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

Evaluation of Factors Affecting the Health-Related Quality of Life in End-Stage Renal Disease Patients Receiving Hemodialysis Treatment in Northern Cyprus

Introduction Health-related quality of life (HR-QoL) is recognized as an important predictor of mortality and morbidity in end-stage renal disease (ESRD) patients receiving hemodialysis (HD). The goal of this study was to obtain HR-QoL scores using the Kidney Disease and Quality of Life questionnaire (KDQOL-36TM) (RAND Corporation, Santa Monica, CA) and to assess the factors affecting HR-QoL in ESRD patients receiving HD. Methods A multicenter cross-sectional study was performed using the KDQOL-36TM for the assessment of HR-QoL of ESRD patients receiving HD in Northern Cypriot state hospitals. Alongside KDQOL-36TM scores for assessing HR-QoL, sociodemographic as well as relevant laboratory data were collected. Spearman Correlations and multiple linear regression analyses using the 'stepwise' method were carried out to identify predictors of HR-QoL. Nonparametric tests were used to determine significantly (p<0.05) associated variables. Ethical approvals were received from the Northern Cypriot Ministry of Health and Eastern Mediterranean University Research and Publication Ethics Boards. Results One hundred and thirty-eight participants were recruited in this study, corresponding to 85.1% of the total study population. Participants had a mean age of 66.49 ± 13.35. 65.2% of the participants were males. Participants had low scores on most dimensions of quality of life, namely, Burden of Disease, Physical Component Summary (PCS), and Mental Component Summary (MCS) subscales. Particularly, females, unemployed patients, and patients with more comorbidities had significantly lower scores (p=0.003, p<0.001, and p=0.005, respectively). Spearman correlation analyses revealed multiple significant moderate correlations between sociodemographic data, laboratory variables, and scores. Furthermore, multiple linear regression analysis identified gender (p=0.006), total number of comorbidities (p=0.005), age (p<0.001), and patient care (p=0.019) as significant predictors of KDQOL-36TM scores. Conclusion This study has shown that the quality of life of hemodialysis patients was highly impaired. Gender, current employment status, and presence of comorbidities were all significant independent factors affecting HR-QoL mean scores. Lastly, further studies regarding the implementation of routine HR-QoL surveillance and targeted interventions are required to better understand their potential therapeutic benefits.

Health-related quality of life of dialysis patients during early COVID-19 lockdowns: a snapshot from a public hospital in Malaysia

Background

End-stage renal disease is the last stage of chronic kidney disease and can affect the quality of life (QOL) of dialysis patients. The aim of this study was to assess the quality of life and examine its determinants.

Methods

A cross-sectional survey involving patients on dialysis in a tertiary hospital was conducted from July 2020 to September 2020. Demographic data were collected using a predesigned questionnaire. QOL was measured using the 36-item KDQOL questionnaire, and statistical analysis was carried out using SPSS version 25.

Results

Of the 108 patients, 59 were men and 49 were women, and the mean age was 48.15 ± 15.4 years. The results showed that there was no significant difference in the mean score of all components of health-related quality of life in different types of dialysis. The demographic data, which included age, gender, ethnicity, marital status, education level, occupation, and monthly income, did not significantly affect the QOL of dialysis patients. Patients with a dialysis duration of more than 5 years had a better QOL compared to other groups. Laboratory parameters such as low albumin and low hemoglobin showed a significant correlation with the health-related quality of life of dialysis patients.

Conclusion

The quality of life among patients on dialysis was impaired, especially in terms of burden of the kidney disease. Hypoalbuminemia and anemia were the two factors that influenced QOL.

Study protocol: Effectiveness of patient centered pharmacist care in improving medication adherence, clinical parameters and quality of life among hemodialysis patients

BACKGROUND

Patients requiring hemodialysis (HD) often have several chronic comorbidities, which necessitate the use of several medications and hence put them at high risk of polypharmacy. Medication-related problems (MRPs) among HD patients are a serious issue as they can increase morbidity and nonadherence with medications. To overcome this issue, a unique pharmacy practice model including medication review (MR) and motivational interviewing (MI) is needed to improve medication adherence, by reducing MRPs and optimizing therapeutic outcomes. The present study aims to assess the effectiveness of MR and MI in improving medication adherence, quality of life (QOL) and clinical outcomes among end-stage renal disease (ESRD) patients who are on dialysis.

