ABSTRACT
Background
Hemodialysis patients experience a high degree of psychosocial impairment.
Methods
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.
Results
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.
Conclusions
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.
KEY INDEXING TERMS
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of the Medical SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- 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)
- Chronic disease in health emergencies: in the eye of the hurricane.Prev Chronic Dis. 2006; 3: A46
- Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOPPS.Kidney Int. 2004; 66: 2047-2053
- Depression in end-stage renal disease patients: a critical review.Adv Chronic Kidney Dis. 2007; 14: 328-334
- Quality of life in patients with chronic kidney disease: focus on end-stage renal disease treated with hemodialysis.Semin Nephrol. 2006; 26: 68-79
- Differences in quality of life across renal replacement therapies: a meta-analytic comparison.Am J Kidney Dis. 2000; 35: 629-637
- Prevalence and predictors of post-traumatic stress disorder among hemodialysis patients following Hurricane Katrina.Am J Kidney Dis. 2007; 50: 585-593
- 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
- Psychometric properties of a hurricane coping self-efficacy measure.J Trauma Stress. 1999; 12: 379-386
- A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.Med Care. 1996; 34: 220-233
- How to score version 2 of the SF-12 health survey (with a supplement documenting version 1). QualityMetric, Incorporated, Lincoln, (RI)2002
- 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
- Survival in hemodialysis patients: the role of depression.J Am Soc Nephrol. 1993; 4: 12-27
- Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis.J Am Soc Nephrol. 2001; 12: 2797-2806
- Self-care self-efficacy, depression, and quality of life among patients receiving hemodialysis in Taiwan.Int J Nurs Stud. 2002; 39: 245-251
- Relative importance and interrelations between psychosocial factors and individualized quality of life of hemodialysis patients.Qual Life Res. 2003; 12: 709-717
- 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
- Renal rehabilitation and improved patient outcomes in Texas dialysis facilities.Am J Kidney Dis. 2002; 40: 331-338
- Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance.Am J Kidney Dis. 1997; 30: 204-212
- Empowerment of patients with end-stage renal disease—a randomized controlled trial.Int J Nurs Stud. 2004; 41: 59-65
Article info
Publication history
Accepted:
May 13,
2008
Received:
April 30,
2008
Footnotes
This study was supported by a subcontract to Tulane University from the National Institutes of Health contract N01-DK-1-2471.
The interpretation and reporting of the data presented here are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the United States government.
Identification
Copyright
© 2008 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
