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The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients

Youngjoo Park1, Haejung Lee2
Korean Journal of Adult Nursing 2015;27(6):718-727.
Published online: December 31, 2015

1College of Nursing, Graduate School, Pusan National University, Yangsan

2Collegeof Nursing, Pusan National University, Yangsan, Korea

Corresponding author: Lee, Haejung College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 626-870, Korea. Tel: +82-51-510-8344, Fax: +82-51-510-8308, E-mail: haejung@pusan.ac.kr
• Received: October 5, 2015   • Accepted: December 11, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to identify the levels of physical activity and its relationships with depression, health-related quality of life (QoL), sleep disturbance, and physiological indicators in hemodialysis patients.
  • Methods
    The participants in this study were 139 patients undergoing hemodialysis in the hospitals in Busan andYangsan-si. Data were collected using hematologic tests and questionnaires that contained items about individual characteristics, International Physical Activity Questionnaires (IPAQ), Center For Epidemiological Studies Depression Scale (CES-D), a 12-item Short-Form Health Survey (SF-12), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using descriptive statistics, one way ANOVA, and correlation.
  • Results
    Mean age of the participants was 59.91±12.63 and mean physical activity levels were 1,660.35±1,654.17. Patients who performed higher physical activities during their daily activities reported lower levels of depression (F=4.16, p=.018) and higher levels of QOL (PCS: F=5.00, p=.008, MCS: F=8.66, p<.001) than those of the others who did not perform physical activities.
  • Conclusion:
    This study showed that the levels of physical activity among hemodialysis patients was significantly associatedwith their depression and QOL. Developing strategies for enhancing physical activity is warranted to improve depression and QOL among hemodialysis patients.
  • Key Words: Renal dialysis; Motor activity; Depression; Quality of life; Dyssomnias
Table 1.
Characteristics of the Participants (N=139)
Characteristics Categories n (%) or M±SD
Age (year)   59.91±12.63
64 ≤ (59.0) 82
65 ≥ (41.0) 57
Gender Male 87 (62.6)
Female 52 (37.4)
Occupation Yes 16 (11.5)
No 123 (88.5)
Monthly income (10,000 won) 100 ≤ 89 (64.0)
100 ＞ 50 (36.0)
Marital status Married 84 (60.4)
Living alone 55 (39.6)
Religion Yes 86 (61.9)
No 53 (38.1)
Level of education Middle school ≤ 55 (39.6)
High school ≥ 84 (60.4)
Number of family 0 32 (23.0)
1 52 (37.4)
2 22 (15.8)
3 ≥ 33 (23.7)
Hemodialysis period (year)   4.56±4.55
1 ≤ 36 (25.9)
2~5 65 (46.8)
5 ≥ 38 (27.3)
DM Yes 73 (52.5)
No 66 (47.5)
HT Yes 70 (50.4)
No 69 (49.6)
Table 2.
Physical Activity, Depression, Quality of Life, and Sleep Disturbance of the Participants (N=139)
Variables Categories M±SD n(%) Min Max
IPAQ Inactive 1,600.54±1,654.17 55 (39.6) 0.0 5,940.0
Minimally active 55 (39.6)
HEPA 29 (20.9)
Depression 16 ≤ 16.7±9.4 81 (58.3) 1.0 44.0
16 ＞ 58 (41.7)
SF-12:PCS 39.2 ≤ 39.2±9.1 63 (45.3) 17.1 55.6
39.2 ＞ 76 (54.7)
SF-12:MCS 46.6 ≤ 46.6±11.2 70 (50.4) 18.8 69.1
46.6 ＞ 69 (49.6)
Sleep Disturbance 5 ≤ 7.8±4.4 47 (33.8) 0.0 19.0
5 ＞ 92 (66.2)

IPAQ=international physical activity questionnaire; Inactive= 600; ＜ Minimally active=600~3000; HEPA= 3000 ＞ (MET-min/week); CES-D=Center for Epidemiological Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; HEPA=health enhancing physical activity.

