Predicting anxiety, depression and emotional distress in Spanish people with advanced chronic kidney disease: The role of resilience, social support, coping strategies, and illness threat perception

Individuals with advanced chronic kidney disease experience significant psychological distress due to disease progression and treatment. This study explored the predictive roles of resilience, social support, coping strategies, and illness threat perception on depression, anxiety, and emotional distress. A cross-sectional design was used with 106 Spanish participants aged 38-88 (M = 68.64, SD = 10.55). Measures included the Hospital Anxiety and Depression Scale, the Connor-Davidson Resilience Scale, the Medical Outcomes Study Social Support Survey, the Brief COPE, and the Brief Illness Perception Questionnaire. Analyses involved Pearson correlations, hierarchical regressions, and fuzzy-set Qualitative Comparative Analysis. Regressions identified social support, coping, and illness perception as key predictors. Qualitative Comparative Analysis showed that low resilience, low support, and high threat perception combinations were linked to greater distress, while the inverse predicted better outcomes. Findings highlight the importance of targeting resilience, support networks, and threat appraisal in interventions for advanced kidney disease.