The Relationship between Quality of Life and Depression, Anxiety in Hemodialysis Patients

혈액투석 환자의 삶의 질과 우울, 불안과의 관계

  • Jeon, Yeong Ae (Department of Nursing Science, Graduate School of Nursing, Sungshin University)
  • 전영애 (성신여자대학교 대학원 간호학과)
  • Received : 2018.02.16
  • Accepted : 2018.05.02
  • Published : 2018.06.30


This descriptive investigation aims to identify a relationship between QOL, depression, and anxiety in hemodialysis patients. I conducted this research on 130 subjects aged 19 or above who have received dialysis for at least one month in the hemodialysis unit at N hospital in the city of S. However, it came to 112 as I took out those who either quit, died, or filled out a questionnaire in the incorrect manner. In regards to average points of QOL on a 100-point scale, it is 57.77, demonstrating quite low QOL. Concerning average points of depression and anxiety, it is 12.25 and 10.52, respectively, showing quite a high figure. With regard to a correlation, there is a significant correlation between the three factors in hemodialysis patients: there is a negative correlation between QOL and depression (r=-.782, p<.001); a negative correlation between QOL and anxiety (r=-.719, p<.001); and a positive correlation between depression and anxiety (r=.873, p<.001). The outcome of multiple regression analysis on factors affecting QOL shows that depression is the element influencing QOL (β=-.585). Therefore, this study is significant in providing basic data for establishing intervention strategies aiming to reduce levels of depression which has the strongest impact on QOL in the patients and for developing a nursing intervention program intending to improve their QOL.


  1. Korean ESRD Registry Committee, "Current Renal Replacement Therapy in Korea" , The Korean Society of Nephrology, 2016.
  2. M. Loghman-Adham, "Medication non compliance in patients with chronic disease Issues in dialysis and renal transplantation", The American Journal of Managed Care, Vol.9, No.2, pp.155-171, 2003.
  3. S. K. Min, "Psychiatric complications of Hemodialysis", Korean Society of Nephrology, Vol.10, No.5, pp.109-122, 1991.
  4. K. S. Baldree, S. P. Murphy & M. J. Powers, "Stress Identification and coping patterns patients on Hemodialysis", Nursing Research, Vol.31, No. , pp.107-112, 1982.
  5. S. G. Oh, "Social Environmental Factors that Influence the Quality of Life for Kidney Disabilities.", Master's thesis, Daejeon University, Daejeon, 2002.
  6. K. H. Jo & K. W. Sung, "Depression Prediction Factors of Hemodialysis Patients.", Journal of Korean Academy of Nursing, Vol.35., No.7, pp.413-424, 2000.
  7. A. A. Kaptein, S. van Dijk, E. Broadbent, L. Falzon, M. Thong & F. W. Dekker, "Behavioural research in patients with nd-stage renal disease: A review and research agenda" , Patient Education and Counseling, Vol.81, No.1, pp.23-29, 2010.
  8. H. Livneh, "Psychosocial adaptation to chronic illness and disability: A conceptual framework", Rehabilitation Counseling Bulletin, Vol.44 No. , pp.151-160, 2001.
  9. K. Kalantar-Zadeh & M. Unruh, (2005). "Health related quality of life in patients with chronic kidney disease", International Urology and Nephrology, Vol.37, No.2, pp.367-378, 2005.
  10. A. Jablonski, "The multidimensional characteristics of symptoms reported by patients on hemodialysis", Nephrology Nursing Journal, Vol.34, No.1, pp.29-37, 2007.
  11. M. S. Thong, S. van Dijk, M. Noordzij, E. W. Boeschoten, R. T. Krediet, F. W. Dekker & A. A. Kaptein,; Netherlands Co-operative Study on the Adequacy Study Group, "Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life", ephrology Dialysis Transplantation, Vol.24, No.1, pp.225-230, 2009.
  12. H. Almutary, A. Bonner & C. Douglas, "Symptom burden in chronic kidney disease: A review of recent literature." Journal of Renal Care, Vol.39, No.3, pp.140-150, 2013.
  13. F. V. N. Danquah, L. M. Zimmerman, P. M. Diamond, J. Meininger & N. Bergstrom, "Frequency, severity, and distress of dialysis-related symptoms reported by patients on hemodialysis". ,Nephrology Nursing Journal, Vol.37, No.6, pp.627-639, 2010.
  14. F. E. Murtagh, J. M. Addington-Hall, P. M. Edmonds, P. Donohoe, I. Carey, K. Jenkins & I. J. Higginson, "Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis. Journal of Palliative Medicine, Vol.10, No.6, pp.1266-1276, 2007.
