Quality of Life among Patients Undergoing Haemodialysis in Bandung: A Mixed Methods Study

Abstract

Quality of life (QoL) has become one of important outcome measures of renal replacement therapy, including haemodialysis. However, the assessment of QoL is not comprehensively measured and most research about it use quantitative approach. Since QoL is subjective, assessing and understanding the qualitative evidence are very important. This study aimed to explore QoL in patients with end-stage renal disease (ESRD) undergoing haemodialysis. This research is a cross-sectional study used a mixed method approach. Patients undergoing dialysis were recruited from the dialysis unit in one private hospital in Bandung. They completed the Kidney Disease and Quality of Life (KDQOL-36™) questionnaire and then went on face to face interview. Quantitative data were analysed descriptively and qualitative data were analysed using thematic analysis with qualitative data analysis software. A total of 87 patients completed the questionnaires and 34 of them participated in 20-60 minutes interview. The symptom and problem list had the highest mean score (M= M=63.60), indicated that patients experienced lack of energy, mobility and physical appearance that further produced difficulties in their daily activities. Additionally, mental component summary showed a higher mean score (M=49.23) than the physical component (M=36.22) indicated that patients most likely had worse mental health condition than their general physical health. Worse mental health condition induced with negative feeling among patients. Patient’s inability to do daily activity and change in physical appearance had impact on their confidence for social relationship. Conclusion: ESRD patients undergoing haemodialysis were bothered by the symptom of illness and worsen by the negative feelings.

Self-Efficacy and Compliance Fluid Intake Restriction as a Determinant of The Interdialytic Weight Gain (IDWG) Level

“…Hemodialized patients need high support from health workers, especially nurses in maintaining the increased IDWG level. According to Kustimah, Siswandi, Djunaidi & Iskandarsyah (2020), it is explained that CKD patients undergoing hemodialysis will experience physical and mental disorders due to their illness which can limit patients''' from doing their activities. By limiting the increase in IDWG level, it can help reduce the burden on patients due to their disease.…”

Symptom Burden’s Associated Factors among Hemodialysis Patients

“…Dialysis process was one of the stressors caused psychological problems, where the patient felt depressed, lacked of social support from the closest person, tired with the dialysis process, felt hopeless, anxious, had thoughts of loss, high awareness of death, and felt uncertain about the disease (Avdal et al, 2020;Cervantes et al, 2016). In addition, lifestyle changes, feeling overwhelmed by self-care, physical symptoms arising from uremia and medication were also associated with depression (Kustimah et al, 2020;Shirazian et al, 2017). The dialysis process and uremic conditions may activate an inflammatory response that results in the release of proinflammatory cytokines (Sukandar, 2006).…”

Multidimensional Symptom Burden among Patients with Hemodialysis in Indonesia

“…This finding was related to the previous research which stated that fatigue or lack of energy was dominant and consistent among patients with hemodialysis along all dimensions . The majority of patients on hemodialysis commonly experienced fatigue or lack of energy (Kustimah, Siswadi, Djunaidi, & Iskandarsyah, 2020). Among patients on hemodialysis, fatigue may be caused by many factors such as inadequate hemodialysis treatment, demographic characteristics (older age and female), psychosocial problem (depression, anxiety, low social support), physiological factors (anemia, lower albumin serum, lower creatinine interdialytic weight gain), and low sleep quality (Horigan, 2012).…”