Dialysis Staff Encouragement Research Articles

#2155 Evaluating the health-related quality of life of patients undergoing haemodialysis: highlights from a multicentric nationwide study

Abstract Background and Aims Haemodialysis (HD) represents the most common renal replacement therapy for end-stage renal disease worldwide. Despite recent advances in HD the health-related quality of life (HRQoL) should be monitored in conjunction with clinical variables to optimize a comprehensive treatment. Method From June to July 2022, all patients from 47 clinics were included. Among other key relevant clinical variables, HRQoL was assessed by using the Kidney Disease Quality of Life Short Form (KDQOL-SF™ 1.3).It`s generic part is summarised in the physical component summary (PCS) and mental component summary (MCS). The specific part evaluates 11 domains: symptom/problem list; effects of kidney disease on daily life; burden of kidney disease; work status; cognitive function; quality of social interactions; sexual function; sleep; social support; dialysis staff encouragement; and patient satisfaction. All scores range from 0 (worst) to 100 (best). To ensure comparability of results, mean ± SD values are outlined, even though non-parametric tests were used to test associations. Results A total of 3,595 patients (67.3% male) completed the KDQOL (out of 4259 HD patients treated during study period). Most of them (67.18%) were over 60yo of age, and 65.67% had a severe comorbidity index score. In addition, 50.54% had a native AV fistula and only 3.92% were incident HD. PCS scores reported were higher in over 75yo (47.68 ± 10.63) rather than normative population (40.16 ± 11.62), indicating an overall good physical function. However, MCS values (33.17 ± 9.36) were indicative of substantial impact. Gender differences were noted across almost all disease-specific and generic domains (all p < 0.05). Severe comorbidity scores were associated with lower scores in certain renal specific domains and MCS. Finally, incident HD patients reported lower satisfaction and poorer perceived overall health (p-values = 0.001). Conclusion Although PCS scores reported were reasonable, a remarkable impact on mental health was found. Moreover, a differential impact of patient's HRQoL was captured based on gender and other variables highlighting the need of individualised evaluation and management of HD patients.

The influence of mindfulness meditation combined with progressive muscle relaxation training on the clinical efficacy and quality of life of patients with sarcopenia receiving haemodialysis: a randomised controlled trial

ObjectiveTo study the effect of mindfulness meditation combined with progressive muscle relaxation training on the clinical efficacy and quality of life in patients with sarcopenia receiving maintenance haemodialysis (MHD).MethodsEligible patients with sarcopenia in our hospital were randomly assigned to a control group (n = 24) and an intervention group (n = 25). The control group received conventional dialysis treatment, while the intervention group underwent mindfulness meditation combined with progressive muscle relaxation training during the interdialysis period in addition to conventional dialysis treatment. The effect of the intervention was evaluated after 12 weeks.ResultsThere were no significant differences in the baseline values of various parameters between the two groups. Exercise capacity (sit-to-stand test,handgrip,time to 10 sit-ups) significantly improved in the intervention group after 12 weeks (32.68 ± 8.32 vs 26.50 ± 6.83; 37.42 ± 10.12 vs 28.12 ± 8.51; 19.8 ± 5.40 vs 25.29 ± 7.18) (p < 0.05). In terms of the kidney disease quality of life (KDQOLTM) score, all other dimensions except sexual function, social functioning, burden of kidney disease and work status dimensions showed significant improvement compared to the baseline (p < 0.05). In the control group, only the dialysis staff encouragement (DSE) and patient satisfaction (PS) dimensions showed slight improvements compared to the baseline (p > 0.05). When compared with the control group, the intervention group showed significant improvements in 10 dimensions of exercise capacity and KDQOLTM scores for physical function, role-physical, general health, energy, symptom/problem list, sleep, DSE, pain, cognitive function, emotional well-being and patient PS after 12 weeks (61.30 ± 5.38 vs 42.98 ± 5.73; 57.50 ± 3.55 vs 50.70 ± 3.62) (p < 0.05). Some inflammatory markers, such as the levels of interleukin-6 and high-sensitivity C-reactive protein (30.29 ± 2.96 vs 17.65 ± 3.22; 8.93 ± 0.99 vs 3.02 ± 0.34), showed a decrease during the intervention, while albumin and prealbumin levels were significantly increased compared with the baseline (30.62 ± 1.65 vs 35.60 ± 1.68; 0.32 ± 0.05 vs 0.44 ± 0.07) (p < 0.05).ConclusionCombined intervention training can improve the motor ability and quality of life of patients with sarcopenia within a short period of time.

