Abstract
BackgroundBoth diabetes and hemodialysis can seriously impair patients’ health related quality of life (HRQOL). This study seeks to obtain data which will help to address the factors associated with impaired HRQOL in hemodialysis patients with diabetes in Palestine.MethodsA cross-sectional study was performed in multiple centers in the period from November 2016 to June 2017. We utilized the Arabic version of EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) scale and EuroQol-visual analogue scale (EQ-VAS) to measure patients’ HRQOL. The study was conducted in six dialysis centers in the North of West Bank, Palestine. Descriptive and comparative statistics were used to describe clinical and socio-demographic features of patients. Multiple linear regression analysis was used to determine the association between clinical and socio-demographic factors and HRQOL score.ResultsOne hundred and forty one diabetic patients undergoing hemodialysis were enrolled in our study. Overall, 52.5% of them (74 patients) were males; the patients had a mean age of 60.32 with 52.5% of them aged below 60. The mean ± standard deviation of EQ-5D-5L index and EQ-VAS score was 0.314 ± 0.4 and 50.85±22.43, respectively. The findings of this study suggest that female patients, uneducated patients, unemployed patients, unmarried patients, and patients with more chronic diseases and comorbidities had a significant poor HRQOL scores (p values <0.05). Variables such as marital status and occupational status were significantly (p < 0.05) associated with the QOL score. More specifically, married status and employed patients positively associated with QOL score (β = 0.22; p = 0.016 and β = 0.27; p = 0.013, respectively).ConclusionsAmong diabetic patients undergoing hemodialysis, married status and being employed were associated with modestly higher scores of QOL. We recommend that healthcare providers give more attention to diabetic dialysis patients who are unemployed and unmarried, as they are at a higher risk of having impaired HRQOL.
Highlights
Both diabetes and hemodialysis can seriously impair patients’ health related quality of life (HRQOL)
Socio-demographic and clinical features A total of 141 diabetic patients undergoing hemodialysis participated in this cross sectional study out of 150 recruited, giving a response rate of 94%
HRQOL was assessed in diabetic patients using the EQ-5D in various nations [2, 6, 26,27,28,29,30]; this scale was used to measure HRQOL among patients undergoing hemodialysis [19, 31,32,33], but our study is the first of its kind to use the EQ-5D to assess HRQOL among diabetic dialysis patients
Summary
Both diabetes and hemodialysis can seriously impair patients’ health related quality of life (HRQOL). Type II diabetes mellitus (DM) is a major long-standing metabolic disorder causing a remarkable load on patients and their community in terms of mortality and morbidity [1]. It causes serious short-term and long-term complications; in the long term, it can lead to microvascular complications (e.g. nephropathy) and macrovascular complications (e.g. myocardial infarction) [2]. Diabetic nephropathy, which occurs in about one third of type 2 diabetic patients, is the most common factor leading to end-stage renal disease (ESRD). The substantial increase in hemodialysis patients with DM is prone to rise even more as the population is getting older, the incidence of obesity is rising, and more people are surviving their cardiovascular incidents [5].
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