Journal of Shanghai Jiao Tong University (Medical Science) >

2022 , Vol. 42 >Issue 7: 904 - 910

DOI: https://doi.org/10.3969/j.issn.1674-8115.2022.07.009

Public health

Effect of combination of medical care and nursing on the quality of life and mental state of elderly patients with chronic kidney disease in Shanghai suburbs

  • Yakun WANG ,
  • Jiarui XU ,
  • Qianqian WU ,
  • Xiaohua ZHANG ,
  • Yingchun ZHU ,
  • Shoujun BAI
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  • 1.Department of Nephrology, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China
    2.Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
BAI Shoujun, E-mail: baishoujun@126.com.

Received date: 2022-03-23

  Accepted date: 2022-06-07

  Online published: 2022-09-04

Supported by

Soft Project of Qingpu District Science and Technology Committee of Shanghai(R2021-07);Shanghai “Science and Technology Innovation Plan” Technical Standard Project(19DZ2205600);Shanghai “Science and Technology Innovation Plan” Yangtze River Delta Scientific and Technological Innovation Community Project(21002411500)

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Abstract

Objective

·To explore the effect of the combination of medical care and nursing on the quality of life and the anxiety/depression symptom of the elderly patients with chronic kidney disease (CKD) in Shanghai surburbs.

Method

·The elderly patients with CKD living in two nursing homes in Qingpu District, Shanghai were selected. The anxiety symptom was assessed by Generalized Anxiety Disorder Scale-7 (GAD-7), the depression symptom was assessed by The Geriatric Depression Scale (GDS), and the quality of life was assessed by The MOS 36-item Short Form Health Survey (SF-36). According to whether they had anxiety/depression symptom, they were divided into one group with mental symptoms (group A) and the other group without mental symptoms (group B). Then, the patients in group A were randomly divided into medical care and nursing-combined intervention group (group A1) and conventional group (group A2). Except group A1, group A2 and group B both adopted the traditional chronic disease management mode. The correlations of the scores of SF-36 in 8 dimensions with the GAD-7 score and the GDS score were analyzed. Multivariate Logistic regression analysis was used to analyze the independent risk factors of life quality of elderly patients with CKD. The mental symptoms and the quality of life before and after the 6-month interventions were compared to evaluate the combination of medical care and nursing.

Results

·A total of 80 elderly patients with CKD were enrolled, including 54 cases (67.5%) in group A and 26 cases (32.5%) in group B, whose incidences of anxiety symptom and depression symptom were 37.5% and 30.0%, respectively. Group A included 27 cases in group A1 and 27 cases in group A2. The GAD-7 score and the GDS score were negatively correlated with the scores of 6 dimensions of quality of life (physiological function, role-physical, general health, vitality, role-emotional, and mental health), respectively (P<0.05). Logistic regression analysis showed that anxiety/depression symptom was an independent risk factor of the quality of life of elderly CKD patients. After the combined intervention of medical care and nursing for 6 months, the scores of GAD-7 and GDS in group A1 were significantly lower than those before intervention (P<0.05), while there was no statistical difference in the scores before and after the intervention in group A2. Before intervention, the scores of 8 dimensions of quality of life in group A1 and A2 were significantly lower than those in group B (P<0.05), and there was no significant difference between A1 and A2 groups. After 6 months of intervention, the scores of 6 dimensions in group A1 were significantly higher than those in group A2 and those in group A1 before the intervention (P<0.05), and there were no obvious changes in role-physical and social functioning.

Conclusion

·The anxiety/depression symptom of elderly patients with CKD in Shanghai surburbs can reduce their quality of life; the combination of medical care and nursing can improve the anxiety/depression symptom of these patients and their quality of life as well.

Key words： medical care and nursing; chronic kidney disease (CKD); quality of life; anxiety; depression

Cite this article

Yakun WANG , Jiarui XU , Qianqian WU , Xiaohua ZHANG , Yingchun ZHU , Shoujun BAI . Effect of combination of medical care and nursing on the quality of life and mental state of elderly patients with chronic kidney disease in Shanghai suburbs[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022 , 42(7) : 904 -910 . DOI: 10.3969/j.issn.1674-8115.2022.07.009