A Prospective Observational Study to Assess Medication Adherence and Health Related Quality of Life in Chronic Kidney Disease Patients in a Tertiary Care Hospital

Chronic Kidney Disease(CKD) patients belong to the group of subjects with large burden of daily pill intake. Failure of adherence to these medications can lead to increased morbidity, mortality, cost, and burden on health care system. Therefore, good medication adherence is important to obtain desired therapeutic outcome which in turn improves the quality of life.&#x0D; The objective of this study is to assess medication adherence and health related quality of life in CKD patients.&#x0D; A prospective observational study was conducted for 6 months at Indiana Hospital and Heart Institute, Mangalore. Total 100 participants diagnosed with CKD were enrolled for the study. Permission from the Ethical Committee was taken and informed consent was obtained from the study subjects before initiating the study. Demographic, clinical and treatment details were collected in a specially designed data collection forms. Patient’s adherence to the medication was assessed with the help of Brief Medication Questionnaire (BMQ) and patient’s quality of life was assessed using Kidney Disease Quality of Life Short Form (KDQOL-SF). The data was expressed using descriptive statistics and analyzed using Chi square test, Mann Whitney test, and Spearman Correlation Statistics.&#x0D; Out of 100 patients enrolled in the study, 63 were male and 37 were female. The average number of medicines taken in a day by each patient was 10. 12% of the study population was completely adherent to the drug therapy. BMQ had 3 domains in which 39% of the patients were adherent and 61% were non adherent to the Regimen screen, 68% were adherent and 32% were non adherent to the Belief screen, and 31% were adherent and 69% were non adherent to the Recall screen. High cost of medicine (69%), Complex dosing schedule (68%), and Unaware about seriousness of condition or use of medicine (63%) were most common reasons for Non-adherence. Using KDQOL questionnaire, mean scores for Dialysis staff encouragement (96.25±9.31) and Quality of social interaction (87.86±17.48) were high whereas Physical role (4.75±16.92) and Emotional role (13.03±31.44) were found to be low.&#x0D; These results indicate that non adherence to medications leads to deteriorating quality of life and high therapeutic complexity.

Assessment of Health-Related Quality of Life in Chronic Kidney Disease Patients: A Hospital-Based Cross-Sectional Study.

