Positive affect and mortality in patients undergoing maintenance haemodialysis: A 4‐year longitudinal study

BACKGROUND: Patients undergoing maintenance haemodialysis (MHD) are vulnerable to elevated mortality risk. The literature has predominantly focused on the link between psychological symptoms (e.g., depression) and mortality risk. However, whether positive psychological constructs, such as positive affect, could play a protective role for survival has yet to be examined among patients undergoing MHD. PURPOSE: To examine the association between positive affect and mortality risk in patients undergoing MHD. METHODS: A total of 160 patients were recruited from a haemodialysis centre in Shanghai, China. After the baseline survey in 2017, patients were re-surveyed annually until July 2021. The study outcome was overall survival by the end of July 2021. Positive and negative affect were assessed by the Positive and Negative Affect Schedule (PANAS). Time-varying Cox proportional hazards models were employed to examine the crude and adjusted association between positive affect and mortality risk. RESULTS: The sample was followed up for an average duration of 3.30 years (SD = 1.20). Forty-two patients (26.3%) died during the follow-up period. After adjustment for socio-demographic characteristics, comorbidities, physical functioning and negative affect, a 1-unit increase in positive affect score was associated with a 5% reduction in mortality risk (hazard ratio = .95, 95% CI = .91-.99, p = .011). CONCLUSIONS: This study indicated that positive affect was associated with improved survival in patients undergoing MHD. It suggests that interventions targeting the enhancement of positive affect may benefit patients and lead to a better prognosis.