Table 3.
Differences in Depression, PCS, MCS, Sleep Disturbance, and Physiological Indicators according to Physical Activity (N=139)
Variables Categories Inactive Minimally active HEPA F p
n (%) & M±SD n (%) & M±SD n (%) & M±SD
Psychometric index Depression 19.09±9.33 16.11±9.42 13.14±8.37 4.16 .018
SF-12: PCS 36.24±8.90 40.88±9.24 41.45±7.90 5.00 .008
SF-12: MCS 42.19±10.94 48.26±11.18 51.65±8.81 8.66 ＜.001
Sleep disturbance 8.64±4.59 7.44±3.87 6.72±4.86 2.05 .132
Physiological Indicators Phosphorous 4.79±1.68 5.08±1.36 5.61±1.40 2.79 .065
Potassium 5.04±0.94 5.14±0.85 5.73±0.84 6.11 .003
Calcium 8.96±1.08 8.85±1.18 9.01±0.99 0.24 .785
BUN 60.09±20.60 61.59±16.28 71.00±17.57 3.60 .030
Cr 8.84±3.25 9.17±2.75 13.88±16.41 4.38 .014
Albumin 4.03±0.49 4.08±0.40 4.08±0.25 0.21 .807
Hemoglobin 10.19±0.94 10.55±1.37 10.36±1.07 1.30 .273

IPAQ=International Physical Activity Questionnaire, Inactive= 600, ＜ Minimally active=600~3,000, HEPA= 3,000 ＞ (MET-min/week), CES-D=Center For Epidemiological Studies Depression Scale, PSQI=Pittsburgh Sleep Quality Index, SF-12: PCS=Physical Component Summary Score, SF-12: MCS=Mental Component Summary Score, HEPA=health enhancing physical activity.

Table 4.
Relationships of Physical Activity with Depression, Quality of Life and Sleep Disturbance (N=139)
Variables X1 X2 X3 X4 X5
IPAQ (X1) 1
CES-D (X2) -.213* 1
PSQI (X3) -.091 .486** 1
SF-12: PCS (X4) .189* -.299** -411** 1
SF-12: MCS (X5) .252** -512** -.274** .108 1

IPAQ=International Physical Activity Questionnaire; CES-D=Center For Epidemiologic Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; *p .05, ** ＜ p .01. ＜

