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Learning Objective 1: How did health insurance system impact on depression symptoms in elderly patients on maintenance hemodialysis?
Learning Objective 2: The contribution of social support and resilience on the severity of depression in elderly MHD.
It is well known that financial security is an important factor influencing depression. In Taiwan, elderly patients on maintenance hemodialysis (MHD) have less depression mood than other countries, one of the important factors is the implementation of the health insurance system, people are free to all dialysis costs and obtain disability benefits handbook, monthly disability payments, and other benefits enjoyed subsidies. This study aimed to explore and analyze the factors related to depressive mood of elderly (Age > 65) on MHD base on resilience framework.
Methods:
The study employed a cross-sectional research design with a convenience sampling. 194 patients on MHD (mean age: 72.64±8.58 years, 84 male & 110 female) were recruited from 3 HD centers in the north of Taiwan. A structured questionnaire through face-to-face interviews was used to collect data, including demographics, illness conditions, Barthel Index, resilience score, Inventory of Socially Supportive Behavior (ISSB), and the Beck Depression Inventory (BDI). SPSS 17.0 statistical software was used to manage and analyze data.
Results:
45.9% (n=100, 39 male & 61 female) of elderly on MHD suffered from depressive mood (BDI >14). Male elderly with higher educational level, higher income, financial independence, less symptoms, and higher activity ability were less depressed. Resilience and social support was positively correlated with depression status. The results of hierarchical regression analysis showed that social support was unable to be a moderator for depression symptoms. Resilience was capable of mitigating the effect of body symptom on depressive mood.
Conclusion:
Enhance resilience capability may contribute to attenuate of depression severity in elderly on MHD under the Taiwan Bureau of National Health Insurance (BNHI) provide a full healthcare coverage for patients on MHD.