  15. J. T. Daugirdas, G. B. Peter & S. I. Todd, "Handbook of dialysis", Philadelphia, PA: Lippincott Williams & Wilkins, 2001.
  16. S. R. Kim, "Original Article : Depression and Anxiety in Maintenance Hemodialysis Patients: A Single Center Study.", Kidney Research and Clinical Practice, Vol.29, No.6, pp.733-741, 2010.
  17. M. S. Kim, "A study on the factors affecting hemodialysis patients' depression and physical functioning", Master's thesis, Yonsei University, Seoul, 2006.
  18. A. Bilgic, A. Akgul, S. Sezer, Z. Arat, F. N. Ozdemir & M. Haberal, "Nutritional status and depression, sleep disorder, and quality of life in hemodialysis patients", Journal of Renal Nutrition, Vol.17, No.6, pp.381-388, 2007.
  19. M. Rai, T. Rustagi, S. Rustagi & R. Kohli, "Depression, insomnia and sleep apnea in patients on maintenance hemodialysis" , Indian Journal of Nephrology, Vol.21, No.4, pp.223-229, 2011.
  20. S. J. Yun, C. K. Yang & H. M. Hahn, "Depression, Anxiety and Sleep Disturbance in Patients with Hemodialysis.", Journal of Korean Neuropsychiatric Association, Vol.38, No.5, pp.997-1005, 1999.
  21. S. S. Han & Y. H. Kim, "Factors Predicting Depression in Hemodialysis Patients.", Journal of Korean Academy of Nursing, Vol.35, No.7, pp.1353-1361, 2005.
  22. M. P. McCurdy, "Factors related to depression in end-stage renal disease patients", Masters dissertation, The University of Tennessee, Chattanooga, 2014.
  23. J. M. Jakobi, C. L. Rice, S. V. Curtin & G. D. Marsh, "Neuromuscular properties and fatigue in older men following acute creatine supplementation", European Journal of Applied Physiology, Vol.84, No.4, pp.321-328, 2002.
  24. S. I. Han & K. A. Song, "The Relation of Trait Anxiety Levels and Complications in Patients on Long-Term Hemodialysis.", The New medical journal, Vol.29, No.2, pp.167-174, 1986.
  25. D. Y. Cho, "Psychology of End-Stage Renal Failure Patients.", Kidney Research and Clinical Practice, Vol.16, No.4, pp.625-631, 1997.
  26. R. B. Curtin, D. C. Bultman, C. T. Hawkins, "Hemodialysis Patients' Symptom experiences: Effects on Physical and Mental Functioning", Nephrology Nursing Journal, Vol.29, No.6, pp.562-574., 2002.
  27. R. Sesso & M. M. Yoshihiro, "Time of diagnosis of chronic renal failure and assessment of quality of life in hemodialysis patients", Nephrology Dialysis Transplantation, Vol.12, No.1, pp.2111-2116., 1997.
  28. D. D. Ignatavicius, & M. L. Workman, "Medical-Surgical Nursing: Critical Thinking for Collaborative Care", Philadelphia, PA: Saunders, 2000.
  29. O. S. Kim, "A study on the correlation between perceived social support and the quality of life of hemodialysis patients.", Master's thesis, Seoul National University, Seoul, 1993.
  30. S. K. Min, C. I. Lee, G. I. Kim, S. Y. Seo & D. G. Kim, "Development of Korean Version of WHO Quality of Life Scale Abbreviated Version(WHOQOL-BREF)", Journal of Korean Neuropsychiatric Association, Vol.39, No.3, pp.571-579, 2000.
  31. J. Battle, "Relationship between self-esteem and depression", Psychological Reports. Vol.30, No.4, pp.745-746, 1978.
  32. A. S. Zigmond & R. P. Snaith, "The hospital anxiety and depression scale", Acta Psychiatrica Scandinavica, Vol.67, No.6, pp.361-370, 1983.
  33. S. M. Oh, K. J. Min & D. B. Park, "A Comparison of Normal, Depressed and Anxious Groups=A Study on the Standardization of the Hospital Anxiety and Depressed Scale for Koreans." Journal of Korean Neuropsychiatric Association, Vol.38. No.2, pp.289-296, 1999.
  34. C. D. Spielberger, "Anxiety : current Trends in theory and research, I" Oxford: Academic Press, 1972.
  35. J. J. Sook, "A Study on the Hemodialysis Patients' Needs for Welfare and Rehabilitation.", Master's thesis, Dankook University, Cheonan-si, 2000.
