The evaluation of depression, suicidal ideation and coping strategies in haemodialysis patients with renal failure

J Clin Nurs. 2011 Oct;20(19-20):2721-32. doi: 10.1111/j.1365-2702.2010.03669.x. Epub 2011 May 5.

Abstract

Aim: This study aimed at evaluating depression and suicidal ideation and coping strategies with stress in patients receiving haemodialysis replacement therapy.

Background: Patients undergoing haemodialysis treatment may often experience depression and accompanying suicidal ideation. Coping strategies with depression-related suicidal ideation may require regular evaluation of the patient and the support of nurses.

Design: A cross-sectional descriptive study.

Method: The sample consisted of 92 adults with an age range of 19-65 who had chronic renal failure and consecutively admitted to the Dialysis Center of Kadiköy and Dialysis Center of Kahraman in Turkey. Four instruments were used: Socio-demographic Form, Beck Depression Inventory, Suicide Behaviors Questionnaire and Coping Strategies with Stress Inventory.

Results: The points obtained from Beck Depression Inventory were above 17 (the cut-off point) in 40·2% of the patients. There were positive correlations between depression and Suicide Behaviors Questionnaire (r = 0·469, p = 0·001), between patients' age and depression (r = 0·43, p = 0·00) and suicidal ideation (r = 0·27, p = 0·01). Depression and behavioural disengagement had a positive correlation (p = 0·001, r = 0·410). Depression and suicidal ideation increased with lower education status (F = 7·42, p = 0·001; F = 4·51, p = 0·014).

Conclusion: Haemodialysis patients frequently experience depression. This study demonstrated that suicidal ideation increased as the severity of depression increased. Depression and suicidal ideation were increasing with age in patients with chronic renal failure. Therefore, it is considered necessary for dialysis patients to be under regular psychiatric evaluation with risk assessment.

Relevance to clinical practice: It is vitally important that nurses in dialysis centres evaluate the psychosocial conditions of patients with renal failure undergoing haemodialysis treatment so as to enhance the quality of nursing care. It is also fundamental for the success of holistic care that nurses properly assess the possibility of depression and suicide as well as coping strategies. This study sheds light on the holistic evaluations of dialysis patients.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Depression / psychology*
  • Female
  • Humans
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Renal Dialysis / psychology*
  • Suicidal Ideation*
  • Surveys and Questionnaires