A study on the Association between Long-term Dialysis and Depression

• Main Authors: Tso-Yi Hsu, 徐作義
• Other Authors: Ching-Wen Chien
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/13563107344573005323

碩士 === 國立陽明大學 === 醫務管理研究所 === 100 === Purposes In our study, we analyzed the National Health Insurance Research Database (NHIRD) data to investigate the correlation and effect on confounding factors that were gender, age, resource utilization bands (RUBs), and comorbidity between the long-term dialysis and depression. Materials and Methods We tried to investigate the correlation on long-term dialysis and depression with the NHIRD from 2003 to 2006. We ruled out that the medical records of cases in 2003 had been diagnosed with depression. To distinguish according to whether that had dialysis treatment medical record from 2003/07/01 to 2003/12/31 was divided into two groups. We assigned 2004 to the observation period, the patient group had dialysis treatment was assigned to the case group, and the patient group without dialysis treatment was assigned to the control group. The number of control group was 4 times the case group and matched according to gender, age, RUBs, and comorbidity. We investigated the depression correlation on case group and control group. The RUBs was calculated according to the Johns Hopkins University Adjusted Clinical Groups Ninth Edition (ACG 9.0). In our research we use SAS 9.2 to test the statistics. We used Student’s t-test and chi-square test to test gender and age. We used the logistic regression model to calculate the odds ratio in case group and control group. We compared the difference in depression incidence to the patient RUBs and comorbidity with independent sample t-test. Results The case group’s depression incidence is 1.216 times the control group. The depression incidence of the male group was occurred 0.618 times the female group. The depression incidence of the middle age group was occurred 1.411 times young adults group. The depression incidence of the relatively healthy group was occurred 1.658 times the relatively unhealthy group. The depression incidence of the patient group with atherosclerotic heart disease was 1.319 times the other patient group. The depression incidence of the patient group with other heart disease was 1.366 times the other patient group. The depression incidence of the patient group with congestive heart failure was 0.561 times the other patient group. The depression incidence of the patient group with diabetes is 0.839 times the other patient group. The depression incidence of the patient group with gastrointestinal bleeding is 1.461 times the other patient group. Conclusion Long-term dialysis was the risk factor in depression incidence. In the depression incidence, male were less than females, middle-aged populations were higher than other populations. The higher RUBs caused the higher depression incidence. The patient with arterial atherosclerotic heart disease, cardiovascular disease or gastrointestinal bleeding would increase depression incidence. The patient with congestive heart failure or diabetes will reduce the depression incidence. We suggest Hospitals should provide more lessons or training to improve the health care workers in the depression of the course to strengthen the health care workers on depression awareness. Detect of depression symptoms in dialysis patients earlier and the efficacy giving them psychological support and medical assistance would be better. The health care workers should dispose appropriate timing of the test and examination to monitor patient’s situation. When patients were discovered atherosclerotic heart disease, gastrointestinal bleeding or other heart disease in addition to giving medical treatment, and should need consultation psychiatric treatment.