[[alternative]]Self-care self-efficacy and depression influence quality of life among patients undergoing hemodialysis in Vietnam

[[abstract]]Background: Chronic kidney disease (CKD) is becoming a global issue and global mortality related to CKD grows significantly every year. Indeed, the Global Burden of Disease (GBD) study estimated that, in 2015, 1.2 million people died from kidney failure, an increase of 32% over a ten years period. CKD is characterized by progressive loss of kidney function gradually leading to end-stage renal disease (ESRD), which requires kidney transplantation or dialysis. In 2010, 2.62 million people received dialysis worldwide. The need for dialysis is projected to double by 2030 mostly in developing regions such as Asia and Africa. The necessity of long-term treatment and changes in daily life among patients undergoing hemodialysis impact their social and psychological state. Because of the challenges of self-care at home, patients’ beliefs about their ability to take care of themselves play an important role in how they face treatment regimens. Moreover, depression is the most common psychological condition among end-stage renal disease patients.Objective: First aim was to describe the level of self-care self- efficacy, depression, and quality of life among hemodialysis patients. The study examined correlations between self-care self-efficacy, depression and quality of life. Third, the study investigated whether self-care self-efficacy and depression can predict patients’ quality of life.Methods: This study was a cross-sectional survey using a convenience sampling method. We used the 36-Item Short Form Health Survey, the Strategies Used by People to Promote Health questionnaire (SUPPH) and the Patient Health Questionnaire-9 to evaluate quality of life, self-care self-efficacy and depression, respectively, among 127 hemodialysis patients. The study produced and validated the first Vietnamese translation of the SUPPH. Data were analyzed using descriptive statistics, the independent t-test, ANOVA and Pearson’s correlation. The study used hierarchical linear regression to explore the relationship between self-care self-efficacy, depression and quality of life. The data were processed using SPSS version 22.Results: The hemodialysis patients had better mental quality of life than physical quality of life. Patients demonstrated a moderate level of self-efficacy regarding their ability to perform self-care behaviors related to the illness, with a mean score of 2.96 on the SUPPH. Results showed that nearly half of participants had mild depression and just 0.8% had severe depression. Physical quality of life was significantly related to age, occupation, monthly income, insurance status, and duration of treatment. Mental quality of life was significantly related to occupation and monthly income. Self-care self-efficacy and depression were significant predictors of quality of life after controlling for demographic variables. Self-care self-efficacy explained 9% of the variance (R²inc=0.09, β= -0.38, p<0.001) in physical quality of life and depression explained 12% (R²inc=0.12, β= -0.22, p<0.001). In mental quality of life, self-care self-efficacy explained 4% of the variance (R²inc=0.04%, β= -0.25, p<0.001) and depression explained 33% (R²inc=0.33, β= -0.51, p