Psychiatry and Behavioral Sciences, 12(2), e11286. https://dx.doi.org/%2010.5812/ijpbs.11286

Al-Jabi, S. W., Sous, A., Jorf, F., Taqatqa, M., Allan, M., Sawalha, L., Lubadeh, E., Sweileh, W. M., & Zyoud, S. e. H. (2021). Depression among end-stage renal disease patients undergoing hemodialysis: A cross-sectional study from Palestine. Renal Replacement Therapy, 7(1), 1-11. https://doi.org/10.1186/s41100-021-00331-1

AlShahrani, M. A., Alayed, A. S. M., AlShehri, A. H., Solaiman, O., Awadalla, N. J., & Alhomrany, M. (2018). Depression and impaired work productivity among hemodialysis patients in south region of Saudi Arabia. Saudi Journal of Kidney Diseases and Transplantation, 29(5), 1133. https://doi.org/10.4103/1319-2442.243970

Athanasiadis, C., Gough, B., & Robertson, S. (2018). What do counsellors need to know about male depression? British Journal of Guidance & Counselling, 46(5), 596-604. https://doi.org/10.1080/03069885.2017.1346232

Bashir, M. (2010). Adapting Araon T. Beck Depression Inventory (BDI-2) Arab Psynet Journal, 25, 92-105.

Beck, A. T. (1996). Manual for the Beck Depression Inventory–II. California: Harcourt Brace & Company.

Call, J. B., & Shafer, K. (2018). Gendered manifestations of depression and help seeking among men. American Journal of Men's Health, 12(1), 41-51. https://doi.org/10.1177%2F1557988315623993

Chan, L., Tummalapalli, S. L., Ferrandino, R., Poojary, P., Saha, A., Chauhan, K., & Nadkarni, G. N. (2017). The effect of depression in chronic hemodialysis patients on inpatient hospitalization outcomes. Blood Purification, 43(1-3), 226-234. https://doi.org/10.1159/000452750

Cohen, S. D., Cukor, D., & Kimmel, P. L. (2016). Anxiety in patients treated with hemodialysis. Clinical Journal of the American Society of Nephrology, 11(12), 2250-2255. https://doi.org/10.2215/CJN.02590316

El Filali, A., Bentata, Y., Ada, N., & Oneib, B. (2017). Depression and anxiety disorders in chronic hemodialysis patients and their quality of life: A cross-sectional study about 106 cases in the northeast of morocco. Saudi Journal of Kidney Diseases and Transplantation, 28(2), 341. https://doi.org/10.4103/1319-2442.202785

Fadzli, N. F. A. M., Rasani, A. A. M., & Keng, S. L. (2021). Assessing the financial burden of hemodialysis treatment in Malaysia. Belitung Nursing Journal, 7(6), 529-534. https://doi.org/10.33546/bnj.1804

Ganu, V. J., Boima, V., Adjei, D. N., Yendork, J. S., Dey, I. D., Yorke, E., Mate-Kole, C. C., & Mate-Kole, M. O. (2018). Depression and quality of life in patients on long term hemodialysis at a national hospital in Ghana: A cross-sectional study. Ghana Medical Journal, 52(1), 22-28. https://doi.org/10.4314/gmj.v52i1.5

Gerogianni, G., Lianos, E., Kouzoupis, A., Polikandrioti, M., & Grapsa, E. (2018). The role of socio-demographic factors in depression and anxiety of patients on hemodialysis: An observational cross-sectional study. International Urology and Nephrology, 50(1), 143-154. https://doi.org/10.1007/s11255-017-1738-0

Goh, Z. S., & Griva, K. (2018). Anxiety and depression in patients with end-stage renal disease: Impact and management challenges–a narrative review. International Journal of Nephrology and Renovascular Disease, 11, 93-102. https://doi.org/10.2147%2FIJNRD.S126615

Hackett, M. L., & Jardine, M. J. (2017). We need to talk about depression and dialysis: but what questions should we ask, and does anyone know the answers? Clinical Journal of the American Society of Nephrology, 12(2), 222-224. https://doi.org/10.2215/CJN.13031216

Jackson-Koku, G. (2016). Beck depression inventory. Occupational Medicine, 66(2), 174-175. https://doi.org/10.1093/occmed/kqv087

Khan, A., Khan, A. H., Adnan, A. S., Sulaiman, S. A. S., & Mushtaq, S. (2019). Prevalence and predictors of depression among hemodialysis patients: A prospective follow-up study. BMC Public Health, 19(1), 1-13. https://doi.org/10.1186/s12889-019-6796-z

Kuehner, C. (2017). Why is depression more common among women than among men? The Lancet Psychiatry, 4(2), 146-158. https://doi.org/10.1016/S2215-0366(16)30263-2

