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Introducción: El optimismo disposicional es un rasgo de personalidad que se relaciona significativamente con el empleo de estrategias positivas de afrontamiento y con el grado de bienestar psicológico y físico percibidos por el paciente, y que parece ser, también, un importante predictor de enfermedad. Objetivo: Analizar si el optimismo disposicional guarda relación con el número de ingresos hospitalarios que han presentado en el último año los enfermos renales crónicos estadio Vd en nuestros centros. Material y métodos: Se estudiaron 239 pacientes en hemodiálisis que fueron categorizados en dos grupos respecto a las variables ingresos /no ingresos hospitalarios en el último año y optimismo/pesimismo disposicional. Se utilizaron los siguientes cuestionarios y variables: 1) O/P disposicional mediante el LOT-R de Scheier (1994) en su versión española: a mayor puntuación, mayor grado de optimismo disposicional. 2) Calidad de vida relacionada con la salud (CVRS) mediante las láminas COOP/WONCA: a mayor puntuación peor calidad de vida referida. 3) Índice de comorbilidad de Charlson (ICM). 4) Edad, tiempo en HD y sexo. Resultados: La edad media fue de 64,8 ± 14,3 años; la mediana de tiempo en hemodiálisis de 2,9 años (rango: 0-32), y la mediana en el LOT-R 21 (rango: 6-30). Los pacientes optimistas (OD) presentaban un menor riesgo de ser ingresados que los pesimistas (PD) (OR: 0,55; IC 95%: 0,32-0,94; p <0,05) y los pacientes con ingresos hospitalarios mostraron una puntuación en el LOT-R significativamente menor que los que no ingresaron (19,4 ± 5,7 frente a 22,3 ± 4,6; p = 0,001). No se encontraron diferencias significativas en cuanto a edad, tiempo en hemodiálisis, e índice de comorbilidad de Charlson entre los pacientes que ingresaron y los que no ingresaron. Los pacientes que ingresaron mostraban peor calidad de vida relacionada con la salud que los pacientes que no ingresaron (CW total: 22,37 frente a 19,42; p <0,001). Los pacientes PD puntuaban significativamente m, Introduction: Dispositional optimism is a personality trait significantly associated with the use of positive adaptive coping strategies as well as with perceived psychological and physical well-being, and it appears to be an important predictor of illness. Objectives: To analyse if dispositional optimism is significantly associated with the number of hospital admissions of our chronic haemodialysis patients, as well as its relationship with perceived state of health. Methods: We studied 239 patients on chronic haemodialysis. Patients were categorised into two groups according to the variables: hospital admissions/no. of admissions in the last year and dispositional optimism (DO). We used the following variables and questionnaires: 1) Dispositional O/P using the Spanish-validated cross-cultural adaptation of the revised version of the Life Orientation Test (LOT-R) (Scheier, 1994): higher scores mean a higher degree of dispositional optimism. 2) Health-related quality of life (HRQoL) using the different aspects of the COOP/WONCA (CW) charts and its total score. In this case higher scores mean lower HRQoL. 3) Modified Charlson Comorbidity Index (mCCI). 4) Age, gender, and time on dialysis. Results: Mean age was 64.8±14.3 years; median time on dialysis 2.9 years (range: 0-32); and median LOT-R 21 (range 6-30). Patients considered DO had a lower risk of hospital admissions than pessimists (DP) (OR: 0.55; IC 95%: 0.32-0.94; P<.05). PD Patients that were admitted in the last year showed a significantly lower score on LOT-R (they were more pessimistic) than those that had no hospital admissions (19.4±5.7 vs 22.3±4.6; P=.001). We found no significant differences between admitted and not admitted patients in age, gender, time on haemodialysis and comorbidity. Admitted patients showed worse HRQoL (higher scores in total CW) than those that were not (Total CW: 22.37 vs 19.42; P<.001). PD patients had significantly higher scores than OD patients in all COOP-WONCA aspects except

