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Nowrooz S, Alanazi T, Al-Ghamdi A, Alzahrani A, Alshammari A, AlYaqoot N, Almutraid M, Jaradat A, El-Agroudy A. Quality of Life among Hemodialysis Patients: Role of the Dialysis Shift. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2023; 34:S122-S132. [PMID: 38995280 DOI: 10.4103/sjkdt.sjkdt_370_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
This study examined the effects of the time of hemodialysis (HD) on patients' quality of life (QOL). This study included 175 HD patients (116 males, 59 females), aged 18-80 years (mean = 58.1 ± 11.3 years). Shift 1 was 7:00-11:00 AM, Shift 2 was 12:00-4:00 PM, Shift 3 was 5:00-9:00 PM, and Shift 4 was 10:00-2:00 AM (38, 38, 43, and 56 patients, respectively). Those on Shift 4 had a higher mean age compared with the other shifts, with a higher number of widowed people (8.6%). The proportions of males and females showed no significant differences among the shifts. The mean duration on dialysis was 42.1 ± 39.3 months, with a shorter duration for Shift 4. We observed the highest QOL score for the psychological and spiritual subscale, followed by the family subscale. Half the patients were dissatisfied with their jobs and had less satisfaction with their sexual life, their education, and getting a kidney transplant. We found a significant difference in overall QOL among shifts, with the greatest difference between Shifts 3 and 4. Health and functioning, psychological and spiritual, and social and economic scores were lowest in Shift 4, which was significantly different from Shift 1 and Shift 3. We found significant associations between overall QOL and general health, and the scores from different domains. Satisfaction was moderate in all groups. The study revealed poor QOL among Shift 4 patients; hence, they need more support in clinical practice guidelines.
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Affiliation(s)
- Safa Nowrooz
- Department of Nephrology, Salmaniya Medical Complex, Arabian Gulf University, Manama, Bahrain
| | - Turki Alanazi
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Abdulmohsen Al-Ghamdi
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Abdulaziz Alzahrani
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Abdulrahman Alshammari
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Neda AlYaqoot
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Mana Almutraid
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmed Jaradat
- Department of Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Amgad El-Agroudy
- Department of Internal Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Khoury R, Ghantous Z, Ibrahim R, Ghossoub E, Madaghjian P, Karam E, Karam G, Fares N, Karam S. Anxiety, depression and post-traumatic stress disorder in patients on hemodialysis in the setting of the pandemic, inflation, and the Beirut blast: a cross-sectional study. BMC Psychiatry 2023; 23:284. [PMID: 37087412 PMCID: PMC10122541 DOI: 10.1186/s12888-023-04798-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/18/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND In 2020, Lebanon has witnessed its worst economic crisis, exacerbated by the COVID-19 pandemic and a massive explosion of its capital. Amidst these stressors, this study aims at assessing the prevalence of depression, anxiety, suicidality, post-traumatic stress disorder (PTSD) and cognitive impairment in patients undergoing hemodialysis in an academic hospital destroyed by the explosion. METHODS This cross-sectional study conducted 6 months after the blast included adults on hemodialysis, with no previous diagnoses of dementia or intellectual disability. It explores prevalence rates of psychiatric disorders, in addition to other medical and psychosocial variables such as frailty, malnutrition, sarcopenia, quality of life and religiosity. RESULTS Forty two patients (mean age 66.1; SD: 11.2 years) undergoing hemodialysis for 6.12 years (SD:7.22 years) were included. Anxiety and depression rates reached 54.8% and 57.1% using cut-offs of 6 and 7 respectively on the Hospital Anxiety and Depression rating Scale. 9.5% of the patients reported being in the hospital at the time of the blast and 7.1% reported being injured. 33.3% screened positively for PTSD using a cut-off of 23 on the PCL-5. 26.2% had passive death wishes and 7.1% had suicide plans, however no one had attempted it. 23.8% were found cognitively impaired as shown by the Mini-Cog (<3). Around two-third of participants were moderately to severely malnourished per the GLIM criteria. One third suffered from frailty, according to the FRAIL screening tool. Around 60% suffered from sarcopenia, based on handgrip strength measures. These findings contrast with "acceptable to good" quality of life subjectively reported by participants on the Short Form 36 (SF-36) Health Survey. While one-third of participants participated in organizational religious activities, 88% reported significant subjective meaning of religion in their heart. CONCLUSIONS Rates of depression, anxiety, PTSD, suicidality, and cognitive impairment were found to be alarming in the setting of an urban dialysis unit following a major explosion. Psychiatric disorders were found to be compounded with increased prevalence of malnutrition, frailty, and sarcopenia. These findings urge healthcare providers to implement early diagnostic and intervention strategies to improve both mental and physical wellbeing of this vulnerable population, in similar settings.
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Affiliation(s)
- Rita Khoury
- Department of Psychiatry, American University of Beirut, PO Box: 11-0236, Beirut, 1107, Riad El Solh, Lebanon.
