Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear models
Objectives This study investigates anxiety’s role as a mediator between symptom burden and quality of life in patients undergoing peritoneal dialysis, emphasizing the potential for targeted interventions to enhance patient outcomes.Methods In a cross-sectional design, 320 peritoneal dialysis patient...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2458763 |
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| author | Sixia Chen Yun Wang Sheng Feng Mingli Shen Fan Zhang Kai Song Wenwen Li Yun- Wang |
| author_facet | Sixia Chen Yun Wang Sheng Feng Mingli Shen Fan Zhang Kai Song Wenwen Li Yun- Wang |
| author_sort | Sixia Chen |
| collection | DOAJ |
| description | Objectives This study investigates anxiety’s role as a mediator between symptom burden and quality of life in patients undergoing peritoneal dialysis, emphasizing the potential for targeted interventions to enhance patient outcomes.Methods In a cross-sectional design, 320 peritoneal dialysis patients were recruited, with 305 providing valid responses (response rate: 95.31%). Symptom burden (occurrence and distress), anxiety levels, and quality of life were measured using validated tools. Multiple linear regression and restricted cubic spline models assessed associations, using β with a 95% confidence interval (95% CI), while mediation analysis with 1000 bootstrap samples quantified anxiety’s mediating effects.Results Participants reported an average of 8.2 ± 2.3 concurrent symptoms, with ‘worry,’, ‘tiredness’, and ‘dry skin’ being the most severe. Both symptom number (β = −0.90; 95%CI: −1.26 to −0.55) and distress (β = −1.20; 95%CI: −1.41 to −0.98) negatively correlated with quality of life. Anxiety mediated these relationships significantly, explaining 38.9% (95%CI: 18%–62%) and 33.3% (95%CI: 19%–49%) of the total effects for symptom number and distress, respectively. Restricted cubic spline models revealed an ‘L-shaped’ relationship between symptom burden and quality of life.Conclusions Anxiety significantly mediates the relationship between symptom burden and quality of life in peritoneal dialysis patients. These findings underline the importance of integrating psychological interventions and routine symptom screening into patient care to enhance quality of life. Future research should explore longitudinal designs and standardized intervention strategies. |
| format | Article |
| id | doaj-art-ffaba6d1950f497ba8c6f22944267e42 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-ffaba6d1950f497ba8c6f22944267e422025-02-04T06:08:39ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2458763Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear modelsSixia Chen0Yun Wang1Sheng Feng2Mingli Shen3Fan Zhang4Kai Song5Wenwen Li6Yun- WangDepartment of Nursing, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Nursing, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Nursing, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Nursing, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Nursing, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaDepartment of Nursing, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, ChinaObjectives This study investigates anxiety’s role as a mediator between symptom burden and quality of life in patients undergoing peritoneal dialysis, emphasizing the potential for targeted interventions to enhance patient outcomes.Methods In a cross-sectional design, 320 peritoneal dialysis patients were recruited, with 305 providing valid responses (response rate: 95.31%). Symptom burden (occurrence and distress), anxiety levels, and quality of life were measured using validated tools. Multiple linear regression and restricted cubic spline models assessed associations, using β with a 95% confidence interval (95% CI), while mediation analysis with 1000 bootstrap samples quantified anxiety’s mediating effects.Results Participants reported an average of 8.2 ± 2.3 concurrent symptoms, with ‘worry,’, ‘tiredness’, and ‘dry skin’ being the most severe. Both symptom number (β = −0.90; 95%CI: −1.26 to −0.55) and distress (β = −1.20; 95%CI: −1.41 to −0.98) negatively correlated with quality of life. Anxiety mediated these relationships significantly, explaining 38.9% (95%CI: 18%–62%) and 33.3% (95%CI: 19%–49%) of the total effects for symptom number and distress, respectively. Restricted cubic spline models revealed an ‘L-shaped’ relationship between symptom burden and quality of life.Conclusions Anxiety significantly mediates the relationship between symptom burden and quality of life in peritoneal dialysis patients. These findings underline the importance of integrating psychological interventions and routine symptom screening into patient care to enhance quality of life. Future research should explore longitudinal designs and standardized intervention strategies.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2458763Peritoneal dialysissymptom distressanxietyquality of lifemediation analysisrestricted cubic splines |
| spellingShingle | Sixia Chen Yun Wang Sheng Feng Mingli Shen Fan Zhang Kai Song Wenwen Li Yun- Wang Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear models Renal Failure Peritoneal dialysis symptom distress anxiety quality of life mediation analysis restricted cubic splines |
| title | Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear models |
| title_full | Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear models |
| title_fullStr | Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear models |
| title_full_unstemmed | Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear models |
| title_short | Anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients: insights from mediation analysis and nonlinear models |
| title_sort | anxiety as a mediator between symptom distress and quality of life in peritoneal dialysis patients insights from mediation analysis and nonlinear models |
| topic | Peritoneal dialysis symptom distress anxiety quality of life mediation analysis restricted cubic splines |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2458763 |
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