Desarrollo de un instrumento para la evaluación del malestar emocional para pacientes renales en diálisis

Abstract

Objective: Currently there are no validated assessment tools to explore emotional distress in patients with chronic kidney disease, even though it is very prevalent in all the phases of the disease. This study describes the development of a brief semi-structured interview to assess emotional distress in renal patients undergoing Dialysis (EE-D).
Method: The EE-D includes five questions with different response formats (dichotomized, Likert scales and open-questions) to assess sadness, anxiety, concerns, and resources to cope with illness, external signs of distress and other considerations. An interjudge process was used with the items of the first version of the EE-D (N= 10 experts). Hereafter a pilot multicentric study was carried on (N= 25 patients in 5 hospitals).
Results: After the interjudge analysis one item was removed from the EE-D, and one item was added. After the pilot study there were no changes in the tool. The average score (range 0 to 10) in sadness was 4.16 (SD= 3.41) and 3.68 (SD= 3.48) in depression. A total of 48% of the participants reported family concerns, 44% concerns about their psychological/ emotional state and 40% about their illness/treatments. The most important resources to cope with the illness were their hope in the possibility of a transplantation and their social support. According to the nursing staff who conducted the interviews 24% of the patients showed facial expression of distress and 16% other external signs of distress.
Discussion: The EE-D has shown adequate preliminary psychometric properties. It has been recently distributed to all the dialysis units in Spain with the objective of conducting a multicentric validation study.