| | - Ziad Ghantous
- Department of Psychiatry, Washington University in St. Louis, Clayton, Missouri, United States
| | - Roy Ibrahim
- Department of Psychiatry and Clinical Psychology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Elias Ghossoub
- Department of Psychiatry, American University of Beirut, PO Box: 11-0236, Beirut, 1107, Riad El Solh, Lebanon
| | - Patille Madaghjian
- Department of Nutrition, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Georges Karam
- Department of Psychiatry and Clinical Psychology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Najat Fares
- Department of Internal Medicine, Division of Nephrology, Saint Georges Hospital University Medical center, Beirut, Lebanon
| | - Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, United States
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Butt MD, Ong SC, Butt FZ, Sajjad A, Rasool MF, Imran I, Ahmad T, Alqahtani F, Babar ZUD. Assessment of Health-Related Quality of Life, Medication Adherence, and Prevalence of Depression in Kidney Failure Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15266. [PMID: 36429988 PMCID: PMC9690334 DOI: 10.3390/ijerph192215266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Kidney failure is a global health problem with a worldwide mean prevalence rate of 13.4%. Kidney failure remains symptomless during most of the early stages until symptoms appear in the advanced stages. Kidney failure is associated with a decrease in health-related quality of life (HRQOL), deterioration in physical and mental health, and an increased risk of cardiovascular morbidity and mortality. This study aimed to evaluate the factors associated with decreased HRQOL and other factors affecting the overall health of patients. Another objective was to measure how medication adherence and depression could affect the overall HRQOL in patients with kidney failure. METHODOLOGY The study used a prospective follow-up mix methodology approach with six-month follow-ups of patients. The participants included in the study population were those with chronic kidney disease grade 4 and kidney failure. Pre-validated and translated questionnaires (Kidney Disease Quality of Life-Short Form, Hamilton Depression Rating Scale Urdu Version, and Morisky Lewis Greens Adherence Scale) and assessment tools were used to collect data. RESULTS This study recruited 314 patients after an initial assessment based on inclusion criteria. The mean age of the study population was 54.64 ± 15.33 years. There was a 47.6% male and a 52.4% female population. Hypertension and diabetes mellitus remained the most predominant comorbid condition, affecting 64.2% and 74.6% of the population, respectively. The study suggested a significant (p < 0.05) deterioration in the mental health composite score with worsening laboratory variables, particularly hematological and iron studies. Demographic variables significantly impact medication adherence. HRQOL was found to be deteriorating with a significant impact on mental health compared to physical health. CONCLUSIONS Patients on maintenance dialysis for kidney failure have a significant burden of physical and mental symptoms, depression, and low HRQOL. Given the substantial and well-known declines in physical and psychological well-being among kidney failure patients receiving hemodialysis, the findings of this research imply that these areas related to health should receive special attention in the growing and expanding population of kidney failure patients.
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Affiliation(s)
- Muhammad Daoud Butt
- School of Pharmaceutical Sciences, University Sains Malaysia, Penang 11800, Malaysia
- Department of Pharmacy, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 15320, Pakistan
| | - Siew Chin Ong
- School of Pharmaceutical Sciences, University Sains Malaysia, Penang 11800, Malaysia
| | | | | | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60000, Pakistan
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60000, Pakistan
| | - Tanveer Ahmad
- Institute for Advanced Biosciences (IAB), CNRS UMR5309, INSERM U1209, Grenoble Alpes University, 38400 Saint-Martin-d’Hères, France
| | - Faleh Alqahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Huddersfield HD1 3DH, UK
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Asghar MS, Ahsan MN, Mal P, Tahir MJ, Yasmin F, Abbasher Hussien Mohamed Ahmed K. Assessment of quality of life determinants in hemodialysis patients of a developing country: A cross-sectional study during ongoing COVID-19 pandemic. Medicine (Baltimore) 2022; 101:e29305. [PMID: 35945800 PMCID: PMC9351511 DOI: 10.1097/md.0000000000029305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Patients of end-stage renal disease are prone to have a very low quality of life (QoL). Variety of factors influence the QoL among sufferers of chronic kidney disease comprising of type of dialysis, sufficiency/adequacy of dialysis, and associated burden of disease. We conducted this study amidst the pandemic to determine the associated factors for poor QoL in hemodialysis patients during the ongoing pandemic. PATIENTS AND METHODS This cross-sectional study was conducted in a hemodialysis unit of a tertiary care hospital. A total of 118 participants responded to the validated questionnaire of Quality of Life Index-dialysis version-III (QLI). Higher scores signify good QoL, total scores are further categorized into subgroups desirable, relatively desirable and undesirable. RESULTS The mean age of the participants was 57.36 ± 10.03 years and mean body mass index of 26.73 ± 5.54 kg/m2. The mean total QoL of the study population was found quite low (12.99 ± 5.89). Majority of respondents fell in undesirable category of QoL (49.2%). Total QoL (P = 0.004) and subscale health/functioning (P = 0.003) were significantly lower in females. All the subscales along with total QoL scores were found lower in twice-weekly dialyzed patients (P < 0.001). Marital status (P = 0.049) and twice-weekly dialysis (P < 0.001) were found significant with undesirable QoL. On multivariate analysis, significant determinants of undesirable QoL were twice-weekly dialysis (P = 0.001), catheter access (P = 0.034), phosphate (P = 0.005) and uric acid (P = 0.006). CONCLUSION Inadequate dialysis due to lesser frequency per week leading to poorly cleared toxic substances were most significant contributors of poor QoL in our study.
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Affiliation(s)
- Muhammad Sohaib Asghar
- Department of Internal Medicine, Dow University of Health Sciences–Ojha Campus, Karachi, Pakistan
| | - Muhammad Nadeem Ahsan
- Department of Nephrology, Dow University of Health Sciences–Ojha Campus, Karachi, Pakistan
| | - Pooran Mal
- Department of Nephrology, Liaquat University of Medical & Health Sciences, Karachi, Pakistan
| | | | - Farah Yasmin
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Khabab Abbasher Hussien Mohamed Ahmed
- University of Khartoum, Faculty of Medicine, Khartoum, Sudan
- *Correspondence: Khabab Abbasher Hussien Mohamed Ahmed, Al-Gama’a Avenue, P. O. Box 321, 11111, Khartoum, Sudan (e-mail: )
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