Patel Samir S, Shah Viral S, Peterson Rolf A, Kimmel Paul L
Department of Medicine, George Washington University, Washington, DC 20037, USA.
Am J Kidney Dis. 2002 Nov;40(5):1013-22. doi: 10.1053/ajkd.2002.36336.
Religious and spiritual aspects of quality of life (QOL) have not been fully assessed in patients with end-stage renal disease (ESRD) treated with hemodialysis (HD), but psychosocial factors are associated with patient survival.
To investigate interrelationships between religious beliefs and psychosocial and medical factors, we studied 53 HD patients. Psychosocial and medical variables included perception of importance of faith (spirituality), attendance at religious services (religious involvement), the Beck Depression Inventory, Illness Effects Questionnaire, Multidimensional Scale of Perceived Social Support, McGill QOL Questionnaire scores, Karnofsky scores, dialysis dose, and predialysis hemoglobin and albumin levels.
Eighty-seven percent of participants were African-American. Men had higher depression scores, perceived lower social support, and had higher religious involvement scores than women. No other parameters differed between sexes. Perception of spirituality and religiosity did not correlate with age, Karnofsky score, dialysis dose, or hemoglobin or albumin level. Greater perception of spirituality and religiosity correlated with increased perception of social support and QOL and less negative perception of illness effects and depression. A one-question global QOL measure correlated with depression, life satisfaction, perception of burden of illness, social support, and satisfaction with nephrologist scores, but not with age or Karnofsky score.
Religious beliefs are related to perception of depression, illness effects, social support, and QOL independently of medical aspects of illness. Religious beliefs may act as coping mechanisms for patients with ESRD. The relationship between religious beliefs and clinical outcomes should be investigated further in patients with ESRD.
终末期肾病(ESRD)接受血液透析(HD)治疗的患者生活质量(QOL)的宗教和精神层面尚未得到充分评估,但社会心理因素与患者生存率相关。
为研究宗教信仰与社会心理及医学因素之间的相互关系,我们对53例HD患者进行了研究。社会心理和医学变量包括对信仰重要性的认知(精神性)、参加宗教仪式情况(宗教参与度)、贝克抑郁量表、疾病影响问卷、感知社会支持多维量表、麦吉尔生活质量问卷得分、卡诺夫斯基得分、透析剂量以及透析前血红蛋白和白蛋白水平。
87%的参与者为非裔美国人。男性的抑郁得分更高,感知到的社会支持更低,且宗教参与度得分高于女性。其他参数在性别之间无差异。精神性和宗教性的认知与年龄、卡诺夫斯基得分、透析剂量或血红蛋白或白蛋白水平无关。更高的精神性和宗教性认知与更高的社会支持和生活质量感知以及对疾病影响和抑郁的负面感知减少相关。一个关于总体生活质量的单问题测量与抑郁、生活满意度、疾病负担感知、社会支持以及对肾病医生评分的满意度相关,但与年龄或卡诺夫斯基得分无关。
宗教信仰与抑郁、疾病影响、社会支持和生活质量的感知相关,独立于疾病的医学方面。宗教信仰可能是ESRD患者的应对机制。ESRD患者宗教信仰与临床结局之间的关系应进一步研究。