Associations between Social Support and Patient-Reported Outcomes in Patients Receiving Hemodialysis: Results from the TACcare Study

Background Patients with ESKD experience high symptom burden, which has been associated with a negative effect on their interpersonal relationships. However, there is limited research exploring associations of social support and patient-reported outcomes among patients receiving hemodialysis. Methods This study is a secondary, cross-sectional analyses of the sociodemographic and clinical correlates of perceived social support (Multidimensional Scale of Perceived Social Support [MSPSS]) at baseline. The study examined the extent to which perceived social support is associated with pain, depression, fatigue, anxiety, sleep, and health-related quality of life (Short Form-12 [SF-12] Mental Component Score [MCS] and Physical Component Score. Results Of the 160 randomized patients, the mean (SD) age was 58 +/- 14 years; years on dialysis was 4.1 +/- 4.2; 45% were female; 29% Black, 13% American Indian, and 18% Hispanic; 88% had at least high school education; and 27% were married. Mean baseline levels of perceived social support were comparable with other chronically ill populations. At least high school education (P = 0.04) and being married (P = 0.05) were associated with higher total MSPSS scores. Higher MSPSS scores were correlated with lower levels of fatigue (r=0.21, P = 0.008; higher fatigue scores signify lower fatigue), pain (r=-0.17, P = 0.03), depressive symptoms (r=-0.26, P < 0.001), anxiety (r=-0.23, P = 0.004), better sleep quality (r=-0.32, P < 0.001), and SF-12 MCS (r=0.26, P < 0.001). Moderation analyses revealed male sex and non-Hispanic ethnicity resulted in stronger positive associations of perceived social support with SF-12 MCS. Conclusions The level of perceived social support observed among patients receiving thrice-weekly hemodialysis in Technology Assisted Stepped Collaborative Care was similar to those observed in other chronic conditions. Because of the associations between perceived social support and patient-reported outcomes, particularly psychosocial and behavioral health outcomes, targeting social support appears to be warranted among patients receiving hemodialysis.