The psychosocial correlates of quality of life in the dialysis population: a systematic review and meta-regression analysis

The psychosocial correlates of quality-of-life (QoL) research in end-stage renal disease (ESRD) are important in identifying
risk and protective factors that may account for the QoL variability. Thus, the present study provides a meta-analysis of
these research results.

Published studies reporting associations between any psychosocial factors and QoL were retrieved from Medline, Embase, and
PsycINFO. Mean effect sizes were calculated for the associations across psychosocial constructs (affect, stress, cognitive
appraisal, social support, personality attributes, and coping process). Multiple hierarchical meta-regressions were applied
to moderator analyses.

Eighty-one studies covering a combined sample of 13,240 participants were identified resulting in 377 effect sizes of the
association between psychosocial factors and QoL. The overall effect size of the association was medium (0.38). Stress, affect,
and cognitive appraisal had the largest effect sizes. Location of study, dialysis type, gender, age and QoL domains measured
(general well-being, subjective QoL, and health-related QoL) were significant substantive moderators for the associations.

The present study shows that there is a moderate association between psychosocial variables and QoL in patients with ESRD,
consistent across different QoL domains. The psychosocial constructs that have the strongest association with QoL are stress,
affect, and cognitive appraisal.