Mediating Role of Psychological Resilience Between Depression and Quality of Life in Maintenance Hemodialysis Patients in Baoding City, China: A Cross-Sectional Study.

Abstract

Objective: Patients with end-stage renal disease (ESRD) are at an increased risk for emotional issues, with depression being the most prevalent psychological concern, significantly impacting their quality of life. This study aimed to explore the mediating effect of psychological resilience on the relationship between depression and quality of life in maintenance hemodialysis (MHD) patients.

Methods: This cross-sectional study aimed to explore the mediating effect of psychological resilience on the relationship between depression and quality of life in MHD patients in Baoding, China. Conducted from January 2024 to July 2024, the study involved a questionnaire survey of 215 MHD patients across five hospitals in Baoding. Data were collected using General information questionnaire, Hemodialysis Patient Depression Scale, Psychological Resilience Scale, and Quality of Life Scale, and structural equation modeling using AMOS 21.0 was employed to analyze the mediating effect.

Results: The scores for depression, psychological resilience, and quality of life in these MHD patients were 9.37±4.6, 30.58±6.1, and 59.48±9.3, respectively. Depression had a negative correlation with quality of life, while psychological resilience had a positive correlation with quality of life (with correlation coefficients of -0.453 and 0.578, respectively, all P<0.01). Psychological resilience played a mediating role in the relationship between depression and quality of life (β=-0.13, P<0.05), with the mediating effect analysis showing a significant indirect effect of depression on quality of life. The direct and indirect effects of depression on quality of life were -0.34 and -0.13, respectively, with a total effect of -0.47. The mediating effect accounted for 27.7% of the total effect. Interpretation: PHQ-9 scores range from 0 to 27, with higher scores indicating more severe depressive symptoms. CD-RISC scores range from 0 to 100, with higher scores reflecting greater psychological resilience. SF-12 scores range from 0 to 100, with higher scores indicating a better quality of life.

Conclusion: Depression, psychological resilience, and quality of life in MHD patients were at a moderately low level. Depression in MHD patients can indirectly affect their quality of life through psychological resilience, suggesting that healthcare professionals should take measures to reduce depression levels, enhance psychological resilience, and ultimately improve the quality of life for these patients. Psychological resilience was identified as a significant mediator in this relationship, highlighting its potential as a target for interventions aimed at improving the mental well-being and quality of life of MHD patients. These results underscore the importance of integrating psychological support into the care of MHD patients.