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- Title
Effects of acceptance of disability on death or dialysis in chronic kidney disease patients: a 3-year prospective cohort study.
- Authors
Hsin-Hung Chiang; Livneh, Hanoch; How-Ran Guo; Mei-Ling Yen; Tzung-Yi Tsai; Chiang, Hsin-Hung; Guo, How-Ran; Yen, Mei-Ling; Tsai, Tzung-Yi
- Abstract
<bold>Background: </bold>Acceptance 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.<bold>Methods: </bold>262 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.<bold>Results: </bold>Of 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.<bold>Conclusion: </bold>AOD 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.
- Subjects
TAIWAN; KIDNEY diseases; DISABILITIES; HEMODIALYSIS; COHORT analysis; PROPORTIONAL hazards models; REGRESSION analysis; FOLLOW-up studies (Medicine); PATIENTS; PSYCHOLOGY; TREATMENT of chronic kidney failure; ADAPTABILITY (Personality); CHRONIC kidney failure; COMPARATIVE studies; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PEOPLE with disabilities; PSYCHOLOGY of People with disabilities; RESEARCH; RISK assessment; ATTITUDES toward death; EVALUATION research; PATIENTS' attitudes
- Publication
BMC Nephrology, 2015, Vol 16, p1
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-015-0197-z