Pain, Anxiety, and Depression in Patients Undergoing Chronic Hemodialysis Treatment: A Multicentre Cohort Study

Abstract

Background Pain is a considerable health concern that interferes with hemodialysis treatment outcomes and can lead to a patient developing anxiety and depression.

Aims To examine the perception of pain in patients on chronic hemodialysis therapy, and to analyze the relationship between their pain, anxiety, depression, and sociodemographic data.

Method The research was conducted using a quantitative, observational, cross-sectional design. The study recruited 138 patients from multicentered hemodialysis units. A battery of questionnaires, including the visual analog scale (VaS) as pain intensity scale, the Hospital Anxiety and Depression Scale (HADS), and an ad hoc sociodemographic data questionnaire, were given to patients to answer during their hemodialysis sessions. A linear regression analysis was conducted to obtain the results.

Results The mean of pain to all participants was generally low, as per AVS scale (0-10) it was 3.6 (stanard deviation [SD] = 3.07). Women manifested lower levels of pain than men (p = .015). One in five participants in both sexes suffered from clinical anxiety and one in six participants in both sexes suffered from clinical depression. Women scored higher on both the anxiety (4.8 versus 4.2) and depression scale (6.8 versus 6.5). Those participants who manifested clinical anxiety were younger compared with those who did not (aged 56.8 versus 66.8 years). Finally, older patients (aged 68.5 years) manifested higher levels of depression.

Conclusions The level of pain perceived by patients undergoing chronic hemodialysis therapy was generally low, especially in women. The study also demonstrated a positive association between levels of pain and anxiety and depression.

Chronic renal insufficiency (CRI) is a serious incurable illness (Li et al., 2016). The most common therapy used worldwide is hemodialysis (HD) (Jha et al., 2013), which entails an absolute life dependency on a blood filtering machine. HD therapy is not free of complications. Therefore, the life of patients undergoing chronic HD therapy is subject to different stressful and threatening situations from the moment of diagnosis (Pabón-Varela et al., 2015). Pain is a real and present factor for patients who are on chronic HD therapy (Brkovic et al., 2016; Fleishman et al., 2018) and has been shown to have a negative effect on their quality of life as well as their physical, emotional, and social condition (Samoudi et al., 2021; Jassal et al., 2016). In 2019, the incidence rate of HD treatment in Spain was 5,614 per million of the population and it has been increasing over the years