Measuring quality of life in trials including patients on haemodialysis: methodological issues surrounding the use of the Kidney Disease Quality of Life Questionnaire

BACKGROUND

Haemodialysis (HD) treatment causes a significant decrease in quality of life (QoL). When enrolled in a clinical trial, some patients are lost prior to follow-up because they die or they receive a kidney transplant. It is unclear how these patients are dealt with in the analysis of QoL data. There are questions surrounding the consistency of how QoL measures are used, reported and analysed.

METHODS

A systematic search of electronic databases for trials measuring QoL in HD patients using any variation of the Kidney Disease Quality of Life (KDQoL) Questionnaire was conducted. The review was conducted in Covidence version 2. Quantitative analysis was conducted in Stata version 16.

RESULTS

We included 61 trials in the review, of which 82% reported dropouts. The methods to account for missing data due to dropouts include imputation (7%) and complete case analysis (72%). Few trials (7%) conducted a sensitivity analysis to assess the impact of missing data on the study results. Single imputation techniques were used, but are only valid under strong assumptions regarding the type and pattern of missingness. There was inconsistency in the reporting of the KDQoL, with many articles (70%) amending the validated questionnaires or reporting only statistically significant results.

CONCLUSIONS

Missing data are not dealt with according to the missing data mechanism, which may lead to biased results. Inconsistency in the use of patient-reported outcome measures raises questions about the validity of these trials. Methodological issues in nephrology trials could be a contributing factor to why there are limited effective interventions to improve QoL in this patient group.

PROSPERO REGISTRATION

CRD42020223869.

The effect of psychosocial distress and self-transcendence on resilience in patients with cancer

PURPOSE

The aim of this study is to determine the effect of psychosocial distress and self-transcendence on resilience in individuals receiving cancer treatment. This descriptive-correlational study was conducted with individuals receiving cancer treatment (N = 105) from in the chemotherapy unit of a private hospital.

CONCLUSION

According to the results of the regression analysis, it was determined that psychosocial distress had a negative relationship with resilience, while self-transcendence had a positive relationship with resilience (p < 0.05).

PRACTICE IMPLICATION

The results show that resilience is negatively affected by psychosocial distress and positively affected by self-transcendence. Psychiatric nurses can help patients with cancer find sources of self-transcendence and resilience.

The relationships between self-transcendence and depressive symptoms, self-esteem, and locus of control in individuals diagnosed with substance addiction

AIMS

This study examined the relationships between self-transcendence and depressive symptoms, self-esteem, and locus of control in persons with substance abuse disorder (SUDs).

METHODS

This descriptive-relational study examined 115 participants who had been diagnosed with SUD.

RESULTS

High self-transcendence scores were positively associated with lower levels of depressive symptoms, higher levels of self-esteem, and internal locus of control.

PRACTICE IMPLICATIONS

Mental health nurses are effective at finding and maintaining resources that promote self-transcendence and support the potential and well-being of individuals with SUD. This study addresses a research gap regarding self-transcendence in such individuals; it provides a basis for nurses to develop interventions to strengthen the mental health of patients and conduct future investigations on the topic.