References

1 JHA V, GARCIA-GARCIA G, ISEKI K, et al. Chronic kidney disease: global dimension and perspectives[J]. Lancet, 2013, 382(9888): 260-272.
2 LIYANAGE T, TOYAMA T, HOCKHAM C, et al. Prevalence of chronic kidney disease in Asia: a systematic review and analysis[J]. BMJ Glob Health, 2022, 7(1): e007525.
3 ZHANG L X, WANG F, WANG L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey[J]. Lancet, 2012, 379(9818): 815-822.
4 DUAN D F, YANG L, ZHANG M, et al. Depression and associated factors in Chinese patients with chronic kidney disease without dialysis: a cross-sectional study[J]. Front Public Health, 2021, 9: 605651.
5 GUERRA F, DI GIACOMO D, RANIERI J, et al. Chronic kidney disease and its relationship with mental health: allostatic load perspective for integrated care[J]. J Pers Med, 2021, 11(12): 1367.
6 ONISHI Y, UCHIDA HA, TAKEUCHI H, et al. Impaired mental health status in patients with chronic kidney disease is associated with estimated glomerular filtration rate decline[J]. Nephrology (Carlton), 2019, 24(9): 926-932.
7 王晓晓, 郭清. 基于CiteSpace的近十年我国医养结合研究热点及发展趋势分析[J]. 中国全科医学, 2021, 24(1): 92-97.
7 WANG X X, GUO Q. Recent 10-year research hotspots and development trends of integrated medical and nursing care in China: a CiteSpace-based visual analysis[J]. Chin Gen Pract, 2021, 24(1): 92-97.
8 张丽艳, 冯思思. 中国医养结合研究热点分析[J]. 中国老年学杂志, 2021, 41(11): 2440-2443.
8 ZHANG L Y, FENG S S. Analysis of hot spots in the research of combination of medical care and health care in China[J]. Chin J Gerontol, 2021, 41(11): 2440-2443.
9 王水莲, 陈丽敏, 张云逸. 医养结合型养老机构入住老人生存质量[J]. 中国老年学杂志, 2021, 41(7): 1531-1535.
9 WANG S L, CHEN L M, ZHANG Y Y. Analysis of the quality of life of the elderly living in medical and nursing care institutions[J]. Chin J Gerontol, 2021, 41(7): 1531-1535.
10 何海燕, 李琳, 罗涛, 等. 医养结合在老年人慢性病管理中的作用及经济学影响的初步研究[J]. 中华医学教育探索杂志, 2021, 20(6): 741-744.
10 HE H Y, LI L, LUO T, et al. Impact of the medical burden under chronic disease management for the elderly based on the “combination of medical care and pension” model: a preliminary study[J]. Chin J Med Edu Res, 2021, 20(6): 741-744.
11 National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification[J]. Am J Kidney Dis, 2002, 39(2 Suppl 1): S1-S266.
12 GARCíA-CAMPAYO J, ZAMORANO E, RUIZ M A, et al. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool[J]. Health Qual Life Outcomes, 2010, 8: 8.
13 GONG Y Q, ZHOU H X, ZHANG Y, et al. Validation of the 7-item Generalized Anxiety Disorder scale (GAD-7) as a screening tool for anxiety among pregnant Chinese women[J]. J Affect Disord, 2021, 282: 98-103.
14 CASTELO M S, COELHO-FILHO J M, CARVALHO A F, et al. Validity of the Brazilian version of the Geriatric Depression Scale (GDS) among primary care patients[J]. Int Psychogeriatr, 2010, 22(1): 109-113.
15 MITCHELL A J, BIRD V, RIZZO M, et al. Diagnostic validity and added value of the Geriatric Depression Scale for depression in primary care: a meta-analysis of GDS30 and GDS15[J]. J Affect Disord, 2010, 125(1-3): 10-17.
16 SIU A L, BIBBINS-DOMINGO K, GROSSMAN D C, et al. Screening for depression in adults: US Preventive Services Task Force recommendation statement[J]. JAMA, 2016, 315(4): 380-387.
17 YARLAS A, BAYLISS M, CAPPELLERI J C, et al. Psychometric validation of the SF-36? Health Survey in ulcerative colitis: results from a systematic literature review[J]. Qual Life Res, 2018, 27(2): 273-290.
18 HAGELL P, WESTERGREN A, ?RESTEDT K. Beware of the origin of numbers: standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations[J]. Res Nurs Health, 2017, 40(4): 378-386.
19 VAN GENDEREN S, PLASQUI G, LACAILLE D, et al. Social Role Participation Questionnaire for patients with ankylosing spondylitis: translation into Dutch, reliability and construct validity[J]. RMD Open, 2016, 2(1): e000177.
20 M?RCK B, PULLERITS R, GEIJER M, et al. Infliximab dose reduction sustains the clinical treatment effect in active HLAB27 positive ankylosing spondylitis: a two-year pilot study[J]. Mediators Inflamm, 2013, 2013: 289845.
21 STASIAK C E, BAZAN K S, KUSS R S, et al. Prevalence of anxiety and depression and its comorbidities in patients with chronic kidney disease on hemodialysis and peritoneal dialysis[J]. J Bras Nefrol, 2014, 36(3): 325-331.
22 王蓓. 上海老龄化社会的特点、应对及其思考[J]. 中国老年学杂志, 2015, 35(2): 532-534.
22 WANG B. Characteristics, countermeasures and thoughts of Shanghai's aging society[J]. Chin J Gerontol, 2015, 35(2): 532-534.
23 严宇珺, 严运楼. 上海人口老龄化发展趋势及其影响因素: 基于GM(1,1)和主成分分析[J]. 中国老年学杂志, 2021, 41(14): 3093-3098.
23 YAN Y J, YAN Y L. The trend of Shanghai's aging population and its influencing factors: based on GM(1,1) and principal component analysis[J]. Chin J Gerontol, 2021, 41(14): 3093-3098.
24 黄佳豪, 孟昉. “医养结合”养老模式的必要性、困境与对策[J]. 中国卫生政策研究, 2014, 7(6): 63-68.
24 HUANG J H, MENG F. Integrating pension service with medical service for the elderly: necessity, dilemmas and solutions[J]. Chin J Health Policy, 2014, 7(6): 63-68.
25 SCHOEVERS R A, DEEG D J, VAN-TILBURG W, et al. Depression and generalized anxiety disorder: concurrence and longitudinal patterns in elderly patients[J]. Am J Geriatr Psychiatry, 2005, 13(1): 31-39.
26 BAIDER L, PERETZ T, HADANI P E, et al. Psychological intervention in cancer patients: a randomized study[J]. Gen Hosp Psychiatry, 2001, 23(5): 272-277.
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