{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:15:22Z","timestamp":1788448522389,"version":"build-2803163510"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psychological disorders such as anxiety and depression are common but often underrecognized among patients with chronic kidney disease (CKD), posing challenges for inpatient nursing care. This study aimed to identify key risk factors and develop predictive models to assist clinical nurses in early psychological risk identification and intervention planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross-sectional study for model development included 1,420 adult inpatients with CKD stages 1\u20135 admitted to a tertiary hospital in Southwest China from March 2023 to March 2025. Anxiety and depression were assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7) and Patient Health Questionnaire 9-item scale (PHQ-9) within 48 hours of admission. Nursing-relevant demographic, clinical, and psychosocial data were extracted from electronic health records. Multivariate logistic regression was used to identify predictors. Two nomograms were developed, and model performance was assessed via ROC curves, calibration plots, and 1,000 bootstrap validations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Screening-positive anxiety and depressive symptoms (GAD-7\/PHQ-9 \u22655) were observed in 33.2% and 35.8% of patients, respectively. Significant predictors of anxiety included younger age, female sex, low income, frequent hospitalizations, hypoalbuminemia, sleep disturbance, diabetes, and absence of family accompaniment. Similar predictors were found for depression, along with low education and dialysis status. Both models demonstrated strong discrimination (AUC\u00a0=\u00a00.830 for anxiety; 0.829 for depression) and good calibration. The nomograms allow bedside nurses to estimate psychological risk using routinely available data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anxiety and depression are highly prevalent among hospitalized CKD patients in Southwest China and are associated with modifiable psychosocial and clinical factors. The validated nursing-oriented prediction models offer practical tools to support early risk stratification and targeted psychological care planning in nephrology nursing practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1683467","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:29:10Z","timestamp":1768458550000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Development and validation of nursing-oriented risk prediction models for anxiety and depression in hospitalized patients with chronic kidney disease: a retrospective cross-sectional study in Southwest China"],"prefix":"10.3389","volume":"16","author":[{"given":"Hong","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Nephrology, The Affiliated Hospital, Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Affiliated Hospital, Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongzhi","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Affiliated Hospital, Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology, The Affiliated Hospital, Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaolan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Affiliated Hospital, Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","article-title":"Epidemiology of chronic kidney disease: an update 2022","volume":"12","author":"Kovesdy","year":"2022","journal-title":"Kidney Int Suppl (2011)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-024-02194-1","article-title":"Depression and anxiety in people with kidney disease: understanding symptom variability, patient experience and preferences for mental health support","volume":"38","author":"Chilcot","year":"2025","journal-title":"J Nephrol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12882-023-03447-0","article-title":"Effect of psychosocial interventions for depression in adults with chronic kidney disease: a systematic review and meta-analysis","volume":"25","author":"Yang","year":"2024","journal-title":"BMC Nephrol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0282789","article-title":"In-hospital stress and patient outcomes: A systematic review and meta-analysis","volume":"18","author":"Ford","year":"2023","journal-title":"PloS One"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1590\/1980-220X-REEUSP-2022-0457en","article-title":"Experience of hospitalization of the family with children and adolescents in psychological distress","volume":"57","author":"Barbosa","year":"2023","journal-title":"Rev Esc Enferm USP"},{"key":"B6","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s12912-025-02829-z","article-title":"The impact of nurse-led care in chronic kidney disease management: a systematic review and meta-analysis","volume":"24","author":"Arooj","year":"2025","journal-title":"BMC Nurs"},{"key":"B7","first-page":"100600","article-title":"Analysis of risk factors for depression in peritoneal dialysis patients and establishment of a risk nomogram model","volume-title":"Clinics (Sao Paulo)","author":"Yang","year":"2025"},{"key":"B8","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1111\/jorc.12489","article-title":"The identification and management of depression in UK Kidney Care: Results from the Mood Maps