Quality of Life and End Stage Renal Disease Therapeutic Programs

Abstract

Because patients with ESRD cannot be cured of their underlying conditions and because the therapeutic programs have an important impact on the patients' life style, the patient's own assessment of health should have a central place in clinical care. Until now, attention has almost exclusively focused on technical and clinical outcomes, and survival. Functional status, well-being and quality of life, satisfaction with care, or in other words "patient's experience", have been only marginally considered. There is a growing recognition that use of mortality data alone is not the most effective way to asses the quality of care provided to these patients. Generic and disease-specific health issues can be investigated with the use of questionnaires, by asking questions that cover physical, psychological and social domains. Health related quality of life data regarding chronic renal failure, dialysis and transplantation are briefly presented and discussed. These data show differences between patient's subjective feelings and physician's opinions about patients, between objective quality of life indexes and subjective quality of life scores. A more comprehensive view of our patients seems possible and useful.