  36. H. M. Lee, "A Study on the Fatigue, Depression, and Sleep Disorder of Hemodialysis Patients.", Master's thesis, Chonnam National University, Gwangju, 2008.
  37. J. W. Hong, "Factors Related to Patient Compliance among Hemodialysis Patients.", Master's thesis, Inje University, Busan, 2015.
  38. H. J. Lee, "Nutritional status stress and depression in diabetic hemodialysis patients.", Master's thesis, Korea University, Seoul, 2015.
  39. E. J. Yim, "Symptom clusters, depression and quality of life in patients on hemodialysis.", Master's thesis, Kyung Hee University, Seoul, 2016.
  40. Y. H. Cho, "Factors Influencing the Quality of Life of Hemodialysis Patients.", Master's thesis, Kongju National University, gongju, 2016.
  41. G. Y. Park,. "Study on the hope, resilience, ability to self-care, and quality of life of hemodialysis patients.", Master's thesis, Hanyang University, Seoul, 2016.
  42. M. S. Mi, "Correlation of the leisure and quality of life among hemodialysis patients.", Master's thesis, Hanyang University, Seoul, 2014.
  43. H. K. Park, "Nutrition Status, Fatigue, Quality of Sleep, and Depression in Hemodialysis Patients.", Master's thesis, Chonnam National University, Gwangju, 2014.
  44. Y. H. Lee & H. S. Kim, "The Effect of Family Support, Self-efficacy and Fatigue on the Life of Life in Hemodialysis Patients", Journal of East-West Nursing Research, Vol21, No.1, pp.1-9, 2015.
  45. S. M. Lim, "The Relationships among Bowel Function, Health Locus of Control, Anxiety, Depression in Patients with Rectal Cancer.", Master's thesis, Ewha Womans University, Seoul, 2013.
  46. E. R. Bossema, M. W. Seuntiens, C. A. Mariinen, M, C. Baas-Thiissen, C. J. vandeVelde, & A.M. Stiqqelbout, (2011). The relation between illness cognitions and quality of life in people with and without astoma following rectal cancer treatment. Psychooncology, Vol.20, No.4, pp.428-434, 2011.
  47. A. Sharma, D. M. Sharp, L. G. Walker & J. R. Monson, "Predictors of early postoperative quality of life after elective resection for colorectal cancer. Annals of Surgical Oncology, Vol.14, No.12, pp.3435-3442, 2007.
  48. J. H. Shin, "Psychiatric aspects of Hemodialysis.", Journal of the Korean Neuropsychiatric Association, Vol.17, No.1, pp.364-373, 1978.
  49. S. I. Han & J. E. Kim, "Changes of affective state and cognitive function following hemodialysis.", The Journal of Catholic Medical College, Vol.40, pp.315-323, 1987.
  50. D. W. Lee, S. J. Lee, S. N. Kim, B. J. Kim, C. S. Lee, B. S. Cha, C. S. Park & J. W. Shon, "Relationship of Psychopathology, Perception of Treatment Goal and Quality of Life in Patients with Cancer.", Journal of Korean Society of Biological Therapies in Psychiatry, Vol.17, No.1, pp.77-86, 2011.
  51. J. E. Cha & M. S. Yi, "Symptom Clusters and Quality of Life in Patients on Hemodialysis.", Clinical Nursing Research, Vol.20, No.1, pp.123-133, 2014.
  52. U. J. Kim, "Anxiety depression and self-esteem in hemodialysis patients.", Master's thesis, Korea National University of Transportation, Chungju-si, 2013.
  53. Y. H. Park, "Hemodialysis patients' stress, depression, fatigue and quality of life." Master's thesis, Chung-Aug University, Seoul, 2007.
  54. D. H. Kim, S. K. Min & D. S. Han, "The Characteristics of Depression in Hemodialysis Patients and Influencing Factors.", Journal of the Korean Neuropsychiatric Association, Vol.33, No.1,. pp.39-46, 1994.
  55. J. N. Lee, T. S. Kwon & C. H. Kim, "A Study on the Affective State and Compliance in End-Stage Renal Disease Patients on Long on Long-Term Hemodiaialysis.", Journal of the Korean Neuropsychiatric Association, Vol.34, No.4, pp.1059-1069, 1995.
  56. Y. J. Jo, "The Relationship between Depression, Self Care Compliance and Physiological Indices of Hemodialysis Patients.", Master's thesis, Keimyung University, Daegu, 2010.
  57. M. Y. Yun, "Factors Affecting Quality of Life in persons on Hemodialysis", Master's thesis, Kyungpook National University, Daegu, 2010.