Associations among perceived negative consequences, perceived deterioration in well-being, fear of progression, and probable depression in Chinese adults with chronic kidney disease: a cross-sectional path analysis

Introduction Individuals with chronic kidney disease (CKD) are vulnerable to probable depression. Perceived negative consequences (PNC) of CKD, perceived deterioration in well-being (PDW), and fear of progression (FoP) are commonly experienced in this population. This cross-sectional study examined the associations among PNC, PDW, FoP, and probable depression. It also tested the indirect associations of PNC and PDW with probable depression through FoP. Additionally, gender differences in these direct and indirect pathways were explored. Methods In this cross-sectional study, a total of 456 Chinese CKD patients were recruited using convenience sampling. Participants completed standardized self-report questionnaires at a single time point. Path analysis and multi-group analysis by gender were conducted using Mplus 8.3. Results The prevalence of probable depression was 37.3%. PDW, PNC, and FoP were positively and significantly associated with probable depression. Significant indirect associations of both PDW and PNC with probable depression through FoP were observed. Significant gender differences were found in the PDW → FoP, PNC → FoP, and PDW → probable depression associations, as well as in the indirect associations of both PDW and PNC with probable depression through FoP. All these associations were stronger among females than males. No significant gender differences were observed in the FoP → probable depression or PNC → probable depression associations. Conclusion Higher levels of PNC, PDW, and FoP were associated with a greater likelihood of probable depression among individuals with CKD. The significant indirect associations through FoP were consistent with its potential explanatory role in the proposed model. Longitudinal and intervention studies are needed to determine whether addressing illness appraisals or FoP can improve psychological well-being in this population.