The Mediating Effect of Symptom Burden in the Depression and Quality of Life in Patients with Maintenance Hemodialysis

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Table 1 Characteristics of the Study Population (n=380)

Variable	Mean(SD)	N (%)
Age (years)	58.98 (13.86)
Female gender		132 (34.74)
Without a spouse		95 (25.00)
Unemployed		298 (78.42)
Education
Middle school and below		165 (43.42)
Technical secondary school and senior high school		112 (29.47)
Junior college and above		103 (27.11)
Income
≤5000 yuan		96 (25.26)
5000–10000 yuan		154 (40.53)
>10000 yuan		130 (34.21)
Medical expenses payment methods
Self-paid		14 (3.68)
Insured for urban residents		321 (84.47)
New rural cooperative medical care system		45 (11.84)
Dialysis age
< 5 years		234 (61.58)
5–10 years		103 (27.11)
>10 years		43 (11.32)
Primary diseases
Hypertensive nephropathy		103 (27.11)
Diabetic nephropathy		97 (25.53)
Glomerulonephritis		96 (25.26)
IGA nephropathy		3 (0.79)
Polycystic kidney disease		15 (3.95)
Drug-induced kidney damage		1 (0.26)
Other cases		65 (17.11)
Blood calcium (mmol/L)	1.80 (0.60)
Blood phosphorus (mmol/L)	2.07 (0.74)
PTH (pg/mL)	217.79 (150.35)
Kt/V	1.51 (0.27)
Antidepressants durg use		11 (2.89)

Abbreviation: SD, standard deviation.

Table 2 Correlation Analysis of Symptom Burden, Depression, and Quality of Life in MHD Patients (n=380, r-Value)

	1	2	3	4	5	6	7	8	9	10	11
1 Total depression scores	1
2 Total symptom burden scores	0.367**	1
3 Frequency	0.370**	0.992**	1
4 Severity scores	0.364**	0.997**	0.983**	1
5 Distress scores	0.362**	0.997**	0.982**	0.998**	1
6 Total Quality of life scores	−0.415**	−0.803**	−0.804**	−0.799**	−0.795**	1
7 Symptoms and problems	−0.351**	−0.832**	−0.828**	−0.830**	−0.829**	0.727**	1
8 Kidney disease impact scores	−0.328**	−0.679**	−0.688**	−0.673**	−0.667**	0.849**	0.619**	1
9 Kidney disease burden scores	−0.428**	−0.616**	−0.607**	−0.616**	−0.614**	0.870**	0.474**	0.604**	1
10 Total physiological scores	−0.160**	−0.436**	−0.454**	−0.430**	−0.425**	0.589**	0.319**	0.483**	0.410**	1
11 Total psychological scores	−0.254**	−0.648**	−0.652**	−0.644**	−0.642**	0.777**	0.531**	0.658**	0.616**	0.351**	1

Note: **P<0.01.

Table 3 Path Analysis of Factors Influencing the Life Quality of MHD Patients

Path	B	β	SE	t	P-value
Depression→symptom burden	5.795	0.398	0.809	7.160	<0.001
Symptom burden→quality of life	−0.634	−0.851	0.028	−22.381	<0.001
Depression→quality of life	−1.638	−0.151	0.35	−4.686	<0.001

Abbreviation: SE, Standard error.

Figure 1 Mediating effects of symptom burden, depression, and quality of life in MHD patients.

Note: ***P <0.001.

Table 4 Mediating Effects Analysis Table of Symptom Burden, Depression, and Quality of Life in MHD Patients

Mediating Path	Effect Value	SE	LLCI	ULCI
Depression→symptom burden→quality of life	−0.339	0.049	−0.440	−0.245
Direct effect	−0.151	0.032	−0.213	−0.089
Total effect	−0.490	0.051	−0.591	−0.389

Abbreviations: S.E, standard error; LLCI, the lower limit confidence interval; ULCI, the upper limit confidence interval.