Background: Health-related quality of life is rapidly becoming recognized as an important indicator of how a disease affects patient lives and for evaluating the quality of care, especially for chronic conditions such as chronic kidney disease (CKD). Objectives: This study is an attempt to assess the quality of life in patients with chronic kidney disease at MMIMSR and also identify characteristics that may be associated with their worsening quality of life. Materials and Methods: This cross-sectional investigation was conducted at the in-patient department (IPD) of the MMIMSR hospital. This study included 105 CKD patients and used a systematic random sampling method for quantitative analysis. This study utilized a 36-item short-form SF-36 (v1.3) questionnaire to assess HRQoL in CKD patients. Descriptive statistics were employed at the baseline. Chi square and ANOVA were used to draw comparisons between two groups or more than two groups, respectively. Logistic regression analysis was utilized to identify the potential QoL determinants. A p value of 0.05 or lower was used to determine statistical significance. Results: Among a total of 105 participants, the mean (±standard deviation) age was found to be 54.53 ± 13.47 years; 48 were male patients, and 57 were female patients. Diabetes Mellitus (61.9%), hypertension (56.2%), chronic glomerulonephritis (7.6%), chronic pyelonephritis (6.7%), and polycystic kidney disease (5.7%) were identified to be the most frequent disorders associated with CKD. The current study also demonstrated that the HRQoL score domains such as symptom problem list, the effect of kidney disease, and the burden of kidney disease decline significantly and progressively as the patient advances into higher stages of CKD (p = 0.005). A similar pattern was observed in work status, sleep, and general health (p < 0.005). Additionally, a statistically significant difference was noted for cognitive function, quality of social interaction, overall health, dialysis staff encouragement, patient satisfaction, social support, physical functioning, role of physical health, pain, emotional well-being, role of emotional health, social functioning, and energy fatigue (p < 0.005). The mean difference for PCS and MCS based on CKD stages was found to be statistically significant (p < 0.005). The PCS and MCS showed a positive correlation with GFR (r = 0.521), and Hb (r = 0.378), GFR (r = 0.836), and Hb (r = 0.488), respectively. Conclusions: The findings of this study demonstrated that a significant decrease in HRQoL was observed among CKD patients, with a progressive deterioration of HRQoL dimensions as the patient advances to end-stage renal disease. This study also revealed that CKD imposes various restrictions on patients' day-to-day lives, particularly in terms of their physical and mental functioning, even in the initial stages of the disease.

Assessment of Quality of Life Studies of Renal Failure patients in different cities of Punjab, Pakistan

Aim: To determine the quality of life (QOL) of renal failure patients on maintenance hemodialysis on the basis of their baseline characteristics in Lahore, Pakistan. Study design: A cross sectional study was carried out with two hundred and ten patients selected randomly from dialysis centers in General, Mayo and Jinnah hospitals, Lahore Pakistan, to measure and analyze the QOL of hemodialysis patients by pre-validated KDQOL-SFTM version 1.3 in English language. Methodology: Interviews of the patients were performed to collect data. SF-36 items mean and standard deviation were performed to analyze data on the basis of gender and age groups. Results: Among the eleven scales targeting End-Stage Renal Disease (ESRD), only the "Effects of Kidney Disease" scale demonstrates a greater impact on males than females. However, three scales including Symptom/Problem list, Quality of Social Interaction, and Dialysis Staff Encouragement show suboptimal results in young patients. Similarly, two of the seven health-related outcome scales, Physical Functioning and Energy Fatigue, exhibit poor outcomes in young patients. Conclusion: Major cause of their kidney disease was hypertension and diabetes. Overall, less number of prescribed medications, decreased hospitalization and reduced hospital visits are the factors showing overall better quality of life.This study helps us understand the impacts of kidney disease on different genders and age groups, guiding the development of personalized care plans. Keywords: Quality of life (QOL), End stage renal disease ESRD, hemodialysis, KDQOL-SFTM version 1.3

Quality of life of patients on Continuous Ambulatory Peritoneal Dialysis

End Stage Renal Disease (ESRD) is a serious medical disorder leading to impaired Quality oflife (QOL). QOL as perceived by patients with ESRD is an important measure of patient outcome. However, there is paucity of literature that assesses the QOL of patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) in our country. A descriptive study was undertaken to assess the QOL of patients on CAPD and to determine the relationship between QOL and selected demographic and clinical variables. A total of 33 subjects were chosen by consecutive sampling technique. Data was collected using self-administered Questionnaire - Kidney Disease Quality of life (KDQOL-SF™ 1.3) questionnaire. The mean age was 53.06+80yrs and the most common cause of ESRD was chronic disease (66.7%) i.e. Diabetes mellitus (33.3%). The overall QOL was satisfactory (58.28+11.5). Highest mean QOL scores were in the area of dialysis staff encouragement (87.50), and symptoms (83.01). The lowest mean score of QOL was in the area of burden of kidney disease (32.27), and role physical (38.78). Highest QOL scores in the area of ‘dialysis staff encouragement’ emphasises on the role of nurses and health care team in optimising the QOL of patients on CAPD.