Lilympaki, I., Makri, A., Vlantousi, K., Koutelekos, I., Babatsikou, F., & Polikandrioti, M. (2016). Effect of perceived social support on the levels of anxiety and depression of hemodialysis patients. Materia Socio-Medica, 28(5), 361-365. https://doi.org/10.5455%2Fmsm.2016.28.361-365

Ma, T. K. W., & Li, P. K. T. (2016). Depression in dialysis patients. Nephrology, 21(8), 639-646. https://doi.org/10.1111/nep.12742

Matsuzawa, R., Hoshi, K., Yoneki, K., Harada, M., Watanabe, T., Shimoda, T., Yamamoto, S., & Matsunaga, A. (2017). Exercise training in elderly people undergoing hemodialysis: A systematic review and meta-analysis. Kidney International Reports, 2(6), 1096-1110. https://doi.org/10.1016/j.ekir.2017.06.008

Nobahar, M., & Tamadon, M. R. (2016). Barriers to and facilitators of care for hemodialysis patients; A qualitative study. Journal of Renal Injury Prevention, 5(1), 39-44. https://doi.org/10.15171%2Fjrip.2016.09

Ormel, J., Hollon, S. D., Kessler, R. C., Cuijpers, P., & Monroe, S. M. (2022). More treatment but no less depression: The treatment-prevalence paradox. Clinical Psychology Review, 91, 102111. https://doi.org/10.1016/j.cpr.2021.102111

Othayq, A., & Aqeeli, A. (2020). Prevalence of depression and associated factors among hemodialyzed patients in Jazan area, Saudi Arabia: A cross-sectional study. Mental Illness, 12(1), 1-5. https://doi.org/10.1108/MIJ-02-2020-0004

Raosoft. (2004). Sample size calculator. http://www.raosoft.com/samplesize.html

Ravaghi, H., Behzadifar, M., Behzadifar, M., Taheri Mirghaed, M., Aryankhesal, A., Salemi, M., & Luigi Bragazzi, N. (2017). Prevalence of depression in hemodialysis patients in Iran a systematic review and meta-analysis. Iranian Journal of Kidney Diseases, 11(2), 90-98.

Reyes, M., Fuertes, J. N., Moore, M. T., Punnakudiyil, G. J., Calvo, L., & Rubinstein, S. (2021). Psychological and relational factors in ESRD hemodialysis treatment in an underserved community. Patient Education and Counseling, 104(1), 149-154. https://doi.org/10.1016/j.pec.2020.06.002

Semaan, V., Noureddine, S., & Farhood, L. (2018). Prevalence of depression and anxiety in end-stage renal disease: A survey of patients undergoing hemodialysis. Applied Nursing Research, 43, 80-85. https://doi.org/10.1016/j.apnr.2018.07.009

Shafi, S. T., & Shafi, T. (2017). A comparison of anxiety and depression between pre-dialysis chronic kidney disease patients and hemodialysis patients using hospital anxiety and depression scale. Pakistan Journal of Medical Sciences, 33(4), 876-880. https://doi.org/10.12669%2Fpjms.334.12656

Sriyuktasuth, A., & Phligbua, W. (2021). Risk factors associated with uncontrolled blood pressure among patients with non-dialysis chronic kidney disease in Vietnam. Belitung Nursing Journal, 7(5), 370-379. https://doi.org/10.33546/bnj.1611

Teles, F., Amorim de Albuquerque, A. L., Freitas Guedes Lins, I. K., Carvalho Medrado, P., & Falcão Pedrosa Costa, A. (2018). Quality of life and depression in haemodialysis patients. Psychology, Health & Medicine, 23(9), 1069-1078. https://doi.org/10.1080/13548506.2018.1469779

Wang, X., & Cheng, Z. (2020). Cross-sectional studies: Strengths, weaknesses, and recommendations. Chest, 158(1), S65-S71. https://doi.org/10.1016/j.chest.2020.03.012

World Health Organization. (2021). Depression. https://www.who.int/news-room/fact-sheets/detail/depression

Yang, Z.-H., Pan, X.-T., Chen, Y., Wang, L., Chen, Q.-X., Zhu, Y., Zhu, Y.-J., Chen, Y.-X., & Chen, X.-N. (2021). Psychological profiles of Chinese patients with hemodialysis during the panic of coronavirus disease 2019. Frontiers in Psychiatry, 12, 616016. https://doi.org/10.3389/fpsyt.2021.616016

Zhang, Q.-L., Wang, S., Zhang, Y., & Meng, F. (2021). The effect of refined nursing intervention on patients undergoing maintenance hemodialysis in the hemodialysis center during the COVID-19 epidemic. BMC Nursing, 20(1), 1-9. https://doi.org/10.1186/s12912-021-00584-5