Economic, Social, and Psychological Factors Associated With Health‐Related Quality of Life of Chronic Hemodialysis Patients in Northern Taiwan: A Multicenter Study

Abstract

This study evaluated the associations between economic, social, psychological factors, and health-related quality of life of hemodialysis patients. Cross-sectional study design was used. End-stage renal disease patients who had received maintenance hemodialysis for more than 2 months at 14 centers in northern Taiwan were invited to participate. Demographic, economic, and psychosocial data of patients were collected. Depression was assessed by the Beck Depression Inventory. Health-related quality of life was measured by the Medical Outcomes Study Short-Form 36. Multivariable linear regression analyses were performed. Eight hundred sixty-one patients (373 males, mean age 59.4 +/- 13.2 years) completed the study. Higher monthly income was positively associated with role emotional and mental health (P < 0.05), and so was increased frequency of social activities with social functioning (P < 0.05). The more worries, the stronger the inverse associations with social functioning (P < 0.05) and mental health (P < 0.01). Higher depression scores were associated with lower scores of all Short-Form 36 dimensions (P < 0.01). Higher monthly income and increased social activities are associated with better health-related quality of life, whereas more worries and higher depression scores are associated with worse health-related quality of life of hemodialysis patients.

Quality of life in end stage renal disease patients

“…In-depth Review Fleck et al [53] , 2007 Discussion Carver et al [57] , 1995 Review Blinkhorn [61] , 2012 Review O'Connor et al [64] , 2012 Review Catania et al [65] , 2013 Report Quantitative Study design Questionnaire used Mapes et al [8] Longitudinal KDQOLSF-36 Kao et al [13] , 2009 Cross sectional SF-36 Abraham et al [14] , 2008 Case control, follow up WHOQOL-BREF Kimmel et al [15] , 2008 Prospective Satisfaction with Life Scale (SLS), McGill QOL, Single item Patel et al [16] , 2002 Prospective McGill QOL, Beck Depression Griva et al [17] , 2009 Cross sectional SF-36 Elder et al [19] , 2008 Cross sectional, case mix KDQOLSF-36 Sanner et al [20] , 2002 Cross sectional SF-36, Nottingham Health Profile Tondra [22] , 2014 Conceptual Framework, CS Quality of Life Index Dialysis, Mingardi et al [23] , 1999 Prospective SF-36 Seica et al [24] , 2009 Cross sectional SF-36, KDQOLSF-36 Bakewell et al [25] , 2002 Longitudinal /intervention KDQOLSF-36 Theofilou [26] , 2012 Cross sectional/ Observational WHOQOL-BREF, GHQ-28 Kim et al [28] , 2013 Cross sectional KDQOLSF-36 White et al [29] , 2002 Retrospective cohort SF-36 Painter et al [32] , 2000 Experimental/Intervention SF-36 Ouzouni et al [33] , 2009 RCT SF-36, Quality of Life Index Agakhani et al [34] , 2012 Case control/comparative SF-36 Hegazy et al [35] , 2013…”

“…[22,25] , influence of dialysis care practice [27] , self-efficacy, treatment satisfaction [28] , pre-dialysis clinic attendance [29] , exercise [30] . Intervention such as dietary counseling [34,35] , individual/group counselling [14,36,37,40] , education on regular exercise [31][32][33] , physical and psychological rehabilitation interventions, palliative care to manage symptoms [38] , and cognitive behavior therapy to reduce depression [39] Inverse association of factors with QOL More worries and higher depression [13] , ignorance about the basic facts of one's disease [14] , Pain, financial constraints [14] , psychological and spiritual factors [15] , emotional impact, physical impact on daily living, role of religious and spiritual beliefs [16] , beliefs related to illness and treatment [17] , anxiety, depression, suicidal ideation, grief of loss of kidney, self-image selfesteem [18] , sleep quality [19] , sleep related breathing disorders [20] , as well as erectile dysfunction, patient satisfaction with care, depressive aspects, symptom burden, and perception of intrusiveness of illness [21] , female gender [22][23][24]26] , ethnicity [25] , older age [26] , less education [24,26] , poor nutritional status [25] and divorced marital status, Illness and treatment beliefs [17] , work and Symptom domain [25] No or very weak association of fa...…”

“…The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease ([ESRD] CHOICE) [27] . Additionally, few researchers use The Kidney Disease Questionnaire -KDQ [58] , Renal Quality of Life Health Profile (RQLP), and Quality of Life Index-D. Each QOL tool covers a number of domains (measurements of different characteristics) and they measure quantitative outcomes 13 . Culture specific validation has been reported for these instruments in many countries.…”

The prevalence of anxiety and depression among end-stage renal disease patients on hemodialysis in Saudi Arabia

“…This issue was discussed in another study, but this study demonstrated the positive effects of a supportive family environment, finding that social and family support was one of the most important factors for improving patients' QOL. 41 In conclusion, anxiety and depressive symptoms are prevalent among ESRD patients in Makkah. To the best of our knowledge, this is the first study to screen HD patients for anxiety and depression in Saudi Arabia.…”

“…Based on previous studies, 2,[8][9][10]12,13,15,16,18,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] we assumed the existence of a 20% difference in the prevalence of depression between the general population and ESRD patients on HD. In order to obtain a confidence level (power) of 95% and a confidence limit of 10%, we aimed to study 246 patients (calculated using the QuesGen Systems sample size calculator).…”