Patient-Focused Disaster Preparedness| Volume 336, ISSUE 2, P94-98, August 2008

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Psychosocial Status of Hemodialysis Patients One Year After Hurricane Katrina



      Hemodialysis patients experience a high degree of psychosocial impairment.


      The psychosocial status of hemodialysis patients after Hurricane Katrina was evaluated using the Hurricane Coping Self-Efficacy (HCSE) measure, the Short Form-12 Health Survey (physical component summary [PCS] and mental component summary [MCS]), and the Center for Epidemiologic Studies Short Depression Scale (CES-D). These scales were administered to 391 hemodialysis patients (86% participation rate), 7 to 14 months after Hurricane Katrina.


      The mean score (standard deviation) was 36.2 (9.6) for the HCSE scale, 37.1 (10.9) and 46.7 (12.7) for the PCS and MCS, respectively, and 10.0 (6.5) on the CES-D. Symptoms of depression (CES-D scores ≥10) were present in 45.5% of patients. After age, race, and gender adjustment, evacuating less than 2 days before Hurricane Katrina making landfall and more fear of dying were associated with less favorable scores on the HCSE, MCS, and CES-D scales. Patients placed in a shelter and with a longer displacement had significantly lower MCS scores and more depressive symptoms. More depressive symptoms were observed among patients hospitalized in the month after the storm. Those who evacuated to a hotel, with more fear of dying and who were hospitalized in the month after Hurricane Katrina had lower scores on the PCS.


      Impaired psychosocial status was common among dialysis patients surviving Hurricane Katrina and associated with reduced coping. These data demonstrate the need for screening and management of psychosocial issues in hemodialysis patients after disasters.


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        • Johnson D.L.
        Service Assessment: Hurricane Katrina. US Department of Commerce, National Oceanic and Atmospheric Administration, National Weather Service, Silver Spring, (MD)2005 (August 23-31, 2006. Available at, Accessed July 9, 2006)
        • Ford E.S.
        • Mokdad A.H.
        • Link M.W.
        • et al.
        Chronic disease in health emergencies: in the eye of the hurricane.
        Prev Chronic Dis. 2006; 3: A46
        • Lopes A.A.
        • Albert J.M.
        • Young E.W.
        • et al.
        Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOPPS.
        Kidney Int. 2004; 66: 2047-2053
        • Kimmel P.L.
        • Cukor D.
        • Cohen S.D.
        • et al.
        Depression in end-stage renal disease patients: a critical review.
        Adv Chronic Kidney Dis. 2007; 14: 328-334
        • Kimmel P.L.
        • Patel S.S.
        Quality of life in patients with chronic kidney disease: focus on end-stage renal disease treated with hemodialysis.
        Semin Nephrol. 2006; 26: 68-79
        • Cameron J.I.
        • Whiteside C.
        • Katz J.
        • et al.
        Differences in quality of life across renal replacement therapies: a meta-analytic comparison.
        Am J Kidney Dis. 2000; 35: 629-637
        • Hyre A.D.
        • Cohen A.J.
        • Kutner N.G.
        • et al.
        Prevalence and predictors of post-traumatic stress disorder among hemodialysis patients following Hurricane Katrina.
        Am J Kidney Dis. 2007; 50: 585-593
        • Benight C.C.
        • Harper M.L.
        Coping self-efficacy perceptions as a mediator between acute stress response and long-term distress following natural disasters.
        J Trauma Stress. 2002; 15: 177-186
        • Benight C.C.
        • Ironson G.
        • Durham R.L.
        Psychometric properties of a hurricane coping self-efficacy measure.
        J Trauma Stress. 1999; 12: 379-386
        • Ware Jr, J.
        • Kosinski M.
        • Keller S.D.
        A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.
        Med Care. 1996; 34: 220-233
        • Ware Jr, J.
        • Kosinski M.
        • Turner-Bowker D.M.
        • et al.
        How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). QualityMetric, Incorporated, Lincoln, (RI)2002
        • Andresen E.M.
        • Malmgren J.A.
        • Carter W.B.
        • et al.
        Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).
        Am J Prev Med. 1994; 10: 77-84
        • Kimmel P.L.
        • Weihs K.
        • Peterson R.A.
        Survival in hemodialysis patients: the role of depression.
        J Am Soc Nephrol. 1993; 4: 12-27
        • Kalantar-Zadeh K.
        • Kopple J.D.
        • Block G.
        • et al.
        Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis.
        J Am Soc Nephrol. 2001; 12: 2797-2806
        • Tsay S.L.
        • Healstead M.
        Self-care self-efficacy, depression, and quality of life among patients receiving hemodialysis in Taiwan.
        Int J Nurs Stud. 2002; 39: 245-251
        • Tovbin D.
        • Gidron Y.
        • Jean T.
        • et al.
        Relative importance and interrelations between psychosocial factors and individualized quality of life of hemodialysis patients.
        Qual Life Res. 2003; 12: 709-717
        • Lowrie E.G.
        • Curtin R.B.
        • LePain N.
        • et al.
        Medical outcomes study short form-36: a consistent and powerful predictor of morbidity and mortality in dialysis patients.
        Am J Kidney Dis. 2003; 41: 1286-1292
        • Curtin R.B.
        • Klag M.J.
        • Bultman D.C.
        • et al.
        Renal rehabilitation and improved patient outcomes in Texas dialysis facilities.
        Am J Kidney Dis. 2002; 40: 331-338
        • DeOreo P.B.
        Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance.
        Am J Kidney Dis. 1997; 30: 204-212
        • Tsay S.L.
        • Hung L.O.
        Empowerment of patients with end-stage renal disease—a randomized controlled trial.
        Int J Nurs Stud. 2004; 41: 59-65