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Multicenter Validation of the Emotional State Instrument for Dialysis Patients

Rodríguez-Rey, Rocío; García-Llana, Helena; Ruiz-Álvarez, María Paz; Gómez-Gómez, Alicia; del Peso, Gloria; Selgas, Rafael

doi: 10.1097/NNR.0000000000000321
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Background The Emotional State Instrument for Dialysis Patients (ES-D) is a brief semistructured questionnaire to assess emotional distress in patients undergoing dialysis. It was designed to be administered by a healthcare provider. A previous study showed preliminary indicators of its content and face validity.

Objective The aim of the current multicenter study was to explore the ES-D’s psychometric properties.

Methods A total of 605 patients with kidney disease undergoing dialysis (524 hemodialysis and 81 peritoneal dialysis) in 19 Spanish dialysis centers completed the ES-D, along with anxiety, depression (Hospital Anxiety and Depression Scale), and resilience (Brief Resilience Scale) questionnaires. The 75 healthcare providers who performed the assessments completed a satisfaction survey.

Results The ES-D showed adequate internal consistency (α = .73). Correlations between the ES-D scores and the scores for anxiety, depression, and resilience showed evidence of its convergent and concurrent validity. The receiver operating characteristic curve analyses showed that a cutoff of nine detected patients with moderate-to-severe emotional distress. According to these criteria, 35.4% of patients showed emotional distress. No significant differences were found between patients undergoing hemodialysis and peritoneal dialysis. The healthcare providers perceived the ES-D as useful for knowing the patients’ emotional state, understanding patients’ concerns, and establishing therapeutic relationships.

Conclusions The ES-D is a useful tool for healthcare providers to explore the emotional dimension of their patients. Thus, its development represents a step forward in the improvement of comprehensive assistance and the quality of life of patients with kidney disease undergoing dialysis.

Rocío Rodríguez-Rey, PhD, is Associate Professor, Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Spain.

Helena García-Llana, PhD, is Psychology Associate Researcher, Department of Nephrology, La Paz University Hospital-IdiPAZ, Madrid, Spain.

María Paz Ruiz-Álvarez, MP, is Registered Nurse, Department of Nephrology, La Paz University Hospital-IdiPAZ, Madrid, Spain.

Alicia Gómez-Gómez, MP, is Registered Nurse, Department of Nephrology, Henares Hospital, Madrid, Spain.

Gloria del Peso, PhD, is Nephrology Consultant, Department of Nephrology, La Paz University Hospital-IdiPAZ, Madrid Spain.

Rafael Selgas, PhD, is Department Head, Department of Nephrology, La Paz University Hospital-IdiPAZ, Madrid, Spain.

Accepted for publication June 28, 2018.

The authors acknowledge the participation in data collection of all members of the Emotional State Working Group: L. Baena Ruiz, MP, F. Dapena Vielba, MP, A. Dorado, MP, M. J. Fernández Manjón, MP, A. Gómez Gómez, MP, S. Hermida Cerro, MP, E. Hernández Meca, MP, A. M. Matamala Gascón, MP, M. A. Morán Caballero, MP, A. Quintano Pintado, MP, Y. Ravelo Valiente, MP, A. Rico González, MP, M. J. Rollán de la Sota, MP, F. L. Sánchez Izquierdo, MP, A. Sánchez Martín, MP, M. Santana Díez, MP, and F. Trocóli González, MP.

Research reported in this publication was supported by the Spanish Society of Nephrology Nursing (SEDEN).

The study was approved by the Ethics Committee of the study’s coordinating hospital (Code HULP:PI-2298).

The authors have no conflicts of interest to report.

Corresponding author: Rocío Rodríguez-Rey, PhD, Department of Psychology, School of Biomedical Sciences, Universidad Europea de Madrid, C/ Tajo S/N Urb El Bosque, Villaviciosa de Odon, Madrid, 28670, Spain (e-mail: rocio.rodriguez.rey@gmail.com).

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