Assessing Illness Acceptance and Quality of Life among the End Stage Renal Disease (ESRD) Patients Undergoing Hemodialysis

Haemodialysis is the best treatment for the long-term survival of end-stage renal disease patients that requires the acceptance of illness, which can maintain patients' Quality of life. Three hundred thirty-seven hemodialysis patients were involved in this study, which reported the acceptance of illness was moderate and was lowest among the males. The Quality of life was good and supported by the emotional well-being, dialysis staff encouragement, social support, and the acceptance of illness. Multidisciplinary intervention should be targeted to address the physical status and disease-specific core aiming to reduce further health complications and improve Quality of life. Keywords: acceptance to illness; quality of life; hemodialysis, end-stage renal disease patients eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning &amp; Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v7i20.3458

The Influence of an Unexpected Switch of Hemodialysis Facilities on the Quality of Life (QOL) in Hemodialysis Patients.

BackgroundWe experienced a sudden breakdown of hemodialysis system during a clinical study of dermal itch and serum BNP concentrations.Patients and MethodsForty-eight hemodialysis patients were enrolled in the itch-related study. It was intended to improve itch by lowering BNP with supportive communication between the patients and the dialysis staff. We planned to collect data, including visual analogue scale (VAS), dermatology life quality index (DLQI), blood samples and QOL score (KDQOL-SF), four times over a four week interval. The first data was obtained just prior to switching facilities due to a breakdown. The patients underwent hemodialysis in other facilities for two weeks and underwent determination of their clinical data, including QOL scores, three times.ResultsWhile mean blood pressure showed no significant differences, serum albumin, iron and phosphate levels were worsened significantly between pre- and post-relocation. Serum BNP and DLQI showed no significant changes. VAS was significantly worsened. The mean values of the cognitive function in the KDQOL-SF and sleep and the role-physical, role-emotional, social function, dialysis staff’s encouragement in SF-36 analysis were identified as statistically significant items by MANOVA. Both SF-12 physical and mental composites were also statistically significant. Although SF-12 physical composites were significant among the patients under 66 yrs of age (median), eight factors were significant among those over 66 yrs. Independent analyses revealed every item that was detected worsened significantly after the switch of facilities.ConclusionUnexpected switching of hemodialysis facilities severely impacts the QOL for a long duration as well as the patients’ symptom and laboratory data.

A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E. Manual on health self-management and patient-reported outcomes among low-income young adult Mexicans on chronic dialysis: Feasibility study

PurposeWe evaluated disease knowledge/self-management skills among low-income Mexican young adults maintained on dialysis and to test the effectiveness of the A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E (AYNIL) Manual – Spanish Version on patient-reported outcomes. This is a low literacy teaching tool designed with patients and educators' input. Design and methodsA quasi-experimental study was conducted in 17 chronic dialysis patients at Mexico City's Hospital General de México, Dr. Eduardo Liceaga. Ages 18–30-year-old completed disease knowledge/self-management and quality of life measures before the intervention and 6 weeks later. ResultsSignificant increases were observed on disease knowledge/self-management scores in the STARx questionnaire from 47 (IQ: 40,51) to 50 (IQ: 48,54) p = 0.04. The UNC-TRxANSITION Index increased significantly from 4.8 (IQ: 3.9,5.7) to 7.7 (IQ: 7.5,8.2) p ≤0.001. Significant increases in scores were detected in the “Burden of kidney disease” (p = 0.008), “Effects of kidney disease” “ (p = 0.03) and “ Dialysis staff encouragement” (p = 0.027) based on the KDQoL survey. ConclusionsIn this vulnerable population, the Spanish version of the A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E. - AYNIL Manual improved CKD/ESRD disease knowledge/self-management skills and HRQoL. This study highlighted the need for low-literacy educational tools to improve patient-reported outcomes. Practice implicationsYoung adults with CKD/ESRD can benefit from patient-centered educational interventions to enhance their autonomy and the development of self-management behaviors that improve patient-reported outcomes and potential complications of the disease. Special attention is needed in low-income patients with low rates of adherence to treatments and poor self-management skills.