  • 1.Health Insurance Review & Assessment Service. 2012 Hemodialysis adequacy assessment (summary) [Internet]. Seoul: Health Insurance Review & Assessment Service; 2015. [cited 2015 February 28]. Available from:.http://www.hira.or.kr/main.do.
  • 2.Kurella S, Kimmel PL, Young BS, Chertow GM. Suicide in the UnitedStates end-stage renal disease program. Journalofthe American Society of Nephrology. 2007;16:774-781. http://dx.doi.org/10.1681/ASN.2004070550.
  • 3.Park KS, Choi SH, Park MJ. Comparisonofmusclestrengthand gait ability between hemodialysis patients and healthy adults. Journal of Korean Public Health Nursing. 2012;26(1):82-91. http://dx.doi.org/10.5932/jkphn.2014.28.3.471.
  • 4.Fiaccadori E, Sabatino A, Schito F, Angella F, Malagoli M, Tuc-cic M, et al. Barriers to physical activity in chronic hemodialysis patients: a single-center pilot study in an Italian dialysis facility. Kidney Blood Press Research. 2014;39:169-75. http://dx.doi.org/10.1159/000355793.
  • 5.Drayer RA, Piraino B, Reynolds CF, Houck PR, Mazumdar S, Bernardini J, et al. Characteristics of depression in hemodialysis patients: symptoms, quality oflife andmortality risk. General Hospital Psychiatry. 2006;28:306-12. http://dx.doi.org/10.1016/j.genhosppsych.2006.03.008.
  • 6.Keskin G, Engin E. Theevaluationofdepression, suicidalideation and coping strategies in haemodialysis patients with renal failure. Journal of Clinical Nursing. 2011;20:2721-32. http://dx.doi.org/10.1111/j.1365-2702.2010.03669.x.
  • 7.Abdelwhab S, Kamel M, Noshey M. Sleep disorders in hemodialysis patients. Kidney. 2010;19(4):175-81. http://dx.doi.org/10.1007/s00596-010-0147-5.
  • 8.Izawa KP, Watanabe S, Oka K, Hiraki K, Morio Y, Kasahara Y, et al. Physical activity in relation to exercise capacity in chronic heartfailure patients. International Journal of Cardiology. 2011;152(1):152-3. http://dx.doi.org/10.1016/j.ijcard.2011.07.069.
  • 9.Ouzouni S, Grekas D, Deligiannis A. Effects of intradialytic exercise training on health-related quality of life indices in haemodialysis patients. ClinicalRehabilitation. 2009;23:53-63. http://dx.doi.org/10.1177/0269215508096760.
  • 10.Afshar R, Emany A, Saremi A, Shavandi N, Sanavi S. Effects of intradialytic aerobic training on sleep quality in hemodialysis patients. Iranian Journal of Kidney Diseases. 2011;5(2):119-23.
  • 11.Makhlough A, Mohseni E, Shahmohammadi S. Effect of intradialytic aerobic exercise on serum electrolytes levels in hemodialysis patients. Iranian Journal of Kidney Diseases. 2012;6(2):119-23.
  • 12.Lima MC, Cicotoste CL, Cardoso KS, Junior LAF, Monteiro BM, Dias KS. Effect of exercise performed during hemodialysis: strength versus aerobic. Renal Failure. 2013;35(5):697-704. http://dx.doi.org/10.3109/0886022x.2013.780977.
  • 13.Lee HJ, Jin HK, Park JN, Chun KJ, Kim JH. Consistency in measuring physical activities and regular exercises and their relationship with exercise capacity and quality of life in patients with heart failure. Journal of Korean Biological Nursing Science. 2014;16(4):284-91. http://dx.doi.org/10.7586/jkbns.2014.16.4.284.
  • 14.Johansen KL, Sakkas GK, Doyle J, Shubert T, Dudley RA. Exer-cise counseling practice among nephrologists caring for patients on dialysis. American Journal of Kidney Disease. 2003;41(1):171-8. http://dx.doi.org/10.1053/ajkd.2003.50001.
  • 15.Curtin RB, Klag MJ, Bultman DC, Schatell D. Renal rehabilitation and improved patient outcomes in Texas dialysis facilities. American Journal of Kidney Disease. 2002;40:331-8. http://dx.doi.org/10.1053/ajkd.2002.34517.
  • 16.Mohseni R, Zeydi AE, Ilali E, Adib-Hajbaghery M, Makhlough A. The effect of intradialytic aerobic exercise on dialysis efficacy in hemodialysis patients: a randomized controlled trial. Oman Medical Journal. 2013;28(5):345-9. http://dx.doi.org/10.5001/omj.2013.99.
  • 17.Oh JY, Yang YJ, Kim BS, Kang JH. Validity and reliability of Korean version of International Physical Activity Questionnaire (IPAQ) short form. Journal of the Korean Academy on Family Medicine. 2007;28(7):532-41.
  • 18.Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1997;1(3):385-401. http://dx.doi.org/10.1177/014662167700100306.
  • 19.Chon KK, Choi SC, Yang BC. Integratedadaptation of CES-Din Korea. Korean Journal of Health Psychology. 2001;6(1):59-76.
  • 20.Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): conceptual framework and item selection. Medical Care. 1992;30:473-83. http://dx.doi.org/10.1097/00005650-199206000-00002.
  • 21.Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh SleepQuality Index: a newinstrumentfor psychiatric practice and research. Psychiatry Research. 1989;28:193-213.
  • 22.Choi HJ, Kim SJ, Kim BJ, Kim IJ. Koreanversions of self-reported sleepquestionnaires for researchandpracticeonsleepdis-turbance. Korean Academic Society of Rehabilitation Nursing. 2012;15(1):1-10. http://dx.doi.org/10.7587/kjrehn.2012.1.
  • 23.Lopes AA, Bragg J, Young B, Goodkin D, Mapes D, Combe C, et al. Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe. Kidney International. 2002;62:199-207. http://dx.doi.org/10.1046/j.1523-1755.2002.00411.x.
  • 24.Lopes GB, Silva LF, Pinto GB, Catto LF, Martins MTS, Dutra MMD, et al. Patient's response to a simple question on recovery after hemodialysis session strongly associated with scores of comprehensive tools for quality oflifeanddepressionsym-ptoms. Quality of Life Research. 2014;23:2247-56. http://dx.doi.org/10.1007/s11136-014-0666-z.
  • 25.Nabolsi MM, Wardam L, Al-Halabi JO. Quality of life, depression, adherence to treatment and illness perception of patients on haemodialysis. International Journal of Nursing Practice. 2013;21:1-10. http://dx.doi.org/10.1111/ijn.12205.
  • 26.Park JH, Lee JJ, Lee SB, Huh YS, Choi AE, Youn JC, et al. Prevalence of major depressive disorder and minor depressive disorder in an elderly Korean population: results from the Korean longitudinal study on health and aging (KLoSHA). Journal of Affective Disorders. 2010;125:234-40. http://dx.doi.org/10.1016/j.jad.2010.02.109.
  • 27.Jo YJ, Shin YH. Depression, self care compliance and physiological indices of hemodialysis patients. Keomyung Journal of Nursing Science. 2011;15(1):115-22.
  • 28.Windsor TD, Rodgers B, Butterworth P, Anstey KJ, Jorm AF. Measuring physical and mental health using the SF-12: implications for community surveys of mental health. Australian and New Zealand Journal of Psychiatry. 2006;40:797-803. http://dx.doi.org/10.1080/j.1440-1614.2006.01886.x.
  • 29.Alshraifeen A, McCreaddie M, Evans JMM. Quality of life and wellbeing of people receiving haemodi alysis treatment in Scotland: a cross-sectional survey. International Journal of Nursing Practice. 2013;20:518-23. http://dx.doi.org/10.1111/ijn.12194.
  • 30.Chavoshi F, Einollahi E, Haghighi KS, Saraei M, Izadianmehr N. Prevalence and sleep related disorders of restless leg synd-romein hemodialysis patients. Nephro-UrologyMonthly. 2015;7(2):1-5. http://dx.doi.org/10.5812/numonthly.24611.

