SP623ASSOCIATIONS OF COPING STRATEGIES WITH QUALITY OF LIFE, DEPRESSION AND MORTALITY AMONG HEMODIALYSIS PATIENTS IN THE DIALYSIS OUTCOMES AND PRACTICE PATTERNS STUDY (DOPPS)
Bibliographic record
Abstract
INTRODUCTION AND AIMS: Little is known about how different strategies used by hemodialysis (HD) patients to cope with their disease might affect their health status. Our objective was to estimate the effects of 4 coping strategies on quality of life (QoL) and mortality. We hypothesized that active engagement coping would lead to better patient outcomes than would avoidance or disengagement. METHODS: Coping strategies were reported by 2,339 HD patients from the US, UK, Australia/New Zealand, Canada, Germany and Sweden in DOPPS 4 (2009-11), using the Coping Strategies Inventory-Short Form (CSI-SF) previously validated for HD patients in these countries. The CSI-SF contains 4 subscales: problem-focused engagement & disengagement (PFE & PFD); and emotion-focused engagement & disengagement (EFE & EFD). Cox or linear regression were used to estimate the associations of each coping strategy (by quartile) with all-cause mortality during follow-up and 6 cross-sectional patient-reported outcomes (3 KDQoL kidney-disease measures with higher scores reflecting less impact on patients’ lives (Effects, Burdens, Symptoms); 2 SF-12 scores (MCS, PCS) reflecting better functional status; and a CES-D score reflecting more depression symptoms), adjusting for age, sex, vintage, BMI, catheter use, 13 comorbidities, and country. RESULTS: PFE was positively associated with less kidney-disease burden and effect scores and better mental and physical function scores, and it was inversely associated with depression symptoms. EFE was not associated with any QoL outcomes (Figure 1). In contrast, disengagement strategies (PFD & EFD) were inversely associated with the kidney-disease and functional-status scores, and they were positively associated with depression symptoms. Compared to patients in the lowest PFE quartile (Q1), the hazard ratio for mortality (95% CI) was 0.73 (0.55, 0.98) for patients in Q2, 0.67 (0.49,0.93) for patients in Q3, and 0.74 (0.53, 1.03) for patients in Q4. Little association was seen between EFE, PFD, or EFD coping with mortality. SP623 Figure
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".