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Bulathwatta DT, Rudnik A, Bidzan M. All Good Without Anything Good. Beyond Survival: Understanding the Psychosocial Experiences of Individuals With Chronic Kidney Disease and Their Caregivers in Sri Lanka. Health Expect 2024; 27:e14157. [PMID: 39087524 PMCID: PMC11292381 DOI: 10.1111/hex.14157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 08/02/2024] Open
Abstract
AIM This study aims to explore the experiences of individuals with chronic kidney disease (CKD) undergoing haemodialysis and their caregivers, focusing on the disease's impact and the treatment process. BACKGROUND In Sri Lanka, CKD is a growing health concern, particularly affecting farming communities and contributing to the strain on the biomedical healthcare system. Despite increasing awareness of CKD's physical implications, its psychosocial impact remains underexplored. This study seeks to fill this gap, aiming to inform culturally sensitive interventions and improve the healthcare system's responsiveness to the unique needs of Sinhala Buddhist individuals with CKD and their caregivers. DESIGN An exploratory qualitative study. METHOD Semistructured interviews were conducted with 10 individuals undergoing haemodialysis and 5 caregivers at a dialysis unit. The interviews were audio-recorded, transcribed and analysed using conventional qualitative content analysis. FINDINGS The analysis revealed three interrelated main themes: (1) impact on standard of living (quality of life), (2) coping strategies and (3) medical experience, with a notable influence of traditional beliefs and practices. CONCLUSION The findings highlight the need for a holistic approach to CKD management that integrates physical, emotional, psychological and social aspects, considering the significant role of traditional influences. Further research is essential to develop effective interventions that can enhance the quality of life for CKD. PATIENT OR PUBLIC CONTRIBUTION The lived experiences of Sinhala Buddhist individuals with CKD and their caregivers served as a cornerstone, providing profound insights into the impact of the condition on their lives. Throughout the study, these participants played an instrumental role in refining the research's cultural sensitivity and relevance. Their engagement extended beyond the data collection phase to encompass feedback sessions, where they actively shared their perspectives. This ongoing collaboration ensured the study's depth and applicability to real-world experiences. By actively involving those directly affected by CKD, this collaborative approach safeguards that the study remains rooted in their voices and addresses their unique needs. REPORTING METHOD This study adhered to relevant EQUATOR guidelines (the COREQ checklist). TRIAL REGISTRATION This study is not a clinical trial, and thus, registration is not applicable.
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Affiliation(s)
- Darshika Thejani Bulathwatta
- Department of Psychology and CounselingFaculty of Health Sciences, The Open University of Sri LankaColomboSri Lanka
- Institute of PsychologyFaculty of Social Sciences, University of GdańskGdanskPoland
- Academic Center for Psychological SupportUniversity of GdanskGdanskPoland
| | - Agata Rudnik
- Institute of PsychologyFaculty of Social Sciences, University of GdańskGdanskPoland
- Academic Center for Psychological SupportUniversity of GdanskGdanskPoland
- Institute of Pedagogy and LanguagesUniversity of Applied Sciences in ElblągElblągPoland
| | - Mariola Bidzan
- Institute of PsychologyFaculty of Social Sciences, University of GdańskGdanskPoland
- Institute of Pedagogy and LanguagesUniversity of Applied Sciences in ElblągElblągPoland
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Gela YY, Tesfaye W, Melese M, Getnet M, Ambelu A, Eshetu HB, Bitew DA, Diress M. Common mental disorders and associated factors among adult chronic kidney disease patients attending referral hospitals in Amhara Regional State. Sci Rep 2024; 14:6812. [PMID: 38514836 PMCID: PMC10957902 DOI: 10.1038/s41598-024-57512-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/19/2024] [Indexed: 03/23/2024] Open
Abstract
Common mental disorders (CMDs) are a wide term that includes disorders like depression, anxiety, and somatic manifestations. Chronic kidney disease (CKD) patients are at high risk of developing a common mental disorders, which leads to a lower survival rate, poor clinical outcome, longer hospitalization, increased health-care utilization, difficulty adhering to medications, an increased risk of initiation of dialysis, poor quality of life, and an increased risk of mortality. However, there is limited study done related to common mental disorders and associated factors among chronic kidney disease patients in Ethiopia. This study aimed to assess the prevalence of common mental disorders and associated factors among chronic kidney disease patients attending referral hospitals in Amhara Regional State. An institution-based cross-sectional study design was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals from January to April 2020. The study participants were selected using systematic random sampling techniques. Common mental disorders were assessed using the Self-Reporting Questionnaire-Falk Institute (SRQ-F) tool. Data were entered into Epi Data Version 3.0 then exported into STATA 14 for analysis. Both bivariable and multi-variable binary logistic regressions were done to identify factors associated with common mental disorders. In multivariable logistic regression analysis, variables with a p-value of ≤ 0.05 were declared as a statistically associated with common mental disorders. In this study, 424 CKD patients were included, with a response rate of 100%. Among screened CKD patients, 40.8% was positive for common mental disorders, with a 95% CI (36-45%). Independent predictors of common mental disorders among CKD patients were poor social support [(AOR 3.1, 95% CI (1.67-5.77)], family history of mental disorders, [AOR 3.6, 95% CI (1.12-11.8)], comorbidity [AOR 1.7, 95% CI (1.03-2.78)], being female [AOR 2.69, 95% CI (1.72-4.20)], and duration of CKD (AOR 3.5; 95% CI (2.28-5.54). Two out of five CKD patients screened for CMDs were found to be positive. Common mental disorders were more common among CKD patients with poor social support, a family history of mental disorders, comorbidity, being female, and the duration of CKD. Therefore, screening CKD patients for common mental disorders is recommended.
