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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis

Jieun Cha1, Myungsun Yi2
Korean Journal of Adult Nursing 2014;26(6):693-702.
Published online: December 31, 2014

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Corresponding author: Cha, Jieun Department of Nursing, Daegu Health College, 15 Youngsong-ro, Buk-gu, Daegu 702-722, Korea. Tel: +82-53-320-1446, Fax: +82-53-320-1470 E-mail: jecha1446@dhc.ac.kr
• Received: September 24, 2014   • Accepted: December 2, 2014

Copyright © 2014 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 examine the relationships between treatment belief, personal control, depressive mood, and health-related quality of life in patients with hemodialysis based on self-regulation theory.
  • Methods
    Data were collected from 220 patients at 27 local hemodialysis clinics in Seoul during 2013 and 2014. The Revised Illness Perception Questionnaire, the Hospital Anxiety and Depression Scale, and Medical Outcomes Study Short Form-12 were used to measure outcome variables. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple regression using the ‘enter’ method.
  • Results
    Treatment belief and personal control scored 3.58 and 3.54 out of 5 points respectively, on average. Treatment belief and personal control of kidney disease were negatively correlated with depressive mood and positively correlated with health-related quality of life. According to the regression analysis, treatment belief, monthly income, and personal control were discovered to account for 21.8% of the variance in depressive mood, where as depressive mood, monthly income, treatment belief, and age were found out to account for 40.6% of the variance in health-related quality of life.
  • Conclusion
    Our study demonstrated significant positive relationships between treatment belief and illness outcome in hemodialysis patients. Interventions aimed to provide the necessary information and trust to maximize the effectiveness of treatment need be developed to improve patients outcomes.
  • Key Words: Cognition; Renal dialysis; Psychological adaptation; Quality of life
Table 1.
Differences of Depressive Mood and Health-related Quality of Life according to General Characteristics (N=220)
Characteristics Categories n (%) Depressive mood Health-related quality of life
M±SD t or F (p) M±SD t or F (p)
Gender Male 155 (70.5) 7.33±4.23 1.13 425.48±164.12 -1.51
Female 65 (29.5) 6.63±4.03 (.259) 460.77±141.00 (.131)
Age (year) (M±SD 48.0±9.2) ＜30a 36 (16.4) 5.56±3.54 2.79 488.89±128.24 3.11
30~39b 86 (39.1) 7.52±4.26 (.041) 451.16±160.37 (.027)
40~49c 75 (34.1) 7.68±4.11 b, c＞a† 403.00±163.68 a＞c, d†
50~65d 23 (10.4) 6.26±4.47   403.26±151.75  
Marital status Married 120 (54.5) 7.18±4.10 0.23 447.50±153.72 0.80
Unmarried 62 (28.2) 7.26±4.24 (.796) 427.42±158.74 (.449)
Divorced/Widowed 38 (17.3) 6.71±4.37   413.16±171.51  
Education level ≤High school 128 (58.2) 7.42±4.43 -2.82 411.72±169.53 1.26
≥College 92 (41.8) 6.71±3.78 (.005) 469.57±134.60 (.211)
Monthly income (10,000 won) ＜200 103 (46.8) 8.37±4.54 4.25 375.49±159.92 -5.69
≥200 117 (53.2) 6.02±3.50 (＜.001) 489.10±136.51 (＜.001)
Job Yes 113 (51.4) 6.14±3.87 -3.68 484.51±159.64 4.93
No 107 (48.6) 8.16±4.25 (＜.001) 384.58±139.90 (＜.001)
Religion Yes 138 (62.7) 6.98±4.08 -0.67 438.41±149.15 0.30
No 82 (37.3) 7.37±4.35 (.507) 431.71±173.12 (.762)
Dialysis period (year) (M±SD 8.7±6.9) ＜5 78 (35.5) 7.31±3.93 0.65 466.99±140.70 2.77
5~10 56 (25.5) 6.57±4.09 (.522) 433.48±155.09 (.065)
＞10 86 (39.1) 7.31±4.44   409.30±171.29  
Primary disease DM 34 (15.5) 8.09±4.07 1.88 394.85±125.19 2.00
HTN 64 (29.1) 7.67±4.07 (.134) 418.36±161.17 (.115)
GN 72 (32.7) 6.35±3.96   467.01±153.76  
others 50 (22.7) 6.88±4.67   441.50±174.79  
TPL waiting Yes 100 (45.5) 6.52±4.14 -1.97 462.25±157.69 2.28
No 120 (54.5) 7.63±4.16 (.050) 413.96±155.80 (.024)

†LSD test; DM=diabetes mellitus; HTN=hypertension; GN=glomerulonephritis; TPL=transplantation.

