Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2020

01-12-2020 | Research

The mediating effect of resilience between family functioning and mental well-being in hemodialysis patients in Japan: a cross-sectional design

Authors: Hiroko Kukihara, Niwako Yamawaki, Michiyo Ando, Midori Nishio, Hiromi Kimura, Yoshiko Tamura

Published in: Health and Quality of Life Outcomes | Issue 1/2020

Login to get access

Abstract

Background

End-stage kidney disease is highly prevalent worldwide. Currently, one of the most effective treatment modalities is dialysis therapy, which leads to serious side effects. Furthermore, psychiatric illnesses are prevalent among dialysis patients. Recently, researchers asserted that psychological resilience and family support could be helpful to maintain or improve patients’ mental well-being. Therefore, the purpose of this study was to examine the mediating effects of resilience on the relationship between family functioning and mental well-being in these patients.

Methods

To investigate the aim of this study, a cross-sectional design was employed. A total of 110 hemodialysis patients, who were receiving outpatient treatment from dialysis units at the University of Fukuoka and St. Maria Health Care Center in Japan, participated. Only the patients who met the criteria and who were willing to participate in this 30-min study were given The General Health Questionnaire-12, Conner-Davidson Resilience Scale, and Family Assessment Device. Structural Equation Modeling (SEM) was performed to test the hypothesis that resilience would mediate the relationship between each subscale of family functioning, namely, cohesion, adaptability, communication, and mental well-being. Then Sobel’s test was employed to examine the indirect effect.

Results

The results of the SEM showed that the model had an acceptable fit (RMSEA = .077; CFI = .93; and IFI = .94). According to the results, resilience fully mediated the relationship between family functioning, specifically family adaptability and communication, and mental health well-being of the dialysis patients. However, family cohesion was not associated with resilience.