Introducción: El optimismo disposicional es un rasgo de personalidad que se relaciona significativamente con el empleo de estrategias positivas de afrontamiento y con el grado de bienestar psicológico y físico percibidos por el paciente, y que parece ser, también, un importante predictor de enfermedad. Objetivo: Analizar si el optimismo disposicional guarda relación con el número de ingresos hospitalarios que han presentado en el último año los enfermos renales crónicos estadio Vd en nuestros centros. Material y métodos: Se estudiaron 239 pacientes en hemodiálisis que fueron categorizados en dos grupos respecto a las variables ingresos /no ingresos hospitalarios en el último año y optimismo/pesimismo disposicional. Se utilizaron los siguientes cuestionarios y variables: 1) O/P disposicional mediante el LOT-R de Scheier (1994) en su versión española: a mayor puntuación, mayor grado de optimismo disposicional. 2) Calidad de vida relacionada con la salud (CVRS) mediante las láminas COOP/WONCA: a mayor puntuación peor calidad de vida referida. 3) Índice de comorbilidad de Charlson (ICM). 4) Edad, tiempo en HD y sexo. Resultados: La edad media fue de 64,8 ± 14,3 años; la mediana de tiempo en hemodiálisis de 2,9 años (rango: 0-32), y la mediana en el LOT-R 21 (rango: 6-30). Los pacientes optimistas (OD) presentaban un menor riesgo de ser ingresados que los pesimistas (PD) (OR: 0,55; IC 95%: 0,32-0,94; p <0,05) y los pacientes con ingresos hospitalarios mostraron una puntuación en el LOT-R significativamente menor que los que no ingresaron (19,4 ± 5,7 frente a 22,3 ± 4,6; p = 0,001). No se encontraron diferencias significativas en cuanto a edad, tiempo en hemodiálisis, e índice de comorbilidad de Charlson entre los pacientes que ingresaron y los que no ingresaron. Los pacientes que ingresaron mostraban peor calidad de vida relacionada con la salud que los pacientes que no ingresaron (CW total: 22,37 frente a 19,42; p <0,001). Los pacientes PD puntuaban significativamente m, Introduction: Dispositional optimism is a personality trait significantly associated with the use of positive adaptive coping strategies as well as with perceived psychological and physical well-being, and it appears to be an important predictor of illness. Objectives: To analyse if dispositional optimism is significantly associated with the number of hospital admissions of our chronic haemodialysis patients, as well as its relationship with perceived state of health. Methods: We studied 239 patients on chronic haemodialysis. Patients were categorised into two groups according to the variables: hospital admissions/no. of admissions in the last year and dispositional optimism (DO). We used the following variables and questionnaires: 1) Dispositional O/P using the Spanish-validated cross-cultural adaptation of the revised version of the Life Orientation Test (LOT-R) (Scheier, 1994): higher scores mean a higher degree of dispositional optimism. 2) Health-related quality of life (HRQoL) using the different aspects of the COOP/WONCA (CW) charts and its total score. In this case higher scores mean lower HRQoL. 3) Modified Charlson Comorbidity Index (mCCI). 4) Age, gender, and time on dialysis. Results: Mean age was 64.8±14.3 years; median time on dialysis 2.9 years (range: 0-32); and median LOT-R 21 (range 6-30). Patients considered DO had a lower risk of hospital admissions than pessimists (DP) (OR: 0.55; IC 95%: 0.32-0.94; P<.05). PD Patients that were admitted in the last year showed a significantly lower score on LOT-R (they were more pessimistic) than those that had no hospital admissions (19.4±5.7 vs 22.3±4.6; P=.001). We found no significant differences between admitted and not admitted patients in age, gender, time on haemodialysis and comorbidity. Admitted patients showed worse HRQoL (higher scores in total CW) than those that were not (Total CW: 22.37 vs 19.42; P<.001). PD patients had significantly higher scores than OD patients in all COOP-WONCA aspects except