Table 2.
Descriptive Statistics of Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)
Variables M±SD Range
Treatment belief
1. There is very little that can be done to improve my kidney disease. (R) 2.90±1.07  
2. My treatment (dialysis, medication, dietary treatment, etc.) will be effective in curing my kidney disease. 3.71±0.85
3. The negative effects of my kidney disease can be prevented (avoided) by my treatment (dialysis, medication, dietary treatment, etc.). 3.65±0.91
4. My treatment (dialysis, medication, dietary treatment, etc.) can control my kidney disease. 3.71±0.84
5. There is nothing which can help my condition. (R) 3.92±0.95
Total 17.89±3.29 5~25
Personal control
1. There is a lot which I can do to control my symptoms. 3.12±0.96  
2. What I do can determine whether my kidney disease gets better or worse. 3.56±0.94
3. The course of my kidney disease depends on me. 3.64±0.90
4. Nothing I do will affect my kidney disease. (R) 3.63±0.99
5. I have the power to influence my kidney disease. 3.60±0.85
6. My actions will have no affect on the outcome of my kidney disease. (R) 3.70±0.96
Total 21.25±4.05 6~30
Depressive mood 7.12±4.18 0~21
Health-related quality of life 435.91±158.15 0~800

R=reverse coded item.

Table 3.
Correlations between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)
Variables Depressive mood Health-related quality of life
r p r p
Treatment belief -.37 ＜.001 .36 ＜.001
Personal control -.35 ＜.001 .25 ＜.001
Depressive mood   - -.58 ＜.001
Table 4.
Influencing Factors on Depressive Mood (N=220)
Predictors Depressive mood
β t (p)
Treatment belief -.23 -3.23 (.001)
Monthly income -.23 -3.16 (.002)
Personal control -.21 -2.97 (.003)
  Adj. R2=.218, F=13.22, p＜.001.

β=standardized coefficients beta; Adj. R

2=adjusted R

2.

Table 5.
Influencing Factors on Health-related Quality of Life (N=220)
Predictors Health-related quality of life
β t (p)
Depressive mood -.45 -7.55 (＜.001)
Monthly income .16 2.58 (.011)
Treatment belief .15 2.37 (.019)
Age -.12 -2.34 (.020)
  Adj. R2=.406, F=22.41, p＜.001

β=standardized coefficients beta; Adj. R

2=adjusted R

2.

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    Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis
    Korean J Adult Nurs. 2014;26(6):693-702.   Published online December 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.6.693
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    Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis
    Korean J Adult Nurs. 2014;26(6):693-702.   Published online December 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.6.693
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    Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis
    Relationships between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life in Patients with Hemodialysis

    Differences of Depressive Mood and Health-related Quality of Life according to General Characteristics (N=220)

    Characteristics Categories n (%) Depressive mood Health-related quality of life
    M±SD t or F (p) M±SD t or F (p)
    Gender Male 155 (70.5) 7.33±4.23 1.13 425.48±164.12 -1.51
    Female 65 (29.5) 6.63±4.03 (.259) 460.77±141.00 (.131)
    Age (year) (M±SD 48.0±9.2) ＜30a 36 (16.4) 5.56±3.54 2.79 488.89±128.24 3.11
    30~39b 86 (39.1) 7.52±4.26 (.041) 451.16±160.37 (.027)
    40~49c 75 (34.1) 7.68±4.11 b, c＞a† 403.00±163.68 a＞c, d†
    50~65d 23 (10.4) 6.26±4.47   403.26±151.75  
    Marital status Married 120 (54.5) 7.18±4.10 0.23 447.50±153.72 0.80
    Unmarried 62 (28.2) 7.26±4.24 (.796) 427.42±158.74 (.449)
    Divorced/Widowed 38 (17.3) 6.71±4.37   413.16±171.51  
    Education level ≤High school 128 (58.2) 7.42±4.43 -2.82 411.72±169.53 1.26
    ≥College 92 (41.8) 6.71±3.78 (.005) 469.57±134.60 (.211)
    Monthly income (10,000 won) ＜200 103 (46.8) 8.37±4.54 4.25 375.49±159.92 -5.69
    ≥200 117 (53.2) 6.02±3.50 (＜.001) 489.10±136.51 (＜.001)
    Job Yes 113 (51.4) 6.14±3.87 -3.68 484.51±159.64 4.93
    No 107 (48.6) 8.16±4.25 (＜.001) 384.58±139.90 (＜.001)
    Religion Yes 138 (62.7) 6.98±4.08 -0.67 438.41±149.15 0.30
    No 82 (37.3) 7.37±4.35 (.507) 431.71±173.12 (.762)
    Dialysis period (year) (M±SD 8.7±6.9) ＜5 78 (35.5) 7.31±3.93 0.65 466.99±140.70 2.77
    5~10 56 (25.5) 6.57±4.09 (.522) 433.48±155.09 (.065)
    ＞10 86 (39.1) 7.31±4.44   409.30±171.29  
    Primary disease DM 34 (15.5) 8.09±4.07 1.88 394.85±125.19 2.00
    HTN 64 (29.1) 7.67±4.07 (.134) 418.36±161.17 (.115)
    GN 72 (32.7) 6.35±3.96   467.01±153.76  
    others 50 (22.7) 6.88±4.67   441.50±174.79  
    TPL waiting Yes 100 (45.5) 6.52±4.14 -1.97 462.25±157.69 2.28
    No 120 (54.5) 7.63±4.16 (.050) 413.96±155.80 (.024)

