Related Experiment Video
Updated: Sep 3, 2025
Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
Published on: December 6, 2024
Validation of Two Screening Tools for Anxiety in Hemodialysis Patients
Els Nadort1,2, Noëlle J K van Geenen1, Robbert W Schouten3
1Department of Psychiatry, OLVG Hospital, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands.
Background:
Symptoms of anxiety are often unrecognized and untreated in dialysis patients. We investigated the diagnostic accuracy of two widely used screening tools for anxiety in hemodialysis patients.
Methods:
For this cross-sectional validation study, chronic hemodialysis patients from eight dialysis centers in the Netherlands were included. The Beck Anxiety Inventory (BAI) and Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) were validated by the Mini International Neuropsychiatric Inventory (MINI) diagnostic interview. Receiver operating characteristic curves were used to determine the optimal cut-off values.
Results:
Of 65 participants, 13 (20%) were diagnosed with one or more anxiety disorders on the MINI, of which 5 were included in the analysis. ROC curves showed a good diagnostic accuracy of the BAI and HADS-A. The optimal cut-off value for the BAI was ≥13 (sensitivity 100%, specificity 85%) and for the HADS-A was ≥10 (sensitivity 80%, specificity 100%).
Conclusions:
Based on our limited data, both the BAI and the HADS-A seem to be valid screening instruments for anxiety in hemodialysis patients that can be used in routine dialysis care. The HADS-A consists of fewer items and showed fewer false-positive results than the BAI, which might make it more useful in clinical practice.
Related Concept Videos
01:25Hemodialysis III: Nursing Management
01:18Anxiety: Overview
Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.
01:24Hemodialysis II: Procedure and Complications
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:18Chronic Kidney Disease IV: Nursing Management
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.