SUN-070 The effects of social support on health-related quality-of-life in peritoneal dialysis patients

Abstract

Aged multi-morbid end-stage renal disease (ESRD) patients requiring dialysis increased rapidly in Taiwan and they often chose more hemodialysis (HD) than peritoneal dialysis (PD). Although PD patients had better health-related quality of life (HRQoL) in literature, to explore the factors to influence detailed physical component summaries (PCS) and mental component summaries (MCS) is essential for healthcare provider to achieve comprehensive ESRD care. A cross-sectional study was conducted for maintenance HD and PD patients in one medical center and five regional hospitals, using two inistruments of SF-12 and kidney disease component summary (KDCS) in KDQOL-SF during June 2013 to November 2014. While SF-12 collected HRQoL information, KDCS collected information related to burden of kidney disease, symptoms/problems of kidney disease, effects of kidney disease, and social support. Two aspects of HRQoL was measured, i.e., MCS and PCS. PD patients were approached during their monthly follow-up outpatient consultation, and HD patients were approached during their regular in-centre therapies, generally three times a week. A multiple regression was employed to examine the effects of dialysis modality, satisfaction with social support, and the interaction of dialysis modality and satisfaction with social support. The covariates interaction measured the difference in HRQoL between dissatisfaction patients in the two modalities (PD vs.HD). The enrolled 646 patients (443 HD vs. 203 PD) were 367 males (56.8%) and PD patients are younger, more satisfied with family and friend companion time, with lower comorbidities (>2) and dialysis vintages (> 4 years) than HD patients. No difference in HRQoL between paients in PD vs. HD patients. Furthermore, for patients dissatisfied with social support, the scores of MCS in HRQoL were significantly lower than those of satisfied ones. However, for patients dissatisfied with social support, the PD patients significantly had the lower scores of MCS in HRQoL than HD ones. The results of this study not only reveal the important contribution of social support to the HRQoL of dialysis patients but also demonstrate the critical role of social support for patients in therapy required considerable self-care. PD patients requires considerable self-care and might need assistances from family or friends. When PD patients could not obtain adequate assistances, they might be dissatisfied with their social support, which could in turn result in lower HRQoL. On the contrary, for those HD patients who were not satisfied with their social supports, their HRQoL might not be affected considerably since most of their dialysis care was performed by medical professionals. Therefore, HD patients could still enjoy better HRQoL than PD patients given that both groups of patients dissatisfied with their social supports. Policymakers and healthcare providers should pay close attention to the social support of dialysis patients since it can play a major role on their HRQoL. Future studies can further investigate the effects of the social support from medical professionals on HRQoL of dialysis patients. Moreover, further investigations on the contributions of different dimensions of social supports, i.e., emotional, appraisal, are warranted.