Assessment of quality of life in patients undergoing hemodialysis using WHOQOL-BREF questionnaire: a multicenter study

Abstract

Background Assessment of quality of life (QOL) of patients with end-stage renal disease has become increasingly important, both in order to evaluate the influence of the disease on patients and the type of renal replacement therapy they require. Therefore, in this study, we aimed to assess QOL in patients undergoing hemodialysis and evaluated the effects of various sociodemographic factors affecting QOL of such patients in Nepal. Methods A cross-sectional study was conducted among 150 patients with chronic kidney disease undergoing hemodialysis at two major centers in Nepal. Demographic data including age, sex, ethnicity, educational status, marital status, employment, income, duration of illness, and duration on hemodialysis were collected. QOL was assessed using the World Health Organization Quality of life (WHOQOL-BREF) questionnaire. Four domains (physical, psychological, social, and environmental) and two items (overall perception of QOL and health) of the WHOQOL-BREF were the primary end points of this study. Bivariate relationship between sociodemographic factors and QOL scores were analyzed using independent samples t -test and one-way analysis of variance. Multiple linear regression analysis was performed to determine independent predictors of QOL. Results Following QOL scores were recorded: environmental domain (53.17±15.59), psychological domain (51.23±18.61), social domain (49.86±21.64), and physical domain (45.93±16.90). Older age was associated with a better QOL score in the social domain ( p =0.005), and employed patients scored better in the environmental domain ( p =0.019). Unemployed patients and those of the Terai/Madhesi ethnic group had significantly low scores in overall perception of health ( p <0.05) as compared to other groups. Low income status and increased duration on hemodialysis were found to be the only independent negative predictors of QOL in patients with hemodialysis ( p <0.05). Conclusion Patients with chronic kidney disease on dialysis had overall low QOL scores in all four domains. Age, ethnicity, employment status, income, and duration on hemodialysis affected one or more domains of QOL in such patients. Low income status and increased duration on hemodialysis were the only independent negative predictors of QOL of patients on maintenance hemodialysis.

Health related quality of life among end stage renal disease patients from low income country, Nepal: a cross sectional study using WHOQOL-BREF

“…The lower QOL in physical domain in dialysis patients than transplant patients can be attributed to physical pain, weakness, insomnia and hindrance to daily activities as identi ed in previous studies [32,33]. A study previously done in Nepal also had pointed increased duration of hameodialaysis as a negative predictor of QOL [34].Similarly, the reason for renal transplant patients having a higher QOL in psychological domain might be due to decrease in mental burden resulting from having to visit health facility for frequent dialysis. Similarly, the increased self-esteem and improved perception regarding own health might have contributed to good mental wellbeing among renal transplant patients [26].…”

Quality of Life Among Patients With Chronic Kidney Disease Who are Undergoing Haemodialysis at Two Selected Teaching Hospitals in Sri Lanka

“…QOL under physical domain was lower than the other domain and QOL under environmental domain was higher than the other domains. Similarly, a study done in Nepal revealed that patients with CKD undergoing dialysis had overall low QOL scores in all four domains (Joshi et al, 2017).…”

“…Another study found that participants of higher education had a better quality of life, possibly because education allows an in-depth understanding of the disease and compliance with the therapeutic regimen. Another alternative explanation is that higher education may reflect higher income and consequently, the ability to afford treatment (Gerasimoula et al, 2015). A similar study conducted in Iran revealed that older age, female gender, and lower educational level were significantly associated with a lower score of all physical, psychological, and social domains of QOL (Tilaki et al, 2017).…”

An ethnography exploring the quality of life of people living with schizophrenia in Zimbabwe: Implications for health service policy and practice

“…whilst the lowest was in the social relationship domain (9.5). However, the low score in the social domain was expected as it was based on three items instead of the four recommended for assessing internal reliability [37]. The low alpha score in the psychological domain (0.59) could be attributed to the limited number of valid responses (n=16) or the poor interrelatedness between the items [38].…”