Abstract
STRESS LEADING TO DEPRESSION; ITS IMPACT ON PATIENTS RECEIVING HEMODIALYSIS TREATMENT: A REVIEW FROM LITERATURE

Patients living with chronic kidney disease and undergoing hemodialysis treatment to sustain their life experience various psychological disturbances including depression, stress and anxiety. Health care professionals must be able to recognize both somatic and psychologic symptoms of depression and stress in patients receiving dialysis treatment. Early detection and treatment facilitates such patients to improve the quality of their life. Objective: This paper explores previous research on symptom experience, prevalence of stress, depression, and its impact on patients living with chronic kidney disease receiving dialysis treatment. Method: An electronic search strategy was conducted using the following databases: CINAHL, MEDLINE, Academic search complete, Psych INFO, Psych articles, and Psychology and Behavioral Science collection. Scholarly peer reviewed papers published in English were included. The Boolean operators ‘depression’ or ‘stress’ or ‘Impact of depression’ or ‘symptoms of depression’. ‘prevalence of depression, stress’ or ‘multiple symptoms’, ‘Depression and stress and ESRD’ or ‘Depression and CKD’ or ‘Depression or stress and Hemodialysis’ were combined to explore the symptoms and prevalence and impact of depression in patients receiving dialysis treatment. Sixteen studies met the inclusion criteria, which includes descriptive studies, systematic reviews, cross sectional studies, qualitative studies and a prospective cohort study. These studies explored prevalence of stress and depression, somatic and psychologic symptoms of depression and the impact of stress and depression in patients with End-stage renal disease receiving hemodialysis treatment. Results: Quality of life of a patient with chronic kidney disease receiving hemodialysis may be impaired with either stress or depression. Depression is considered as the most common psychological illness among hemodialysis patients and it is associated with increased mortality and morbidity. A recent study done in Saudi Arabia revealed that the overall prevalence of depression among patients on hemodialysis to be 43.6% and it is varying from mild (12.8%) depressed to severe depression (15.1%). Symptoms of depression includes both somatic and psychologic aspects. Health care professional working in hemodialysis unit must be able to differentiate between somatic symptoms of uremia and depression. Self-care and self-efficacy played a vital role in delaying chronic kidney disease progression, showed a better quality of life, lower level of anxiety, depression and stress. Early detection and treatment of depression is one of the primary responsibly of doctors and nurses dealing with such patients