Analysis of the influencing factors of life quality in patients undergoing maintaining hemodialysis

Abstract

To determine the influencing factors and life quality of patients undergoing maintaining hemodialysis (MHD). One hundred and two MHD patients in hemodialysis center were enrolled, and a questionnaire investigation using KDQOL-SF(TM) 1.3 was employed. This questionnaire was disease-specific for chronic kidney disease. The object was to evaluate the quality of life, in relation with the patients' kidney disease and dialysis (KDTA) and the patients' general health (SF-36), and to analyze the influencing factors. Among the influencing factors revealed in questionnaire investigation, the items such as encouragement from medical staff, social support, symptoms, cognitive function, quality of social relationship and satisfaction degree of patients won higher scores, while the items such as sex function, difficulties in daily activity due to kidney disease, expectation of general health and self-evaluation of health won lower scores. Among the influencing factors, the scores of physical functions and body pain were much lower in female than male patients (63.52±17.96 vs. 71.65±18.66, 64.33±21.23 vs. 76.58±19.20, both P<0.05). Patients of age>60 won higher scores than patients of age≤40 and 40-60 in respect to work condition and sex function (61.98±13.63 vs. 52.27±7.54 and 55.23±19.97, 68.33±4.04 vs. 5.45±9.34 and 15.81±26.92, all P<0.05); patients of 60 years old or older won higher scores in respect of satisfaction degree of patients but lower scores in respect of physical functions. Among primary diseases, only patients with diabetes won much encouragement from medical staff (93.57±11.29). Patients whose serum albumin was lower than 3.5 g/L won much lower scores than those with serum albumin higher than 3.5 g/L in respect of scoring of KDTA, influence to daily life due to kidney disease, cognitive function, physical functions, expectation of general health, and scores obtained previously (53.62±8.87 vs. 61.26±9.42, 44.58±12.52 vs. 57.47±17.15, 65.56±20.60 vs. 78.18±15.73, 54.38±19.73 vs. 68.87±17.57, 31.11±10.23 vs. 41.19±66.27, 44.44±27.06 vs. 68.57±26.94, all P<0.05). Patients who had undergone hemodialysis for longer than 6 years won higher scores in respect to symptoms, body pain, vigour and expectation of general health (86.92±6.67, 85.08±57.34, 78.40±13.04, 53.33±24.22, respectively), while patients who had hemodialysis for as long as 3 to 6 years won highest scores in respect to social support (94.23±10.96, all P<0.05). The level of hemoglobin and urea clearance index showed no obvious influence to MHD patients' daily life. MHD patients have poor self-confidence and they usually lose self-confidence. Nutritional status greatly influences patients' daily life. So it is important to improve the quality of daily life in MHD patients, especially in respect of nutritional support, and this aspect should form our focus of medical support.