Study","volume":"50","author":"Chilcot","year":"2024","journal-title":"J Ren Care"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_355_24","article-title":"Prevalence of anxiety and depression among end-stage kidney disease patients on dialysis: A cross-sectional multiple-centre study in Riyadh, Saudi Arabia","volume":"13","author":"AlShammari","year":"2024","journal-title":"J Family Med Prim Care"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000040952","article-title":"Advancements in the application of precision nursing model on hemodialysis for diabetic nephropathy: A review","volume":"103","author":"Ma","year":"2024","journal-title":"Med (Baltimore)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s41043-025-00890-7","article-title":"Development and validation of a nomogram for predicting depression risk in patients with chronic kidney disease based on NHANES 2005-2018","volume":"44","author":"Yan","year":"2025","journal-title":"J Health Popul Nutr"},{"key":"B12","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.jad.2025.04.139","article-title":"Development and validation of a predictive model for depression in patients with advanced stage of cardiovascular-kidney-metabolic syndrome","volume":"383","author":"Zha","year":"2025","journal-title":"J Affect Disord"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S456499","article-title":"Development and validation of a nomogram model for accurately predicting depression in maintenance hemodialysis patients: A multicenter cross-sectional study in China","volume":"17","author":"Zhou","year":"2024","journal-title":"Risk Manag Healthc Policy"},{"key":"B14","doi-asserted-by":"publisher","first-page":"12159","DOI":"10.1038\/s41598-022-15906-z","article-title":"Depression is a main determinant of health-related quality of life in patients with diabetic kidney disease","volume":"12","author":"Kim","year":"2022","journal-title":"Sci Rep"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000035812","article-title":"Association of anxiety, depression symptoms and sleep quality with chronic kidney disease among older Chinese","volume":"102","author":"Huang","year":"2023","journal-title":"Med (Baltimore)"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1080\/07317115.2023.2236097","article-title":"Family support during hospitalization buffers depressive symptoms among independent older adults","volume":"47","author":"Shulyaev","year":"2024","journal-title":"Clin Gerontol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2024.154829","article-title":"Family-centered interventions and patient outcomes in the adult intensive care unit: A systematic review of randomized controlled trials","volume":"83","author":"Duong","year":"2024","journal-title":"J Crit Care"},{"key":"B18","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.neures.2023.04.006","article-title":"Bidirectional relationship between sleep and depression","volume":"211","author":"Yasugaki","year":"2025","journal-title":"Neurosci Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/nu14204297","article-title":"Evolving concepts on inflammatory biomarkers and malnutrition in chronic kidney disease","volume":"14","author":"Graterol Torres","year":"2022","journal-title":"Nutrients"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1423200","article-title":"Systemic immune inflammation index is a valuable marker for predicting hemodialysis patients with depression: a cross-sectional study","volume":"15","author":"Han","year":"2024","journal-title":"Front Psychiatry"},{"key":"B21","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1186\/s12875-024-02483-5","article-title":"Integrated behavioral health implementation and chronic disease management inequities: an exploratory study of statewide data","volume":"25","author":"Buchanan","year":"2024","journal-title":"BMC Prim Care"},{"key":"B22","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s12882-025-03983-x","article-title":"Associations between depressive and anxiety symptoms and incident kidney failure in patients with diabetic nephropathy","volume":"26","author":"Qin","year":"2025","journal-title":"BMC Nephrol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1075809","article-title":"Cortisol excess in chronic kidney disease - A review of changes and impact on mortality","volume":"13","author":"Sagmeister","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1453240","article-title":"Identification of independent risk factors for hypoalbuminemia in patients with CKD stages 3 and 4: the construction of a nomogram","volume":"11","author":"Wang","year":"2024","journal-title":"Front Nutr"},{"key":"B25","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12937-024-01047-8","article-title":"Lower prognostic nutritional index is associated with a greater decline in long-term kidney function in general population","volume":"23","author":"Park","year":"2024","journal-title":"Nutr J"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1683467\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:56:11Z","timestamp":1771916171000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1683467\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":25,"alternative-id":["10.3389\/fpsyt.2025.1683467"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1683467","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]},"article-number":"1683467"}}