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Affiliation(s)
- Yibeltal Yismaw Gela
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Winta Tesfaye
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihret Melese
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihret Getnet
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Ambelu
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mbeje PN. Factors affecting the quality of life for patients with end-stage renal disease on dialysis in KwaZulu-Natal province, South Africa: A descriptive survey. Health SA 2022; 27:1932. [PMID: 36570086 PMCID: PMC9772709 DOI: 10.4102/hsag.v27i0.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background End-stage renal disease (ESRD) is a world-wide public health problem that requires renal replacement therapy in the form of dialysis. Although dialysis prolongs the patients' lifespan, it is not necessarily associated with an improved quality of life (QoL). Aim To determine the factors affecting the QoL of patients with ESRD on dialysis. Setting The study was conducted in three public sector hospitals in the province of KwaZulu-Natal. Methods A convenience sample of 316 participants was used. The World Health Organization - QoL Biomedical Research and Education Foundation (WHOQOL-BREF) instrument was used and adapted to include economic factors. Data were analysed using descriptive and inferential statistics. Results Majority had poor QoL through economic (98.1%), psychological (94.6%), physical (70.3%), and social factors (55.1%). Factors affecting their QoL were influenced by the type of dialysis, and statistical significances were noted in psychological and social factors (p < 0.0001), with those on peritoneal dialysis being affected the most. Overall, majority of patients (91.7%, n = 288) had a score of less than 50, which indicated poor QoL. Conclusion Poor QoL is associated with increased risk of mortality and hospitalisation in patients with ESRD and is mainly influenced by a broad range of dimensions of life. Contribution In addressing challenges encountered by patients, study findings may influence the policymakers to intervene in view of all the dimensions of QoL, to prolong life.
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Affiliation(s)
- Pretty N. Mbeje
- School of Nursing and Public Health, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Gunarathne TGNS, Tang LY, Lim SK, Nanayakkara N, Damayanthi HDWT, Abdullah KL. Factors Associated with Symptom Burden in Adults with Chronic Kidney Disease Undergoing Hemodialysis: A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5540. [PMID: 35564935 PMCID: PMC9105408 DOI: 10.3390/ijerph19095540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 02/01/2023]
Abstract
People with end stage renal disease and undergoing hemodialysis experience a high symptom burden that impairs quality of life. This study aimed to assess the prevalence, dynamicity and determinants of symptom burden among middle-aged and older adult hemodialysis patients. A descriptive cross-sectional study together with a longitudinal assessment was used. A total of 118 and 102 hemodialysis patients were assessed at baseline and at a 6-month follow-up. Validated questionnaires were used to assess the symptom burden, stress, illness perception and social support. Multiple linear regression analysis was used to determine the factors associated with symptom burden. The median number of symptoms experienced was 21 (Interquartile Range (IQR); 18−23) and 19 (IQR; 13−22) at baseline and 6 months, respectively. Having elevated stress (β = 0.65, p ≤ 0.005) and illness perception (β = 0.21, p = 0.02) were significantly predicted symptom burden at baseline (F (4, 112) = 55.29, p < 0.005, R2 = 0.664). Stress (β = 0.28, p = 0.003), illness perception (β = 0.2, p = 0.03), poor social support (β = −0.22, p = 0.01) and low body weight (β = −0.19, p = 0.03) were the determinants for symptom burden at 6 months (F (5, 93) = 4.85, p ≤ 0.005, R2 = 0.24). Elevated stress, illness perception level, poor social support and low post-dialysis body weight were found to be determinants for symptom burden. Attention should be given to psychosocial factors of hemodialysis patients while conducting assessment and delivering care to patients.
