Influence of positive and negative affect on self-management among patients with early chronic kidney disease during the COVID-19 pandemic: The mediating and suppressing effect of ego depletion

Yi Cui; Rong Li; Tianqi Yang; Hua Wang; Shasha Jin; Na Liu; Hongbao Liu; Yinling Zhang

doi:10.3389/fpsyt.2022.992404

Influence of positive and negative affect on self-management among patients with early chronic kidney disease during the COVID-19 pandemic: The mediating and suppressing effect of ego depletion

Front Psychiatry. 2022 Sep 29:13:992404. doi: 10.3389/fpsyt.2022.992404. eCollection 2022.

Authors

Yi Cui¹, Rong Li², Tianqi Yang³, Hua Wang⁴, Shasha Jin⁴, Na Liu¹, Hongbao Liu⁴, Yinling Zhang¹

Affiliations

¹ Department of Nursing, Air Force Medical University, Xi'an, China.
² Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an, China.
³ Department of Military Medical Psychology, Air Force Medical University, Xi'an, China.
⁴ Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China.

Abstract

Background: Self-management in patients with early chronic kidney disease (CKD) can effectively delay damage to renal function. However, with the continuous spread of COVID-19, patients cannot receive timely treatment, which can lead to different affects, resulting in ego depletion and serious challenges to self-management. This study aimed to investigate the mediating and suppressing roles of ego depletion on the relationship between positive and negative affect and self-management among patients with early CKD during the COVID-19 pandemic in China.

Methods: A total of 383 patients with early CKD from three tertiary hospitals were enrolled by convenience sampling in our cross-sectional study from September 2021 to March 2022. Participants completed the Sociodemographic Questionnaire, Positive Affect and Negative Affect Scale, Self-Regulating Fatigue Scale and Chronic Kidney Disease Self-Management Instrument. A structural equation model was conducted to test the mediating and suppressing effects of ego depletion on the relationship between positive and negative affect and self-management.

Results: The average score of the participants' self-management was 84.54 (SD: 19.72), and nearly 60% of them were at low and moderate levels. The mediating effect of positive affect on self-management through ego depletion was significant (β = 0.248, 95% CI: 0.170 to 0.376), accounting for 53.22% of the total effect. The suppressing effect of negative affect on self-management through ego depletion was significant (β = -0.191, 95% CI: -0.310 to -0.118), and the absolute value of the ratio of the suppressing effect to the direct effect was 66.55%.

Conclusions: Ego depletion partially mediated the relationship between positive affect and self-management while suppressing the relationship between negative affect and self-management among patients with early CKD during the COVID-19 pandemic. The reduction of patients' ego depletion must be taken as the intervention target to improve self-management and delay the progression of CKD.

Keywords: COVID-19; chronic kidney disease; ego depletion; mediating effect; positive and negative affect; self-management; suppressing effect.