    †LSD test; DM=diabetes mellitus; HTN=hypertension; GN=glomerulonephritis; TPL=transplantation.

    Descriptive Statistics of Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)

    Variables M±SD Range
    Treatment belief
    1. There is very little that can be done to improve my kidney disease. (R) 2.90±1.07  
    2. My treatment (dialysis, medication, dietary treatment, etc.) will be effective in curing my kidney disease. 3.71±0.85
    3. The negative effects of my kidney disease can be prevented (avoided) by my treatment (dialysis, medication, dietary treatment, etc.). 3.65±0.91
    4. My treatment (dialysis, medication, dietary treatment, etc.) can control my kidney disease. 3.71±0.84
    5. There is nothing which can help my condition. (R) 3.92±0.95
    Total 17.89±3.29 5~25
    Personal control
    1. There is a lot which I can do to control my symptoms. 3.12±0.96  
    2. What I do can determine whether my kidney disease gets better or worse. 3.56±0.94
    3. The course of my kidney disease depends on me. 3.64±0.90
    4. Nothing I do will affect my kidney disease. (R) 3.63±0.99
    5. I have the power to influence my kidney disease. 3.60±0.85
    6. My actions will have no affect on the outcome of my kidney disease. (R) 3.70±0.96
    Total 21.25±4.05 6~30
    Depressive mood 7.12±4.18 0~21
    Health-related quality of life 435.91±158.15 0~800

    R=reverse coded item.

    Correlations between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)

    Variables Depressive mood Health-related quality of life
    r p r p
    Treatment belief -.37 ＜.001 .36 ＜.001
    Personal control -.35 ＜.001 .25 ＜.001
    Depressive mood   - -.58 ＜.001

    Influencing Factors on Depressive Mood (N=220)

    Predictors Depressive mood
    β t (p)
    Treatment belief -.23 -3.23 (.001)
    Monthly income -.23 -3.16 (.002)
    Personal control -.21 -2.97 (.003)
      Adj. R2=.218, F=13.22, p＜.001.

    β=standardized coefficients beta; Adj. R

    2=adjusted R

    2.

    Influencing Factors on Health-related Quality of Life (N=220)

    Predictors Health-related quality of life
    β t (p)
    Depressive mood -.45 -7.55 (＜.001)
    Monthly income .16 2.58 (.011)
    Treatment belief .15 2.37 (.019)
    Age -.12 -2.34 (.020)
      Adj. R2=.406, F=22.41, p＜.001

    β=standardized coefficients beta; Adj. R

    2=adjusted R

    2.
    Table 1. Differences of Depressive Mood and Health-related Quality of Life according to General Characteristics (N=220)

    LSD test; DM=diabetes mellitus; HTN=hypertension; GN=glomerulonephritis; TPL=transplantation.

    Table 2. Descriptive Statistics of Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)

    R=reverse coded item.

    Table 3. Correlations between Treatment Belief, Personal Control, Depressive Mood and Health-related Quality of Life (N=220)

    Table 4. Influencing Factors on Depressive Mood (N=220)

    β=standardized coefficients beta; Adj. R

    =adjusted R

    .

    Table 5. Influencing Factors on Health-related Quality of Life (N=220)

    β=standardized coefficients beta; Adj. R

    =adjusted R

    .

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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