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    The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients
    Korean J Adult Nurs. 2015;27(6):718-727.   Published online December 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.6.718
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    The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients
    Korean J Adult Nurs. 2015;27(6):718-727.   Published online December 31, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.6.718
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    The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients
    The Levels of Physical Activity and Its Relationships with Depression, Health-related Quality of Life, Sleep Disturbance, and Physiological Indicators in Hemodialysis Patients

    Characteristics of the Participants (N=139)

    Characteristics Categories n (%) or M±SD
    Age (year)   59.91±12.63
    64 ≤ (59.0) 82
    65 ≥ (41.0) 57
    Gender Male 87 (62.6)
    Female 52 (37.4)
    Occupation Yes 16 (11.5)
    No 123 (88.5)
    Monthly income (10,000 won) 100 ≤ 89 (64.0)
    100 ＞ 50 (36.0)
    Marital status Married 84 (60.4)
    Living alone 55 (39.6)
    Religion Yes 86 (61.9)
    No 53 (38.1)
    Level of education Middle school ≤ 55 (39.6)
    High school ≥ 84 (60.4)
    Number of family 0 32 (23.0)
    1 52 (37.4)
    2 22 (15.8)
    3 ≥ 33 (23.7)
    Hemodialysis period (year)   4.56±4.55
    1 ≤ 36 (25.9)
    2~5 65 (46.8)
    5 ≥ 38 (27.3)
    DM Yes 73 (52.5)
    No 66 (47.5)
    HT Yes 70 (50.4)
    No 69 (49.6)

    Physical Activity, Depression, Quality of Life, and Sleep Disturbance of the Participants (N=139)

    Variables Categories M±SD n(%) Min Max
    IPAQ Inactive 1,600.54±1,654.17 55 (39.6) 0.0 5,940.0
    Minimally active 55 (39.6)
    HEPA 29 (20.9)
    Depression 16 ≤ 16.7±9.4 81 (58.3) 1.0 44.0
    16 ＞ 58 (41.7)
    SF-12:PCS 39.2 ≤ 39.2±9.1 63 (45.3) 17.1 55.6
    39.2 ＞ 76 (54.7)
    SF-12:MCS 46.6 ≤ 46.6±11.2 70 (50.4) 18.8 69.1
    46.6 ＞ 69 (49.6)
    Sleep Disturbance 5 ≤ 7.8±4.4 47 (33.8) 0.0 19.0
    5 ＞ 92 (66.2)

    IPAQ=international physical activity questionnaire; Inactive= 600; ＜ Minimally active=600~3000; HEPA= 3000 ＞ (MET-min/week); CES-D=Center for Epidemiological Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; HEPA=health enhancing physical activity.