Comparison of quality of life in end-stage renal disease patients undergoing hemodialysis and peritoneal dialysis in a Moroccan city.

End-stage renal disease patients (ESRD) generally complain about a poor quality of life (QOL). The current study aims to describe and compare ESRD patients' QOL according to dialysis modalities (hemodialysis [HD] and peritoneal dialysis [PD]). This is a cross-sectional study, conducted in dialysis facilities of a Moroccan university hospital, during October 2018. All adult ESRD patients, treated either by HD or PD for more than 3 months and agreeing to participate, were included. Medical data were collected using a questionnaire, whereas the QOL data were collected using the Kidney Disease Quality of Life Short Form (KDQOL SF v 1.3) scale previously validated in dialectal Arabic. The patients' characteristics and QOL data were compared between dialysis modalities (HD vs. PD), using a linear regression, before and after adjustment on several demographic and medical factors as well as a propensity score created to reduce the effect of confounding factors related to the choice of the treatment. Out of the 91 included patients (50.5% of men, median age 52.0 (IQR [36.5; 62.0]) years), 71 were on HD and 20 were on PD. The highest subscale score, for all participants, was the social support's one with a median of 83.3 (IQR [66.7; 100]), and the lowest one was the kidney disease burden with a median of 25.0 (IQR [0.00; 46.9]). The univariate analysis showed that the Physical Component Score (PCS), the cognitive function, and the dialysis staff encouragement were better in PD patients (p = 0.03, p = 0.04, and p = 0.007, respectively), while the multiple linear regression indicates that the PCS, the dialysis Staff encouragement, and the patient's satisfaction subscores decreased within patients on HD compared with those on PD (p = 0.01, p = 0.03, and p = 0.02, respectively) and that the burden of the kidney disease and the work status subscores increased within patients on HD against those on PD (p = 0.007 and p = 0.04, respectively). This study showed a significant difference between dialysis modalities in some sides of quality of life.

Health-Related Quality of Life Profiles in Dialyzed Patients With Varying Health Literacy. A Cross-Sectional Study on Slovak Haemodialyzed Population.

Objectives: Chronic kidney disease (CKD) strongly affects patients’ health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL. Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life – Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test. Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were <0.001. Conclusion: Patients with low HL have a worse HRQoL in several domains than patients with a higher HL. Increasing HL capacities and better supporting patients with low HL should thus be given priority to support their HRQoL and at least maintain its level.

Impact of health-related quality of life on survival after dialysis initiation: a prospective cohort study in Korea.

BackgroundThe effect of each health-related quality of life (HRQOL) component on hemodialysis prognosis has not been well studied. We aimed to investigate the clinical factors associated with HRQOL and the effect of HRQOL after dialysis initiation on long-term survival in an Asian population.MethodsA total of 568 hemodialysis patients were included from a nationwide prospective cohort study. HRQOL was evaluated using the Kidney Disease Quality of Life (KDQOL) Short FormTM 1.3 at 3 months after dialysis initiation. The effect of each KDQOL item score on mortality was analyzed. Multivariable Cox analysis was performed after adjusting for age, sex, modified Charlson comorbidity index, and causes of primary kidney disease.ResultsOld age, diabetes mellitus, high comorbidities, and low serum albumin levels were associated with poor physical health status. Decreased urine output was associated with both poor physical and mental health status. The scores of 3 indices in the kidney disease domain (effect of kidney disease, social support, and dialysis staff encouragement) showed significant associations with mortality, as did the 3 indices (physical function, physical role limitation, and body pain) in the physical health domain. Neither the 4 indices in the mental health domain nor the mental composite score showed a significant association with mortality. However, a high physical composite score was associated with decreased overall patient mortality (P = 0.003). The effect of physical composite score on survival was prominent among young or middle-aged groups.ConclusionPoor physical health status 3 months after hemodialysis start correlates significantly with overall mortality.

