Relationships of social support and attitudes towards death: A mediator role of depression in older patients on haemodialysis.

Convenience sample from only two teaching hospitals, so results may not apply to other dialysis populations or settings. Only older patients who were clear-minded and able to communicate were included, so patients with severe cognitive problems, acute illness, or shorter life expectancy were not represented. The design was cross-sectional, so it cannot show that social support caused lower depression or that depression caused better death attitudes. Measures were self-report, and the authors note that death attitudes are culturally sensitive in Chinese populations, with many neutral answers. The study did not test an intervention, so it cannot show that adding social support or starting death conversations improves outcomes.

The authors declared no conflicts of interest.

Do not conclude that increasing social support will reduce depression or improve attitudes about death. This was a cross-sectional survey, so it shows associations and a statistical mediation model, not that an intervention works.