Physical and psychological well-being of kidney patients: a scoping review exploring the mediating or moderating role of psychological resilience.

BACKGROUND

Extensive literature has documented the psychological burden of chronic kidney disease and kidney failure. Psychological resilience, the ability to adapt to challenging life experiences, offers a critical lens for understanding the variability in how individuals experience and adapt to chronic medical conditions. We aimed to synthesize existing evidence that has explored resilience among patients with kidney diseases.

METHODS

This scoping review followed the JBI Scoping Review framework. Empirical studies that measured resilience with no time restriction were considered and resilience could be an exposure, outcome, or variable.

RESULTS

Of the 4525 reports screened, 36 studies (33 observational, 3 interventional) from 11 countries that included 6028 patients met the inclusion criteria. Most studies focused on patients on hemodialysis (n = 30). Multiple studies reported that resilience was negatively correlated/associated with depression (n = 10), and anxiety (n = 7), as well as psychological vulnerabilities. A positive correlation between resilience and post-traumatic growth, coping, and mental well-being was reported. Higher resilience positively correlated with measures of physical health (health-related quality of life, frailty, and instrumental activities of daily living). Factors, such as religiosity, spirituality, health-promoting behaviors, social support, family functioning, and family resilience, were enablers of resilience. Three studies reported positive impacts of resilience-enhancing interventions.

CONCLUSION

Lower resilience is associated with depression and other inferior psychological and physical outcomes in patients with kidney diseases. Psychological resilience is measurable and modifiable. Given the multifaceted and often debilitating nature of kidney diseases and kidney failure, we propose that resilience can help to improve patient outcomes.