Background: A significant percentage of patients on hemodialysis (HD) present with affective disorders such as anxiety and/or depression. The purpose of this study was to explore adaptive mixed affective disorders of patients on HD and to analyze the clinical value of a brief health-related quality-of-life (HRQoL) instrument, the COOP-WONCA charts, in our population of HD patient. Methods: Seventy-five patients (mean age 49.2 years; range 20.1-64.9), who had been on HD for a mean 110 months (range 6.1-364.5 months) were studied. The Beck Depression Inventory (BDI), Hamilton Scale of Depression (HDRS) and Hamilton Scale of Anxiety (HARS) were used. To evaluate patient HRQoL, we used the validated Spanish version of the COOPWONCA charts. Results: Of the 75 patients studied, 44.0% (BDI) and 53.4% (HDRS) had some depressive symptoms which were moderatesevere in 14.7% (BDI) and in 22.7% (HDRS). Anxiety symptoms were observed in 46.6% of the patients (13.3% were of moderate- severe degree). There was a high level of association between both depression scales (BDI and HDRS) (r=0.70; p<0.001), as well as between both scales and the HARS (HDRS, r=0.82; p<0.001; BDI, r=0.53; p<0.001). The most affected dimensions of the COOP-WONCA charts were “Physical fitness” and “Overall health,” whereas the least affected were “Social activities” and “Daily activities.” The global score of the COOP-WONCA charts was associated with the presence of depressive (BDI, r=0.64, and HDRS, r=0.75; p<0.001) and anxiety symptoms (HARS, r=0.52; p<0.001). A score of ≥3 corresponding to the dimension “Feelings” on the COOP-WONCA charts allowed the detection of 81.8% of the patients with clinically significant depressive symptoms (BDI >18), with a sensitivity of 96.8% and a specificity of 75% for this cutoff point. Conclusions: A high percentage of patients on HD present with mixed emotional disorders (anxiety and/or depression); a good correlation is observed between HRQoL and the levels of anxiety and

Background: A significant percentage of patients on hemodialysis (HD) present with affective disorders such as anxiety and/or depression. The purpose of this study was to explore adaptive mixed affective disorders of patients on HD and to analyze the clinical value of a brief health-related quality-of-life (HRQoL) instrument, the COOP-WONCA charts, in our population of HD patient. Methods: Seventy-five patients (mean age 49.2 years; range 20.1-64.9), who had been on HD for a mean 110 months (range 6.1-364.5 months) were studied. The Beck Depression Inventory (BDI), Hamilton Scale of Depression (HDRS) and Hamilton Scale of Anxiety (HARS) were used. To evaluate patient HRQoL, we used the validated Spanish version of the COOPWONCA charts. Results: Of the 75 patients studied, 44.0% (BDI) and 53.4% (HDRS) had some depressive symptoms which were moderatesevere in 14.7% (BDI) and in 22.7% (HDRS). Anxiety symptoms were observed in 46.6% of the patients (13.3% were of moderate- severe degree). There was a high level of association between both depression scales (BDI and HDRS) (r=0.70; p<0.001), as well as between both scales and the HARS (HDRS, r=0.82; p<0.001; BDI, r=0.53; p<0.001). The most affected dimensions of the COOP-WONCA charts were “Physical fitness” and “Overall health,” whereas the least affected were “Social activities” and “Daily activities.” The global score of the COOP-WONCA charts was associated with the presence of depressive (BDI, r=0.64, and HDRS, r=0.75; p<0.001) and anxiety symptoms (HARS, r=0.52; p<0.001). A score of ≥3 corresponding to the dimension “Feelings” on the COOP-WONCA charts allowed the detection of 81.8% of the patients with clinically significant depressive symptoms (BDI >18), with a sensitivity of 96.8% and a specificity of 75% for this cutoff point. Conclusions: A high percentage of patients on HD present with mixed emotional disorders (anxiety and/or depression); a good correlation is observed between HRQoL and the levels of anxiety and