The impact of illness perception on the quality of life in initial peritoneal dialysis patients: the mediating role of activation, depression and medication adherence

Patients who suffering the initial period of dialysis were prone to heavy physical and psychological burden, which ultimately impacting the quality of life of peritoneal dialysis (PD) patients. This study aimed to clarify the mediating relationships between illness perception and quality of life in initial peritoneal dialysis patients. This study was a cross-sectional survey. Two hundred and one initial peritoneal dialysis patients were included, which from three hospitals in Guangdong Province from January 2022 to December 2023. Structural equation modeling with bootstrapping was adjusted for the exploring the pathway between the illness perception and quality of life. It was demonstrated that illness perception (<i>r</i> = -0.645, <i>p</i> < 0.01), patient activation (<i>r</i> = 0.284, <i>p</i> < 0.05), depression (<i>r</i> = -0.693, <i>p</i> < 0.01) and medication adherence (<i>r</i> = 0.266, <i>p</i> < 0.01) were closely correlated with quality of life in PD patient, respectively. The structural equation model results showed good model fit that CMIN/DF = 1.310, RMSEA = 0.039, GFI = 0.991, AGFI = 0.955, CFI = 0.997, NFI = 0.989, TLI = 0.990. The path results showed that the total direct effect of illness perception on quality of life was -0.429, accounting for 59.83% of the total effect. Patient activation and depression played chain mediating roles in the path between illness perception and quality of life, with an effect size of -0.288, accounting for 40.17% of the total effect. But medication adherence did not demonstrate significant mediation effects. The patient activation and depression were the mediating variables between illness perception and quality of life in initial peritoneal dialysis patients. Enhancing patients' illness perception so that pushing the patient activation levels and alleviating depression symptoms which will improve quality of life in initial peritoneal dialysis patients.