Hemodiyaliz ve periton diyalizi hastalarında yaşam kalitesi ve ilişkili olduğu faktörler

Purpose: This study aimed to examine the quality of life (QOL) in hemodialysis (HD) and peritoneal dialysis (PD) patients. Additionally, associations between QOL and clinical and demographic factors were investigated.Materials and Methods: Patients under dialysis treatment were included in this cross-sectional study. Demographic data, disease history, and laboratory data were collected. Charlson comorbidity index (CCl) was used to score the level of comorbidity. Health-related quality of life (HRQOL) was measured by Kidney Disease Quality of Life Short Form Version 1.3 (KDQOL-SF 1.3).Results: One hundred and five patients, 60 of whom were under HD, and 45 were under PD (45.7% were females; mean age 54.63±13.86 years) were enrolled in the study. PD patients had better scores in five domains of the KDQOL-SF 1.3 questionnaire (emotional role, work status, cognitive function, dialysis staff encouragement, patient satisfaction). Older age, female sex, lower education level, high comorbidity score and, hospitalization in the last 12 months were found to be related to low QOL. We detected positive correlations between serum hemoglobin levels, albumin, and some subgroups of KDQOL-SF 1.3 scale; whereas negative correlations were detected between serum ferritin levels and some of the KDQOL-SF 1.3 items. Conclusion: According to our study, HRQOL was better in PD patients compared to HD in specific domains of the KDQOL-SF 1.3. Age, gender, education level, hemoglobin level, albumin, and ferritin were associated with HRQOL.

Better Quality of Life of Peritoneal Dialysis compared to Hemodialysis over a Two-year Period after Dialysis Initiation

This study aimed to compare health-related quality of life (HRQOL) over time in patients initiating hemodialysis (HD) or peritoneal dialysis (PD). A total of 989 incident patients starting HD or PD were included from a prospective nationwide cohort study. HRQOL was assessed 3, 12, and 24 months after the start of dialysis. The scores of questionnaires were adjusted for clinical and socioeconomic parameters. The adjusted three months scores of patients on PD showed better HRQOL in eight end-stage renal disease (ESRD), three physical component summary and one mental component summary domains compared with patients on HD. Both patients on HD and PD experienced significant decreases in different HRQOL domains over two years and the degree of changes in HRQOL over time was not different between dialysis modality. However, the scores of three (effects of kidney disease, burden of kidney disease, and dialysis staff encouragement, all P < 0.05) and two (sexual function and dialysis staff encouragement, all P < 0.05) ESRD domains were still higher in patients on PD compared with patients on HD at one and two years after initiation of dialysis, respectively. PD shows better HRQOL during the initial period after dialysis even after adjusting for clinical and socioeconomic characteristics, and the effect lasts up to two years. It was similar in terms of changes in HRQOL over time between HD and PD.

QUALITY OF LIFE OF PATIENTS UNDERGOING HEMODIALYSIS

Objective: The objective of the study was to assess the quality of life (QOL) of patients undergoing hemodialysis (HD). The QOL of HD patients was found to be considerably impaired when compared to that of healthy individuals of the general population. The careful assessment of QOL helps to guide and achieve medical management to optimize their health experience.Methods: Cross-sectional research design was adopted with 130 samples who met the inclusion criteria to conduct the study in the dialysis unit, India. The instrument used for the study was to collect the data are demographic variable and kidney disease QOL - short form version 1.3 scale.Results: The mean total score of QOL was 48.73±22.65, the highest score was for dialysis staff encouragement scale (84.04±14.89) followed by social support scale (80.38±20.38) and quality of social interaction (71.52±18.74). However, role limitation caused by physical health problems, role limitation caused by emotional health, and burden of kidney disease scales yielded the lowest scores (22.12±18.05, 26.92±24.15, and 38.03±12.81, respectively).Conclusion: The present study findings concluded that patients on HD were not having adequate QOL in all domains except patient satisfaction due to changes in the physiological, chemical changes occur in the kidney.

Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients.

