Dongqing Cai, Guiqin Wan, Qianqian Yang, Lu Dai
Depressive symptoms among couples in the peri‑dialysis period manifest as four heterogeneous dyadic profiles. Clinicians and nursing staff should adopt couple‑based, tailored psychological interventions to effectively address these distinct patterns of distress. The identified factors should be interpreted as being associated with, rather than causally driving, profile membership.
OBJECTIVE: This cross-sectional study aimed to identify the latent profiles of depressive symptoms within patient-spouse dyads during the peri-dialysis period and to examine the dyadic-level factors associated with these distinct profiles.
METHODS: From June to December 2023, 397 dyads were recruited, and 389 dyads were included in the final analysis (valid response rate: 97.98%). A total of 351 dyads were included in multivariate logistic regression due to listwise deletion of missing covariates. Data were collected using a sociodemographic questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Dialysis Symptom Index (DSI), the Fear of Progression Questionnaire-Short Form (Fop-Q-SF), and the Caregiver Benefit Scale. Latent profile analysis was employed to classify the dyadic patterns of depressive symptoms, and multinomial logistic regression was used to identify the associated factors of profile membership.
RESULTS: Four distinct dyadic depressive symptom profiles were identified: both partners with no depression (9.8%), patient mild depression with spouse moderately severe depression (29.6%), patient moderately severe depression with spouse no depression (19.5%), and patient severe depression with spouse mild depression (41.1%). These profiles demonstrated clear dyadic heterogeneity, characterized by asymmetric distributions of depressive symptom severity between patients and their spouses. Significant differences were observed across the four profiles with respect to patient age, monthly household income, number of comorbidities, DSI score, and Fop-Q-SF score.
CONCLUSION: Depressive symptoms among couples in the peri‑dialysis period manifest as four heterogeneous dyadic profiles. Clinicians and nursing staff should adopt couple‑based, tailored psychological interventions to effectively address these distinct patterns of distress. The identified factors should be interpreted as being associated with, rather than causally driving, profile membership.