Program Directors
 

Supervisor: Dr. Istvan Mucsi
Award: KRESCENT Summer Studentship
Institution: University Health Network
Year: 2025

Project Title: Attachment style and symptom burden in adults with kidney failure: A multi-centre, cross-sectional study

Biography:
Devron Swaby is an Honours Life Sciences student at McMaster University, entering his final year in Fall 2025. He is a Clinical Research and Project Assistant at the University Health Network with the Kidney Health Education and Research Group, supervised by Dr. Istvan Mucsi. His research focuses on psychosocial factors and racial disparities in chronic kidney disease and transplantation, with an emphasis on promoting health equity for African, Caribbean, and Black (ACB) communities. Devron also engages in community-based programming and research to understand and address systemic barriers faced by Black, neurodivergent, racialized, newcomer, and other marginalized youth in systems including education and employment. He is deeply committed to advancing equity and justice for marginalized communities through community-centred research and advocacy. 

Lay Summary:
Background: People living with chronic kidney disease, especially those with kidney failure, often experience many challenging mental and physical symptoms. This “symptom burden” can negatively impact their quality of life and increase their risk of hospitalization and even death. One factor that may play a role in how patients experience symptoms is their attachment style, that is, how a person typically thinks, feels, and behaves in close relationships, often shaped by early life experiences and triggered by threatening experiences such as chronic illness. Research shows that insecure attachment (high attachment anxiety and/or attachment avoidance in relationships) may be linked to worse health outcomes. However, very little research has explored the impact of attachment styles on people with chronic kidney disease.
Purpose: This study aims to examine how attachment style is related to the symptom burden experienced by adults with kidney failure.
Methods: We will conduct a cross-sectional analysis using data from approximately 215 adults with kidney failure treated at four hospitals in Toronto, Canada. Self-reported questionnaires that have been proven to accurately and consistently capture information were used to gather data on patients’ attachment style, symptom burden and sociodemographic factors, while clinical data were extracted from patients’ medical records. The Experiences in Close Relationships Scale - Short Form (ECR-SF) was used to assess attachment style. The Edmonton Symptom Assessment System Revised (ESAS-r) was used to measure symptom burden. We will use statistical models to determine whether attachment style is associated with symptom burden, while considering sociodemographic and clinical factors that may play a role in this relationship.
Anticipated Outcomes: We expect that patients with more insecure attachment will experience higher symptom burden compared to patients with more secure attachment.
Relevance to Patients and Community: This study is important because more than 4 million Canadians are living with chronic kidney disease, and many report distressing symptoms that affect their daily lives. Despite this, we still have a limited understanding of the psychological and social factors that may influence these symptoms or how to manage them. Patients and caregivers continue to identify symptom burden as a top priority. By identifying how attachment style may influence symptoms, our study can help inform more personalized and supportive approaches to care for this large and growing patient population.
Conclusion: This study will provide further evidence for the development of personalized, whole-person approaches to kidney care. Including designing future psychosocial therapies for patients with chronic kidney disease to improve their quality of life and health outcomes.