The Subset Population : Esrd Patients On Hemodialysis With Depression

According to the Anxiety and Depression Association of America, depression is the leading cause of disability in America for people ages 15 to 44. Unfortunately, it is still widely misunderstood, which causes people to neglect themselves. There are so many different forms, the most major two being major depressive disorder and dysthymia. Symptoms can vary in the way they manifest themselves, and causes are still widely unknown. Luckily, there are many treatment options available. Understanding depression is the best way to combat it.

The depression groups baseline and posttest depression mean scores dropped by 0.64 (14 - 13.36). The hypothesis stated that the empowerment program will result in the improvement in the depression result by decreasing and that is why this was expected. As the depression result is improving this is appositive impact on the self-care efficiency of the ESRD patients.

There are at least 66,000 Americans awaiting kidneys, while only a tenth of that number of kidneys are transplanted from deceased donors per year (Postrel). The amount of people awaiting organs is rising, and with the shortage of organs that are

Patients require continuous treatments up to 3 times a week as they wait for a kidney transplant, while others are reliant on lifelong dialysis treatments due to their ineligibility of being a transplant recipient. Since wait times for kidney transplants can extend into several months and years, the cost incurred for these patients in relatively high. With the incidence of ESRD on the rise, there is a continuing need to provide services to address it. Healthcare organizations are expected to adapt their healthcare delivery models to address this increase of ESRD pertaining to kidney failure while staying financially viable.

Depression is a clinical condition associated with the normal emotions of bereavement and sadness. However, this condition does not pass on when the external causes of these emotions dissolve and is usually inconsistent to their cause. In essence, the classic severe conditions of depression have not been attributed to external precipitating cause. One of the most common conditions of depression is Major Depressive Disorder (MDD), which is a psychiatric condition that impairs moods, behavioral patterns, and thoughts for a protracted duration. This psychiatric illness tends to impair the patient’s social functioning and quality of life due to its impacts on cognitive functioning. Some of the most common symptoms of the condition include difficulty in concentration, weight change, minimal interest in pleasure, high rate of suicide, and physical impairment. The severity of this disease was evident in the year 2000 when the World Health Organization ranked it as the fourth cause of disability and premature death across the globe.

Enworom, C. D., & Tabi, M. (2015). Evaluation of Kidney Desiase Education On Clinical Outcomes and Knowledge of Self-Management Behaviors of Patients with Chronic Kidney Disease. Neprology Nursing Journal, 363-373.

Answer: The experimental group subjects scored lower on the depression posttest (mean = 13.36 vs. the baseline score of mean = 14.00), meaning that they were less depressed after the completion of the empowerment program. This was an expected finding, because the researchers hypothesized that the empowerment program would be beneficial to ESRD patients and result in a decrease in their depression scores. However, the difference in the depression baseline and posttest means for the experimental group was only 0.64, which is less than what might have been expected.

One of the first things that we learn about Enid is that she must be a good nurse. The first paragraph on page 31 is full of observations that a nurse would make. She notes the coloration of Mrs. Quinn’s urine, which is an indication of the condition of her failing kidneys. She also observes the smell of her patient’s breath and the stains on her body. These are all signs that give her some idea of how much time Mrs. Quinn has before dying as well as her mental state.

Nonadherence rates are 27% higher for patients with depression. (Martin, et al.). “The prevalence of depressive disorders in chronic medical illness is 1.5 to 4 times higher than the general population (DiMatteo, 2012). Depression is one of the strongest predictors of patient nonadherence (DiMatteo 2000, Martin). Depressed patients experience feelings of hopelessness, worthlessness, loss of energy, loss of interest and enjoyment, weight changes, sleep disorders,

The National Kidney Foundation has many key facts about this patient population. Kidney disease affects twenty-six million American adults and millions more are at risk (NKF,2012). Having kidney disease is what influences ESRD, which refers to irreversible kidney failure. There are more than one million ESRD sufferers worldwide, with more than 571,000 individuals living in the U.S. More

Before six months and 249 did not participate in the assessment at the six month period. At the twevle month follow up period, 255 patients were still alive and 44 had died. Of the patients who did participate in the CES-D assessment at the six month period, 310 patients met the criterion for depression, 213 patients met the criterion for mild depression ad 97 patients met the criterion for moderate to severe depression. However, no one had died. At the six month follow up period, 490 patients were still alive and 65 had died (Babyak, et al.,

My community assessment project focused on adults with chronic renal disease who are receiving peritoneal dialysis under the care of the Davita Dialysis Clinic located in Dothan, Alabama. This modality of artificial kidney replacement minimizes the disruption of the user’s daily life by allowing them to remove waste products from their bodies on daily basis during their ordinary sleeping hours. According the Centers for Disease Control and Prevention, it was estimated that as many as 10% of adults or more than 20 million people in the United States may be suffering from chronic kidney disease and in 2011 alone, 113,136 of these individuals began treatment for their end stage renal disease ("National chronic kidney disease fact sheet,

The Mayo Clinic (2015) defines dysthymia as “a continuous long-term (chronic) form of depression… [that] may lose interest in normal daily activities, feel hopeless, [or] lack productivity”. This is less severe than major depression. What makes this different from major depression is that it has less symptoms, only two of the symptoms that are listed under dysthymia must be present, this is long term instead of a two-week period, and symptoms like suicidal thoughts are only present in major depression. In a two-year period, while depressed, a person must have two or more of the following symptoms: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concertation or difficulty making decisions,

Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,

It is known that depression can lead to complications in chronic conditions, such as cardiovascular disease and stroke, increase morbidity and mortality, and increases health care expenditures. However, while “many older adults may face widowhood or loss of function or independence…depression is not considered a normal part of aging” (Buigues et al. 2014). Despite depression being one of the two syndromes being explored in this article, the authors have not given a specific, clinical definition for depression. During their primary search, they used the term “depression” and included articles that measured depressive symptoms or depression. This lack of specificity may have lead to some bias or inappropriate inclusions in this review. The authors would have benefited by creating or using a more defined definition for depression, such as the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) or stated clearly whether or not the relationship they were exploring was between frailty and depression or frailty and depressive symptoms. The DSM-V defines depression as requiring “five (or more of) the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood (2) loss of interest or pleasure” and includes the following