Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study

Comorbidities cause psychological distress to patients on hemodialysis and cause their physical function to deteriorate. This study aims to examine whether physical patterns are associated with anxiety, depression and fatigue among patients with and without comorbidities who are on hemodialysis. To this end, a cross-sectional survey was administered to 120 patients on hemodialysis. Data were collected using the International Physical Activity Questionnaire-Short Form, Beck Depression Inventory-Second Edition, Beck Anxiety Inventory, and Brief Fatigue Inventory-Taiwan Version. An independent sample t test and generalized linear model analyses were conducted. The results revealed that patients with comorbidities exhibited more severe levels of depression (p < 0.001), anxiety (p < 0.001), and fatigue (p = 0.010) than patients without comorbidities. Additionally, patients on hemodialysis with a high physical activity level (>= 600 metabolic equivalent of task per min/week) exhibited less depression (B = -4.03; p < 0.001; 95% confidence interval [CI] = -6.04, -2.03) and anxiety (B = -2.64; p = 0.002; 95% CI = -4.27, -1.00) severity than those with a low physical activity level; those who engaged in weekly physical activities exhibited less fatigue severity (B = -1.17; p = 0.001; 95% CI = -1.84, -0.49) and fatigue interference (B = -0.61; p = 0.015; 95% CI = -1.10, -0.12). For patients on hemodialysis, having comorbidities was correlated with more severe levels of depression, anxiety, and fatigue. Weekly moderate-intensity physical activities were revealed to be correlated with less severity levels of depression, anxiety, and fatigue. The study findings aid the development of interventions for promoting physical activity among patients on hemodialysis to prevent the exacerbation of complications caused by comorbidities and psychological distress.