Role of resilience and social support in alleviating depression in patients receiving maintenance hemodialysis

Figures & data

Table 1 Demographic data of the participants (N=194)

Variable	n	%	M ± SD
Age (years)
60–64	44	23	72.64±8.58
65–96	150	77
Gender
Male	84	43
Female	110	57
Education
Literate	37	19
Illiterate	157	81
Living with family
Yes	179	92.3
No	15	7.7
Primary caregiver
Spouse	62	32
Child/child-in-law	63	32.5
Relatives/friends/employee	29	14.9
Institution/nursing home	7	3.6
Oneself	33	17
Monthly income allowance
< NT$10,000	69	35.6
NT$10,000–20,000	64	33
NT$20,000–30,000	28	14.4
> NT$30,000	33	17
Income sources
Oneself	60	30.9
Spouse	15	7.7
Children	103	53.1
Others	16	8.2
Physical symptoms
Fatigue	138	71.1
Muscle weakness	125	64.4
Skin itchiness	123	63.4
Laboratory variables
Hemoglobin (g/dL)			10.24±1.53
Albumin (g/dL)			3.91±0.39
Kt/V			1.67±0.93
ADL
100	103	53.1	87.56±19.05
91–99	13	6.7
61–90	55	28.4
21–60	21	10.8
0–20	2	1.0
IADL
Independent	33	17	13.45±8.04
Dependent	161	83
Resilience
147–175 (high)	33	17	116.72±31.52
121–146 (moderate)	71	36.6
<120 (low)	90	46.4
Social support
46–60 (high)	113	58.2	47.14±9.32
31–45 (moderate)	70	36.1
15–30 (low)	11	5.7
BDI-II scale
0–13 (minimal)	105	54.1	13.43±9.51
14–19 (mild)	42	21.6
20–28 (moderate)	32	16.5

Abbreviations: ADL, activity of daily living; BDI, Beck Depression Inventory; IADL, instrumental activity of daily living; NT$, New Taiwan Dollar.

Table 2 Association between the severity of depression and demographic characteristics (N=194)

Variable	n (%)	M ± SD	t-test	F-test
Age (years)
60–64	44 (23)	72.64±8.58		2.173
65–96	150 (77)
Gender
Male	84 (43.3)	11.3±9.3	2.726**
Female	110 (56.7)	15.0±9.3
Education
Literate	157 (80.9)	12.6±9.5	2.668**
Illiterate	37 (19.1)	16.5±8.6
Living with family
Yes	179 (92.3)	13.3±9.49	0.286
No	15 (7.7)	14.1±9.97
Primary caregiver
Spouse	62 (32)	13.0±10.32		3.299**
Child/child-in-law	63 (32.5)	13.3±7.94
Relatives/friends	4 (2)	11.5±6.13
Employee	25 (12.9)	16.4±10.00
Institution/nursing home	7 (3.6)	24.0±6.97
Oneself	33 (17)	10.0±9.36
Monthly income allowance
< NT$30,000	161 (83)	14.23±9.93		4.251**
> NT$30,000	33 (17)	8.79±7.54

Note:

** p<0.01.

Abbreviation: NT$, New Taiwan Dollar.

Table 3 Correlations between illness, physical symptoms, activities of daily living, resilience, social support, and depression (N=194)

Variable	Illness	Duration of HD	Phy. Sym.	ADL	IADL	RES	SS
Illness
Duration of HD	−0.206**
Phy. Sym.	0.159*	0.187**
ADL	−0.099	0.017	−0.161*
IADL	−0.174*	0.067	−0.138	0.644**
RES	−0.105	0.030	−0.262**	0.549**	0.556**
SS	−0.029	0.040	−0.177*	0.184*	0.176*	0.417**
Dep.	0.085	0.004	0.420**	−0.479**	−0.490**	−0.743**	−0.506**

Notes:

* p<0.05,

** p<0.01. Statistical method: Pearson’s correlation coefficient.

Abbreviations: ADL, activities of daily living; Dep., depression; HD, hemodialysis; IADL, instrumental activities of daily living; Phy. Sym., physical symptoms; RES, resilience; SS, social support.

Table 4 Buffering effects of RES on the severity of depression according to demographics, symptom severity, and ADLs (N=194)

Variable	Model 1		Model 2		Model 3
	b	SE	b	SE	b	SE
Elder demographics
Gender	−0.120	1.435	−0.057	0.948	−0.068	0.940
Education	−0.103	1.534	−0.034	1.009	−0.060	1.000
Income source	0.038	1.547	−0.006	1.018	−0.003	0.998
Major caregiver	0.135	1.771	−0.015	1.222	−0.006	1.199
Monthly allowance	−0.107	1.494	−0.011	1.010	−0.012	0.991
Illness
Symptom severity			0.232***	0.126	0.627***	0.370
Daily living activity
ADL			−0.061	0.032	−0.156	0.077
IADL			−0.085	0.077	0.240	0.273
RES			−0.596***	0.018	−0.595***	0.018
Interactions
ADL × RES					0.116	0.001
IADL × RES					−0.355	0.003
Symptom severity × RES					−0.436**	0.004
Model R^2	0.088		0.623		0.644
ΔR^2	0.088		0.535		0.021
ΔF	3.631**		65.159***		3.633*

Note:

* p<0.05,

** p<0.01,

*** p<0.001.

Abbreviations: ADL, activities of daily living; IADL, instrumental activities of daily living; RES, resilience; SE, standard error.

Table 5 Buffering effects of SS on the severity of depression according to demographics, symptom severity, and ADLs (N=194)

Variable	Model 1		Model 2		Model 3
	β	SE	b	SE	b	SE
Elder demographics
Gender	−0.12	1.435	−0.067	1.039	−0.064	1.036
Education	−0.103	1.534	−0.004	1.104	−0.009	1.110
Income source	0.038	1.547	0.059	1.118	0.058	1.116
Major caregiver	0.135	1.771	0.051	1.357	0.053	1.359
Monthly allowance	−0.107	1.494	−0.058	1.091	−0.059	1.094
Illness
Symptom severity			0.277**	0.136	0.266***	0.137
Daily living activity
ADL			−0.201**	0.033	−0.137	0.037
IADL			−0.212**	0.082	−0.242**	0.083
SS			−0.381**	0.054	−0.374***	0.055
Interactions
ADL × SS					0.098	0.003
IADL × SS					−0.036	0.008
Symptom severity × SS					−0.069	0.014
Model R^2	0.088		0.549		0.560
ΔR^2	0.088		0.461		0.011
ΔF	3.631**		46.965***		1.496

Note:

** p<0.01,

*** p<0.001.

Abbreviations: ADL, activities of daily living; IADL, instrumental activities of daily living; SS, social support.