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Affiliation(s)
- Thalwaththe Gedara Nadeeka Shayamalie Gunarathne
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; or
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka;
| | - Li Yoong Tang
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; or
| | - Soo Kun Lim
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | | | | | - Khatijah L. Abdullah
- Department of Nursing, School of Medical and Life Science, Sunway University, Bandar Sunway 47500, Malaysia;
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Keskin G. Resilience in patients with dialysis-dependent renal failure: Evaluation in terms of depression, anxiety, traumatic growths. Appl Nurs Res 2022; 65:151575. [DOI: 10.1016/j.apnr.2022.151575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/27/2022] [Accepted: 03/11/2022] [Indexed: 11/27/2022]
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Senanayake S, Gunawardena N, Palihawadana P, Senanayake S, Karunarathna R, Kumara P, Kularatna S. Health related quality of life in chronic kidney disease; a descriptive study in a rural Sri Lankan community affected by chronic kidney disease. Health Qual Life Outcomes 2020; 18:106. [PMID: 32326945 PMCID: PMC7178581 DOI: 10.1186/s12955-020-01369-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 04/16/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The current epidemic of chronic kidney disease (CKD) in Sri Lanka is ascribed to the exponential increase in the number of CKD patients, which cannot be attributed to any known etiology (CKDu). The aim of this study is to describe the health related quality of life (HRQOL) and the associated factors among CKD/CKDu patients in a rural district in Sri Lanka. METHODS A community based cross-sectional study included 1174 CKD/CKDu patients. Kidney Disease Quality of Life-Short Form was used to assess the HRQOL, while Centre for Epidemiologic Studies Depression Scale, General Health Questionnaire (GHQ) 12 and CKD Symptom Index - Sri Lanka were used to assess presence of depression, psychological distress and symptom burden respectively. Three summary scores; kidney disease (KDSC), physical (PCS) and mental (MCS) are derived from Kidney Disease Quality of Life-Short Form (KDQOL-SF™). RESULTS Mean age of the study population was 58.3 years (standard deviation (SD) 10.7). Median KDSC (58.4; inter-quartile range (IQR) 54.2-63.4), was higher than the median scores of PCS (35.0; IQR 26.2-41.9) and MCS (58.4; IQR 54.2-63.4). Multiple linear regression revealed low income, advanced stages of CKD, symptom burden, being positive for depression and psychological distress were significantly associated with low HRQOL. CONCLUSION The HRQOL of the CKD patients in this rural Sri Lankan population was found to be poor. Superior socio-economic status, less physical and psychological symptom burden were found to be independently associated with better HRQOL. Periodical screening of the CKD patients for depression and psychological distress and measures to alleviate symptom burden seem to be important to improve the HRQOL of these patients.
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Affiliation(s)
| | | | | | - Shanika Senanayake
- Australian Centre for Health Service Innovation, Queensland University of Technology, Brisbane, Australia
| | - R Karunarathna
- North Central Provincial Directors Office, Anuradhapura, Sri Lanka
| | - Priyantha Kumara
- North Central Provincial Directors Office, Anuradhapura, Sri Lanka
| | - Sanjeewa Kularatna
- Australian Centre for Health Service Innovation, Queensland University of Technology, Brisbane, Australia
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Wang Q, Liu H, Ren Z, Xiong W, He M, Li N, Fan X, Guo X, Li X, Shi H, Zha S, Zhang X. The Associations of Family Functioning, General Well-Being, and Exercise with Mental Health among End-Stage Renal Disease Patients. Psychiatry Investig 2020; 17:356-365. [PMID: 32252511 PMCID: PMC7176562 DOI: 10.30773/pi.2019.0204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/04/2020] [Accepted: 02/12/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress. Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioning and psychological distress. METHODS Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item General Health Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzed using multiple linear regression analysis and path analysis. RESULTS The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factors of psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by general well-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated by exercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029). CONCLUSION The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercise were associated with psychological distress. Family functioning could affect psychological distress partially by affecting general well-being. Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Xiong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Nan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
- The First Hospital of Qiqihar City, Qiqihar, China