METHOD AND DESIGN

This pre-post study will be conducted prospectively among patients with ESRD who have been on dialysis at the Hemodialysis Unit, Hospital Kuala Lumpur and the Hemodialysis Affiliated Centers of the University Malaya Medical Centre, from August 2020 till August 2021. Medication adherence will be assessed using the General Medication Adherence Scale (GMAS), whilst patients' HRQOL will be assessed using the Kidney Disease Quality of Life Short Form 36 (KDQOL-36). Clinical parameters such as blood glucose level, calcium, phosphate, hemoglobin and serum low-density lipoprotein (LDL) levels will be obtained from medical records. A total of 70 patients will be recruited.

DISCUSSION

We hypothesize that the implementation of pharmacy-based MR and MI may expect an increase in medication adherence scores and increase in HRQOL scores from baseline as well as achieving the clinical lab parameters within the desired range. This would indicate a need for a pharmacist to be involved in the multidisciplinary team to achieve a positive impact on medication adherence among hemodialysis patients.

TRIAL REGISTRATION

Ethical approval has been obtained from the National Medical Research and Ethics Committee NMRR: 20-1135-54435 and Medical Research Ethics Committee, University Malaya Medical Centre MREC ID NO: 202127-9811.

Intradialytic Exercise on Changes in Blood Pressure in Chronic Kidney Failure Patients during Hemodialysis Therapy

Abstract BACKGROUND: Chronic renal failure (CRF) is a reduction in chronic renal function that leads to non-reversible and progressive kidney tissue damage. Blood pressure is a major risk factor that can increase the mortality rate by up to 20 times in patients with chronic renal failure who are undergoing hemodialysis therapy. Intradialytic exercise is an intervention that can be used to control systolic blood pressure. AIM: This study was to analyze the effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital. METHODS: The research method is quasi-experimental design pre-post with control group design. The study population was 97 dialysis patients. The sampling technique used a purposive sampling of 30 people. Data analysis using Paired t-Test. RESULTS: The research results showed  that the sex characteristics of most respondents were male as many as 17 people (56.7%), the average age of the respondents was 51.03 years, the pre-intervention in the control group obtained an average systolic blood pressure of 168.93 mmHg and 106 diastole, 120 mmHg, while the blood pressure in the control group post was 173.13 mmHg systole and 107 mmHg diastoles. In the treatment group, the average blood pressure in the pre-intradialytic exercise showed 162.20 mmHg systole and 104.27 mmHg diastole, while the post-intradialytic exercise system blood pressure was 153.13 mmHg and diastole 94.33 mmHg. CONCLUSION: There is an effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital with a p-value of 0.025. Intradialytic exercise can be recommended as structured physical exercise therapy for hemodialysis therapy patients.   KEYWORDS: intradialytic exercise, chronic renal failure, patients, changes in blood pressure, hemodialysis

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

Background

The 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.

Methods

A 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.

Results

Old 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.

Conclusion

Poor physical health status 3 months after hemodialysis start correlates significantly with overall mortality.

The effect of nutritional education program on quality of life and serum electrolytes levels in hemodialysis patients: A single-blind randomized controlled trial

OBJECTIVE

To determine the effect of nutrition education program on hemodialysis patients' quality of life (QoL) and serum electrolytes levels.

METHODS

This study was a randomized controlled trial in which 94 eligible hemodialysis patients were randomly assigned to intervention (n = 48) and control (n = 46) groups. In the intervention group, the patients were trained in healthy nutrition for four weeks. After two months, samples of both groups completed the Kidney Disease Quality of Life Instrument (KDQOL) and Na, K, P, Ca and Mg levels were also measured and compared.

RESULTS

There were no significant differences in QoL scores and electrolytes between the two groups before intervention (p > 0.05). After intervention the QoL scores in the intervention group were significantly higher than in the control group (p < 0.05). However, after intervention the levels of Na, K, P and Mg in the intervention group were significantly lower than in the control group (p < 0.05). Calcium level was not significantly different between the two groups after intervention (p = 0.16).