BackgroundHealth-related quality of life (HRQoL) surveys are needed to evaluate regional and ethnic specificies. The aim of the present study was to evaluate the differences in HRQoL, frailty, and disability according to dialysis modality in the Korean population.Patients and methodsWe enrolled relatively stable maintenance dialysis patients. A total of 1,616 patients were recruited into our study. The demographic and laboratory data collected at enrollment included age, sex, comorbidities, frailty, disability, and HRQoL scales.ResultsA total of 1,250 and 366 participants underwent hemodialysis (HD) and peritoneal dialysis (PD), respectively. The numbers of participants with pre-frailty and frailty were 578 (46.2%) and 422 (33.8%) in HD patients, and 165 (45.1%) and 137 (37.4%) in PD patients, respectively (P = 0.349). Participants with a disability included 195 (15.6%) HD patients and 109 (29.8%) PD patients (P < 0.001). On multivariate analysis, the mean physical component scale (PCS) and mental component scale (MCS), symptom/problems, and sleep scores were higher in HD patients than in PD patients. Cox regression analyses showed that an increased PCS in both HD and PD patients was positively associated with patient survival and first hospitalization–free survival. An increased MCS in both HD and PD patients was positively associated with first hospitalization–free survival only.ConclusionThere was no significant difference in frailty between patients treated with the two dialysis modalities; however, disability was more common in PD patients than in HD patients. The MCS and PCS were more favorable in HD patients than in PD patients. Symptom/problems, sleep, quality of social interaction, and social support were more favorable in HD patients than in PD patients; however, patient satisfaction and dialysis staff encouragement were more favorable in PD patients than in HD patients.

Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study

BackgroundThe increasing prevalence of treated end-stage renal disease and low transplant rates in Africa leads to longer durations on dialysis. Dialysis should not only be aimed at prolonging lives but also improve quality of life (QOL). Using mixed methods, we investigated the QOL of patients on chronic haemodialysis (HD) and peritoneal dialysis (PD).MethodsWe conducted a cross-sectional study at Tygerberg Hospital in Cape Town, South Africa. All the PD patients were being treated with continuous ambulatory peritoneal dialysis. The KDQOL-SF 1.3 questionnaire was used for the quantitative phase of the study. Thereafter, focus-group interviews were conducted by an experienced facilitator in groups of HD and PD patients. Electronic recordings were transcribed verbatim and analysed manually to identify emerging themes.ResultsA total of 106 patients completed questionnaires and 36 of them participated in the focus group interviews. There was no difference between PD and HD patients in the overall KDQOL-SF scores. PD patients scored lower with regard to symptoms (P = 0.005), energy/fatigue (P = 0.025) and sleep (P = 0.023) but scored higher for work status (P = 0.005) and dialysis staff encouragement (P = 0.019) than those on HD. Symptoms and complications were verbalised more in the PD patients, with fear of peritonitis keeping some housebound. PD patients were more limited by their treatment modality which impacted on body image, sexual function and social interaction but there were less dietary and occupational limitations. Patients on each modality acknowledged the support received from family and dialysis staff but highlighted the lack of support from government. PD patients had little opportunity for interaction with one another and therefore enjoyed less support from fellow patients.ConclusionsPD patients experienced a heavier symptom burden and greater limitations related to their dialysis modality, especially with regards to social functioning. The mixed-methods approach helped to identify several issues affecting quality of life which are amenable to intervention.

A cross sectional study on assessment of health related quality of life among end stage renal disease patients undergoing hemodialysis

