The impact of personal resilience resources on dialysis patients’ health-related quality of life across culture

Abstract

OBJECTIVES: Resilience resources are an important predictor of outcomes in a range of chronic diseases. This study with in-centre haemodialysis patients in Australia (N = 144) and Taiwan (N = 272) examined the impact of personal resilience resources on health-related quality of life (HRQOL). We hypothesized that resilience resources are the overarching principle determining HRQOL among known psychosocial factors. DESIGN: Non-invasive study with cross-sectional design, using quantitative data collected from standardized self-report measures to examine the ability of resilience resources to predict HRQOL over and above other previously researched variables. METHODS: Hierarchical regression equations determined whether resilience resources (perceived control, optimism, self-esteem) were able to predict HRQOL over and above social support, loss of control to doctor and hope. Moderator analysis determined indirect effects. Control variables included: gender; age; relationship, vocational, socio-economic status; living alone; cultural identity; religious beliefs; and disease-related variables such as cause of renal failure, number of co-morbidities, time since dialysis onset, transplant status, kidney disease impact. Outcome measure: SF-36v2 health survey. RESULTS: Resilience resources had a direct effect on physical functioning, general health, vitality, emotional role performance and mental health in Taiwan, an indirect effect on physical health in Australia, and an indirect effect on bodily pain and social functioning in Taiwan, accounting for between 2 and 5 per cent of variance (ΔR²). No effects on mental health of Australian patients and physical role performance of Taiwanese patients could be detected. CONCLUSIONS: Resilience resources play an important role in HRQOL outcomes of dialysis patients, often exceeding the impact of previously identified psychosocial factors. Differences emerged across study populations that could be attributed to culture, healthcare or age. Future research should address these differences and design treatments that are sensitive to patients’ resilience resources.