ムラヤマ ノリオ    Murayama Norio
   村山 憲男
   所属
人間社会学部 心理学科
 
生活機構研究科 心理学専攻
 
生活心理研究所 所属教員
 
生活機構研究科 生活機構学専攻
   職種
准教授
言語種別 英語
発行・発表の年月 2023/06
形態種別 学術雑誌
査読 査読あり
標題 Interactional effects of depressive symptoms and physical function on daily physical activity in ambulatory patients receiving hemodialysis
執筆形態 共著
掲載誌名 Renal Replacement Therapy
掲載区分国外
著者・共著者 Yusuke Matsunaga, Yuta Suzuki, Shohei Yamamoto, Keigo Imamura, Shun Yoshikoshi, Manae Harada, Toshiki Kutsuna, Kentaro Kamiya, Atsushi Yoshida, Kanako Ichikura, Yuko Fukase, Norio Murayama, Hirokuni Tagaya, Atsuhiko Matsunaga
概要 Background: Clarification of the factors associated with decreased physical activity is crucial for effective disease management in patients undergoing hemodialysis. Although evidence suggests that physical activity may be associated with physical function or depressive symptoms, limited studies have demonstrated these factors to be independently associated with the former in patients undergoing hemodialysis. This study aimed to examine whether physical function and depressive symptoms were independently or interactively associated with daily physical activity in patients undergoing hemodialysis.
Methods: This cross-sectional study analyzed 157 clinically stable outpatients (median age: 68 years) receiving hemodialysis. Physical activity (steps/day) was measured using an accelerometer for four consecutive non-dialysis days. Physical function was evaluated by calculating usual walking speed along a 10-m walkway. The 10-item version of the Center for Epidemiologic Studies for Depression Scale was use to assess depressive symptoms.
Results: The hierarchical multiple regression model (Model 2), constructed by adding physical function to Model 1 (clinical characteristics), showed a significant increase in coefficient of determination (R2), compared to Model 1 (ΔR2 = 0.15, P < 0.01). There was no significant increase in R2 between Models 2 and 3, where depressive symptoms were added to Model 2. The interaction term of physical function with depressive symptoms in Model 4 indicated an increase in R2 (ΔR2 = 0.01, P = 0.03), compared with Model 3. The simple slope analysis demonstrated that the difference in physical activity between patients with or without depressive symptoms at higher levels of physical function was greater than that at its lower levels.
Conclusions: Physical function was a strong and independent factor associated with physical activity, but no independent relationship between depressive symptoms and the physical activity was observed in patients undergoing hemodialysis. In contrast, physical function and depressive symptoms were interactively associated with daily physical activity in patients undergoing hemodialysis who were capable of walking independently. Our findings suggested that a two-step screening, primarily based on physical function and then depressive symptoms, can be useful to identify factors associated with physical inactivity in hemodialysis patients.