It is well known that depression and sense of hopelessness worsen the quality of life in end-stage renal disease (ESRD) patients receiving dialysis. However, the characteristics of depression in continuous ambulatory peritoneal dialysis (CAPD) patients have not been analyzed in detail. We performed this study to investigate the severity of depression and the factors affecting depression in CAPD patients. With 96 CAPD patients, we evaluated each patient's depressive mood and hopelessness with CES-D (Center for Epidemiologic Studies Depression) scale and Beck Hopelessness Scale. We also evaluated the degree of stress of each patient with internal individual stress scale. Most CAPD patients experienced severe depression compared with the general population. Their depression was better explained by psychological factors, such as stress and sense of hopelessness, than by demographic or physical factors. On the basis of these findings, we suggest that the treatment of depression in CAPD patients might be possible by modulation of psychological factors.
Adult ; Aged ; Depression/*etiology ; Female ; Humans ; Kidney Failure, Chronic/psychology/*therapy ; Male ; Middle Aged ; Peritoneal Dialysis, Continuous Ambulatory/*adverse effects ; Sex Factors ; Stress, Physiological

PURPOSE: This study was to evaluate the effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis(CAPD) patients. METHOD: A nonequivalent control group with a pre-post test was designed. Data collection was done from December, 2002 to June, 2003 at a hoapital. The degree of depression and anxiety of the patients was assessed by the score of SCL-90-R, and exercise compliance was measured by exercise period, frequency, time and intensity. The experimental group was composed of 19 participants who were educated based on an exercise education protocol and carried out walking exercises two to four times a week after hearing verbal persuasion biweekly through the telephone or a face-to-face interview for 12 weeks, while 17 participants in control group received no intervention. RESULT: 1. The experimental group showed significant improvement in self-efficacy of exercise compliance (U=79.00, p=.01), exercise period (x2=20.84, p=.00), exercise frequency (x2=9.03, p=.01), exercise time (x2=9.03, p=.01) and exercise intensity (x2=11.09, p=.00) compared to those of the control group. 2. The experimental group showed a lower depression score (U=84.50, p=.01) than the results of the control group. 3. However, there were no changes in anxiety level compared to the control group. CONCLUSION: The physical activity reinforcement program was found to have an effect on exercise compliance and the depression score of CAPD patients. The results provided evidence for the importance of physical activity and verbal persuasion in CAPD patients.
Adolescent ; Adult ; Anxiety/diagnosis/*etiology ; Depression/diagnosis/*etiology ; *Exercise ; Female ; Humans ; Male ; Middle Aged ; *Patient Compliance ; Peritoneal Dialysis, Continuous Ambulatory/*psychology