    Differences in Depression, PCS, MCS, Sleep Disturbance, and Physiological Indicators according to Physical Activity (N=139)

    Variables Categories Inactive Minimally active HEPA F p
    n (%) & M±SD n (%) & M±SD n (%) & M±SD
    Psychometric index Depression 19.09±9.33 16.11±9.42 13.14±8.37 4.16 .018
    SF-12: PCS 36.24±8.90 40.88±9.24 41.45±7.90 5.00 .008
    SF-12: MCS 42.19±10.94 48.26±11.18 51.65±8.81 8.66 ＜.001
    Sleep disturbance 8.64±4.59 7.44±3.87 6.72±4.86 2.05 .132
    Physiological Indicators Phosphorous 4.79±1.68 5.08±1.36 5.61±1.40 2.79 .065
    Potassium 5.04±0.94 5.14±0.85 5.73±0.84 6.11 .003
    Calcium 8.96±1.08 8.85±1.18 9.01±0.99 0.24 .785
    BUN 60.09±20.60 61.59±16.28 71.00±17.57 3.60 .030
    Cr 8.84±3.25 9.17±2.75 13.88±16.41 4.38 .014
    Albumin 4.03±0.49 4.08±0.40 4.08±0.25 0.21 .807
    Hemoglobin 10.19±0.94 10.55±1.37 10.36±1.07 1.30 .273

    IPAQ=International Physical Activity Questionnaire, Inactive= 600, ＜ Minimally active=600~3,000, HEPA= 3,000 ＞ (MET-min/week), CES-D=Center For Epidemiological Studies Depression Scale, PSQI=Pittsburgh Sleep Quality Index, SF-12: PCS=Physical Component Summary Score, SF-12: MCS=Mental Component Summary Score, HEPA=health enhancing physical activity.

    Relationships of Physical Activity with Depression, Quality of Life and Sleep Disturbance (N=139)

    Variables X1 X2 X3 X4 X5
    IPAQ (X1) 1
    CES-D (X2) -.213* 1
    PSQI (X3) -.091 .486** 1
    SF-12: PCS (X4) .189* -.299** -411** 1
    SF-12: MCS (X5) .252** -512** -.274** .108 1

    IPAQ=International Physical Activity Questionnaire; CES-D=Center For Epidemiologic Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; *p .05, ** ＜ p .01. ＜
    Table 1. Characteristics of the Participants (N=139)

    Table 2. Physical Activity, Depression, Quality of Life, and Sleep Disturbance of the Participants (N=139)

    IPAQ=international physical activity questionnaire; Inactive= 600; ＜ Minimally active=600~3000; HEPA= 3000 ＞ (MET-min/week); CES-D=Center for Epidemiological Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; HEPA=health enhancing physical activity.

    Table 3. Differences in Depression, PCS, MCS, Sleep Disturbance, and Physiological Indicators according to Physical Activity (N=139)

    IPAQ=International Physical Activity Questionnaire, Inactive= 600, ＜ Minimally active=600~3,000, HEPA= 3,000 ＞ (MET-min/week), CES-D=Center For Epidemiological Studies Depression Scale, PSQI=Pittsburgh Sleep Quality Index, SF-12: PCS=Physical Component Summary Score, SF-12: MCS=Mental Component Summary Score, HEPA=health enhancing physical activity.

    Table 4. Relationships of Physical Activity with Depression, Quality of Life and Sleep Disturbance (N=139)

    IPAQ=International Physical Activity Questionnaire; CES-D=Center For Epidemiologic Studies Depression Scale; PSQI=Pittsburgh Sleep Quality Index; SF-12:PCS=Physical Component Summary Score; SF-12:MCS=Mental Component Summary Score; *p .05, ** ＜ p .01. ＜

    Table 1.

    Table 2.

    Table 3.

    Table 4.

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