CONCLUSION

The results showed that e-learning is effective in improving the QoL and serum electrolytes of hemodialysis patients.

PRACTICE IMPLICATIONS

This paper could serve as support for clinical healthcare professionals to improve patient knowledge and QoL through virtual education methods.

Gambaran Tingkat Pengetahuan Penyakit Ginjal Dan Terapi Diet Ginjal Dan Kualitas Hidup Pasien Hemodialisis Di Rumkital Dr. Ramelan Surabaya

Background: Patients condition during haemodialysis therapy program would trigger multiple problems regarding physical and psychological condition, life style disruption, and spontaneous social changes which afflict quality of life. However, a knowledge of chronic kidney disease patients would influence healthy lifestyle attitude and behaviour in haemodialysis and diet therapies.Objectives: The objective of this research was to analyze the relationship between knowledge and quality of life in chronic renal failure (CRF) patients with haemodialysis (HD) therapy.Method: This research utilized analytical observational type with cross sectional approach. There were 53 patients as random samples. The data consisted of the characteristic, knowledge and quality of life score of CRF patients with HD therapy. Furthermore, the datas were analyzed through Spearman Correlation statistical test with CI approximately 95% (α = 0,05).Results: As many as 62.3% of respondents were categorized as having a good quality. The entire of information source were obtained from medical workers. In addition. There was a positive relation between knowledges and quality of life (p=0.023). However, based on quality of domain, only psychological health had significant relation with knowledges (p=0.014). Meanwhile, significant relations cannot be shown between knowledges and physical health (p=0.125) or social relation (p=0.277) with it.Conclusion: The quality of life of CRF with HD patients can be influenced by the level of knowledges, especially quality of life related to psychological health. There is And the role of health workers as a source of information, for it needs an effort to improve science such as attending seminars, workshops and training related profession, so it is expected to provide information according to the latest developments in scienceABSTRAKLatar Belakang: Kondisi pasien yang menjalani terapi hemodialisis akan memicu berbagai masalah seperti masalah fisik, psikologis, gaya hidup, dan perubahan sosial yang akan berdampak pada kualitas hidup pasien. Namun, dengan pengetahuan tentang penyakit ginjal dan terapi diet ginjal, yang dimiliki oleh seorang pasien gagal ginjal kronik akan mempengaruhi sikap dan perilaku hidup sehat dalam melaksanakan terapi hemodialisis dan terapi diet dengan benar.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan tingkat pengetahuan dengan kualitas hidup pasien gagal ginjal kronik (GGK) yang menjalani terapi hemodialysis (HD).Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Sampel penelitian sebanyak 53 orang, diambil secara acak. Pengumpulan data melalui wawancara meliputi karakteristik pasien, tingkat pengetahuan dan skor kualitas hidup pasien GGK dengan HD. Analisa data yang digunakan dalam penelitian ini adalah uji statistik Spearman Correlation dengan CI sebesar 95% (α = 0.05).Hasil: Tingkat pengetahuan responden 62.3% termasuk dalam kategori baik. Sumber informasi yang diperoleh responden 100% berasal dari petugas kesehatan. Terdapat hubungan antara tingkat pengetahuan dengan kualitas hidup responden (p=0.023). Berdasarkan domain kualitas hidup, kesehatan psikologis mempunyai hubungan dengan tingkat pengetahuan (p=0.014), sedangkan kesehatan fisik (p=0.125) dan hubungan sosial (p=0.277) tidak ada hubungan dengan tingkat pengetahuan.Kesimpulan: Kualitas hidup pasien GGK dengan HD dapat dipengaruhi dari tingkat pengetahuan, terutama kualitas hidup terkait kesehatan psikologis. Peran tenaga kesehatan sebagai sumber informasi, untuk itu perlu adanya usaha untuk meningkatkan ilmu pengetahuan seperti mengikuti seminar, workshop dan pelatihan terkait profesinya, sehingga diharapkan dapat memberikan informasi sesuai perkembangan ilmu yang terbaru.