| | - Xinwen Fan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xia Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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Wang Q, Liu H, Ren Z, Xiong W, He M, Fan X, Guo X, Li X, Shi H, Zha S, Qiao S, Zhao H, Li N, Zhang X. Gender difference in the association of coping styles and social support with psychological distress among patients with end-stage renal disease. PeerJ 2020; 8:e8713. [PMID: 32257634 PMCID: PMC7103200 DOI: 10.7717/peerj.8713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/10/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives The study aimed to explore the association of coping styles and social support with psychological distress among patients with end-stage renal disease (ESRD) as well as gender differences in these associations. Methods A cross-sectional study of 769 ESRD patients was conducted at 25 hospitals in Qiqihar City, China. All information was collected using structured questionnaires that were self-administered by the patients. Patients' psychological health status, coping styles and perceived social support were measured using the 12-item General Health Questionnaire, the Medical Coping Modes Questionnaire and the Multidimensional Scale of Perceived Social Support. Student's t test, analysis of variance (ANOVA) and binary logistic regression analysis were used for data analysis. Results A total of 72.3% of participants reported psychological distress, and the prevalence of distress was higher in females (77.0%) than in males (68.8%). The usage of the acceptance-resignation coping style was positively related to psychological distress (B = 0.459, P < 0.001). Social support level was negatively associated with psychological distress (B = -0.049, P < 0.001). The use of the confrontation style was negatively related to psychological distress in females (OR = 0.87, 95% CI [0.78-0.96]) but not in males (OR = 0.98, 95% CI [0.91-1.06]) (P for interaction term = 0.007). Conclusions Greater use of the acceptance-resignation style and lower social support are related to a higher risk of psychological distress. Greater use of the confrontation style is related to a lower risk of psychological distress in females but not in males.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Wenjing Xiong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xinwen Fan
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xia Guo
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuyin Qiao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Nan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.,The First Hospital of Qiqihar City, Qiqihar, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
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Zhao Y, Chen YP, Wu YQ, Bao BY, Fan H. Effect of physical activity on depression symptoms in patients with IgA nephropathy. J Int Med Res 2020; 48:300060519898008. [PMID: 31948307 PMCID: PMC7113810 DOI: 10.1177/0300060519898008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yu Zhao
- Department of Nephrology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang Province, China
| | - Ya-ping Chen
- Department of Psychiatry, Ningbo Psychiatric Hospital, The Demobilized Veterans Psychiatric Sanatorium of Zhejiang Province, Ningbo, Zhejiang Province, China
| | - Yue-qing Wu
- Department of Psychiatry, Ningbo Psychiatric Hospital, The Demobilized Veterans Psychiatric Sanatorium of Zhejiang Province, Ningbo, Zhejiang Province, China
| | - Bei-yan Bao
- Department of Nephrology, Ningbo Urology and Nephrology Hospital, Ningbo, Zhejiang Province, China
- Bei-yan Bao, Department of Nephrology, Ningbo Urology and Nephrology Hospital, No.1 Qianhe Road, Ningbo, Zhejiang Province, People’s Republic of China.
| | - Heng Fan
- Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, Zhejiang Province, China
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Senanayake S, Mahesh PKB, Gunawardena N, Graves N, Kularatna S. Validity and internal consistency of EQ-5D-3L quality of life tool among pre-dialysis patients with chronic kidney disease in Sri Lanka, a lower middle-income country. PLoS One 2019; 14:e0211604. [PMID: 31242189 PMCID: PMC6594575 DOI: 10.1371/journal.pone.0211604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/12/2019] [Indexed: 11/18/2022] Open
Abstract
Objective EQ-5D-3L is a generic QOL tool used mainly in economic evaluations. Burden of Chronic Kidney Disease (CKD) is rising in Sri Lanka. Assessing the validity of generic QOL tools creates new opportunities of their utilization among patients with CKD. Methods A cross-sectional study was conducted among 1036 CKD patients, selected using the simple random sampling technique. The validity was tested with six a-priori hypotheses. These included construct validity assessments, evaluating convergent validity and performing known group comparisons. EQ-5D-3L, Short Form-36 (SF-36) were used to assess QOL. Center for Epidemiological Studies Depression Scale (CES-D-20) and General Health Questionnaire-12 (GHQ-12) were used to assess the presence of depression and psychological distress respectively. Internal consistency of the whole tool and when each item is removed was assessed by Cronbach alpha. Results The response rate was 99.2%. Majority of participants were males (n = 646,62.4%) in the age category of 41–60 (n = 530; 51.2%). Most were in either stage 4 or 5 of CKD (n = 646,75.1%). The summary measures of SF-36, positively and significantly correlated with the EQ-5D-3L index and VAS scores (p<0.001). EQ-5D-3L QOL scores were significantly different between the group with depression and without as measured by CES-D-20 (p<0.001). Assessed using GHQ-12, similar significance was detected between the group with psychological distress and without (p<0.001). The Cronbach alpha was 0.834 and when each item was removed, ranged from 0.782 to 0.832. Conclusion EQ-5D-3L is a valid generic QOL tool with satisfactory internal consistency to be used among CKD patients in the pre-dialysis stage.
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Affiliation(s)
- Sameera Senanayake
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
- Ministry of Health, Colombo, Sri Lanka
- * E-mail:
| | - P. K. B. Mahesh
- Ministry of Health, Colombo, Sri Lanka
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Nicholas Graves
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia
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