Conclusions

The present study revealed that higher family adaptability and communication resulted in greater resilience, thus associated with better mental health. Given that poor mental health among dialysis patients is significantly associated with a decreased likelihood to adhere to treatment plans, it may lead to a significant risk to therapeutic compliance. As such, patients may experience detrimental consequences, such as death. This study showed that in order to maintain healthy mental well-being, developing resilience is a vital factor for hemodialysis patients.
Literature
1.
Levin A, Tonelli M, Bonventre J, et al. ISN global kidney health summit participants. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017;390(10105):1888–917.PubMed
2.
3.
Wang H, Naghavi M, Allen C, et al. GBD 2015 mortality and causes of death collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388(10053):1459–544.
4.
Kassebaum NJ, Arora M, Barber RM, et al. GBD 2015 DALYs and HALE collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388(10053):1603–58.
5.
Wakai K, Nakai S, Kikuchi K, et al. Trends in incidence of end-stage renal disease in Japan, 1983–2000: age-adjusted and age-specific rates by gender and cause. Nephrol Dial Transplant. 2004;19:2044–52.PubMed
6.
7.
Lysaght MJ. Maintenance dialysis population dynamics: current trends and long-term implications. J Am Soc Nephrol. 2002;13(suppl 1):S37–40.PubMed
8.
Japanese Society for Dialysis Therapy. An overview of regular dialysis treatment in Japan as of 31 December 2003. Ther Apher Dial. 2005;9:431–58.
9.
Murtagh FE, Addington-Hall JM, Edmonds PM, et al. Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis. J Palliat Med. 2007;10:1266–76.PubMed
10.
Lam LW, Lee DT, Shiu AT. The dynamic process of adherence to a renal therapeutic regimen: perspectives of patients undergoing continuous ambulatory peritoneal dialysis. Int J Nurs Stud. 2014;51:908–16.PubMed
11.
Macdonald JH, Fearn L, Jibani M, Marcora SM. Exertional fatigue in patients with CKD. Am J Kidney Dis. 2012;60(6):930–9.PubMed
12.
Oyekcin DG, Gülpek D, Sahin EM, Mete L. Depression, anxiety, body image, sexual functioning, and dyadic adjustment associated with dialysis type in chronic renal failure. Int J Psychiatry Med. 2012;43(3):227–41.PubMed
13.
Couch S. Psychiatric problems faced by patients of dialysis: missing elements. Am Soc Nephro. 2019;14:1275–6.
14.
Wagnild G. Resilience and successful aging: comparison among low and high income older adults. J Gerontol Nurs. 2003;29:42–9.PubMed
15.
Kukihara H, Yamawaki N, Uchiyama K, et al. Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima, Japan. Psychiatry Clin Neurosci. 2014;68(7):524–33.PubMed
16.
Woollett N, Cluver L, Hatcher A, Brahmbhatt H. “To be HIV positive is not the end of the world”: resilience among perinatally infected HIV positive adolescents in Johannesburg. Child Youth Serv Rev. 2016;70:269–75.
17.
Connell MA, Omole O, Subramaney U, Olorunju S. Post traumatic stress disorder and resilience in veterans who served in the south African border war. Afr J Psychiatry. 2013;16:8–10.
18.
Bahremand M, Rai A, Alikhai M, Mohammadi S, Shahebrahimi K, Janjani P. Relationship between family functioning and mental health considering the mediating role of resiliency in type 2 diabetes mellitus patients. Global J Health Sci. 2014;7(3):254–9.
19.
Dean A, Kolody B, Wood P. Effects of social support from various sources on depression in elderly persons. J Health Soc Behav. 1990;31:148–61.PubMed
20.
21.
22.
Roshanravan B, Gamboa J, Wilund K. Exercise and CKD: skeletal muscle dysfunction and practical application of exercise to prevent and treat physical impairments in CKD. Am J Kidney Dis. 2017;69:837–52.PubMedPubMedCentral
23.
Doi Y, Minowa M. Factor structure of the 12-item general health questionnaire in the Japanese general adult population. Psychiatry Clin Neurosci. 2003;57:379–83.PubMed
24.
Goldberg D, Williams P. A User’s guide to the general health questionnaire, vol. 29. Windsor: Nfer-Nelson Publishing; 1988.
25.
Honda S, Shibata Y, Nakane Y. Screening of mental disorder using 12-item general health questionnaire. Kousei-no-shihyou. 2001;48:5–10.
26.
Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson resilience scale (CD-RISC). J Depress Anxiety. 2003;18:76–82.
27.
28.
Matsuoka Y, Nishi D, Yonemoto N, et al. Tachikawa project for prevention of postraumatic stress disorder with polyunsaturated fatty acid (TPOP): study protocol for a randomized controlled trial. BMC Psychiatry. 2013;13:8.PubMedPubMedCentral
29.
Epstein NB, Bishop DS, Levin S. The McMaster model of family functioning. J Marriage Fam Couns. 1978;4:19–31.
30.
Aarons GA, McDonald EJ, Connelly CD, Newton RR. Assessment of family functioning in Caucasian and Hispanic Americans: reliability, validity, and factor structure of the family assessment device. Fam Process. 2007;46:557–69.PubMed
31.
Saeki T, Yokoyama T, Saek M, Asukai N, Miyake Y, Yamawaki S. Response bias on the Japanese version of the Family Assessment Device (FAD): Low correlation with social desirability and score disagreement between family members. Arch Psychiat Diag Clin Eval. 1999;10:75–82 (In Japanese with an English abstract.).
32.
Takemoto Y, Kagawa K. Relationship between cognitive family functioning and mental health in hemodialysis patients. J Jpn Health Sci. 2009;12:67–76.
33.
Black K, Lobo M. A conceptual review of family resilience factors. J Fam Nurs. 2008 Feb;14(1):33–55.PubMed
34.
Kline RB. Convergence of structural equation modeling and multilevel modeling in Williams M & Vogt WP (Eds.), handbook of methodological innovation (pp. 562–589). Thousand oaks: Sage; 2011.
35.
Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6:1–55.
36.
Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. Sociol Methodol. 1982;13:290–312.
37.
Cvengros JA, Christensen AJ, Lawton WJ. The role of perceived control and preference for control in adherence to a chronic medical regimen. Ann Behav Med. 2004;27(3):155–61.PubMed
38.
Cukor D, Cohen SD, Peterson RA, Kimmel PL. Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. J Am Soc Nephrol. 2007;18:3042–55.PubMed
39.
Cukor D, Rosenthal DS, Jindal RM, Brown CD, Kimmel PL. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney Int. 2009;75:1223–9.PubMed
40.
Grenard JL, Munjas BA, Adams JL, et al. Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis. J Gen Intern Med. 2011;26:1175–82.PubMedPubMedCentral
41.
42.
Luthar SS, Cicchetti D, Becker B. The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71(3):543–62.PubMedPubMedCentral
43.
44.
Rabiei L, Eslami AA, Abedi H, Masoudi R, Sharifirad GR. Caring in an atmosphere of uncertainty: perspectives and experiences of caregivers of peoples undergoing hemodialysis in Iran. Scand J Caring Sci. 2016;30(3):594–601.PubMed
45.
Gewirtz A, Forgatch M, Wieling E. Parenting practices as potential mechanisms for child adjustment following mass trauma. J Martial Fam Ther. 2008;34(2):177–92.
46.
Kukihara H, Yamawaki N, Ando M, Tamura Y, Arita K, Nakashima E. The mediating effects of resilience, morale, and sense of coherence between physical activity and perceived physical/mental health among Japanese community-dwelling older adults: a cross-sectional study. J Aging Phys Act. 2018;26(4):544–52.PubMed
47.
Galante J, Dufour G, Vainre M, et al. A mindfulness-based intervention to increase resilience to stress in university students (the mindful student study): a pragmatic randomised controlled trial. Lancet Public Health. 2018;3(2):e72.PubMed
48.
Schmidt M, Haglund K. Debrief in emergency departments to improve compassion fatigue and promote resiliency. J Trauma Nurs. 2017;24(5):317–22.PubMed
Metadata
Title
The mediating effect of resilience between family functioning and mental well-being in hemodialysis patients in Japan: a cross-sectional design
Authors
Hiroko Kukihara
Niwako Yamawaki
Michiyo Ando
Midori Nishio
Hiromi Kimura
Yoshiko Tamura
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2020
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-020-01486-x

Other articles of this Issue 1/2020

Health and Quality of Life Outcomes 1/2020 Go to the issue

Research

Health-related quality of life is strongly associated with self-efficacy, self-esteem, loneliness, and stress in 14–15-year-old adolescents: a cross-sectional study

Research

Psychometric evaluation of a Canadian version of the Seattle Angina Questionnaire (SAQ-CAN)

Research

Health related quality of life and healthcare utilization among adults with diabetes and kidney and eye complications in the United States

Research

Patient reported symptoms, coping and quality of life during somatostatin analogue treatment for metastatic small- intestinal neuroendocrine tumours

Research

Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy – a feasibility study

Research

Cross-sectional validity and specificity of comprehensive measurement in lymphedema and lipedema of the lower extremity: a comparison of five outcome instruments