BackgroundNumerous advancements are nowadays being developed in the field of medicine to improve the clinical outcomes among chronic kidney disease patients. Though these therapies help the patients to live longer life, still their quality of life remain uncertain. ObjectiveThe objective of the study was to assess the health related quality of life (HRQOL) among end stage renal disease patients undergoing hemodialysis. MethodsA cross-sectional descriptive study was conducted among 50 patients undergoing maintenance hemodialysis in a tertiary level referral hospital in Kerala. Patients who had completed at least three months of maintenance hemodialysis, and aged 18 years and above of either sex were included in the study. The socio demographic details of the patients were collected through patient and bystander interviews and from their hospital case records. HRQOL was evaluated using a standardized scale of Kidney Disease Quality of Life-Short Form questionnaire. ResultsAmong HRQOL, the mean score of kidney disease component summary was higher than Mental Component Summary and Physical Component Summary (60.48±11.81, 41.83±15.78 and 36.49±16.30 respectively). Patients possessed better quality of life in Social support (73.54), Dialysis staff encouragement (67.56) and Quality of social interaction (67.56) and the worst scores in Role-physical (13.57) and Role-emotional (17.72) scales. ConclusionThe study has shown that the quality of life of hemodialysis patients was highly impaired and it clearly defines how the disease state adversely affects the physical and mental status of the patient.

Translation, Cultural Adaptation and Validation of the Kidney Disease Quality of Life–Short Form 1.3 in an African Country

BackgroundThe impact of dialysis on patient quality of life has been recognized as an important outcome measure. The Dialysis Outcomes and Practice Patterns Study compared quality of life in 4 continents [1], but very scarce information is available about dialysis patients' quality of life in Africa. The objective of this study was to translate the Kidney Disease Quality of Life–Short Form (KDQOL-SF) into Moroccan and measure its psychometric properties. MethodsThe questionnaire was first translated into Moroccan by 2 independent translators, and then 2 backward translations into English were performed after pretesting in 10 dialysis patients. The final questionnaire was then administered to 80 dialysis patients. Reliability was estimated by internal consistency and test–retest reliability. Validity was assessed using known group comparisons and correlations between overall health rating and scales scores. ResultsSome activities were substituted since they were not common in Morocco. All subscales had a Cronbach α above the recommended value except for 3 scales. All of the items showed good test–retest reliability. Correlation of items within subscales was higher than that of items outside subscales in 87% of cases. Regarding construct validity, all KDQOL-SF scales had significant correlation with overall health rating except for sexual function and dialysis staff encouragement. Furthermore, the questionnaire could be used to discriminate between subgroups of the patients. ConclusionsThe psychometric properties of the KDQOL-SF resulting from this first-time administration of the instrument support the validity and reliability of the KDQOL-SF as a measure of quality of life of patients having hemodialysis in Morocco.

Measurement Properties of the Chinese Version of the Kidney Disease Quality of Life-Short Form (KDQOL-SF™) in End-Stage Renal Disease Patients With Poor Prognosis in Singapore

ContextThe Kidney Disease Quality of Life (KDQOL™) instrument is widely used to assess care of end-stage renal disease (ESRD) patients. ObjectivesThis study aimed to demonstrate the measurement properties of the Chinese (simplified characters) version of the KDQOL-Short Form™ (KDQOL-SF™) in ethnic Chinese ESRD patients in Singapore. MethodsSeventy-eight new ESRD patients, initially conservatively managed, were interviewed and followed-up; 31 later commenced dialysis. Quality of life (with the KDQOL-SF), Karnofsky Performance Status, and estimated glomerular filtration rate (eGFR) were assessed at 0, 3, 6, 9, 12, 18, and 24 months. Nonparametric statistics were used to assess correlation and changes. ResultsThe patterns of descriptive summary and floor and ceiling effects were similar to those reported in the original English version. Most of the kidney disease-targeted scales and the generic scales of the KDQOL-SF demonstrated 1) criterion validity in terms of correlation with objectively measured and/or subjectively rated variables, 2) convergent/divergent validity in terms of correlation patterns between kidney disease-targeted and generic scales, and 3) responsiveness to change in terms of difference before and after dialysis, except for Work Status. Internal consistency reliability was satisfactory, but that for the Work Status scale was too low (alpha=0.32) and for two other kidney disease-targeted scales, Sexual Function and Dialysis Staff Encouragement, was too high (1.0). ConclusionMost of the scales in the Chinese version of the KDQOL-SF were valid and achieved internal consistency reliability, except for the Work Status scale. Also, the internal consistency reliability of two disease-targeted scales was too high, suggesting room for reduction of some items to reduce burden on respondents.