Quality of life and social reinsertion of patients on maintenance haemodialysis in three regions of Cameroon

Abstract

Background Reduced quality of life is associated with shorter survival in chronic illnesses. However, the health-related quality of life (HRQOL) and social reinsertion of patients on maintenance haemodialysis is much more underappreciated in resource-limited countries such as Cameroon. Method A hospital-based cross-sectional study was carried out from February 22nd to May 20th, 2022, in 4 government-funded haemodialysis centres in three randomly selected regions of Cameroon. Patients received twice-weekly dialysis sessions. Social reinsertion and HRQOL were assessed using a structured questionnaire and the kidney disease quality of life instrument (KDQOL-36™). HRQOL scores < 50 were categorized as low, while scores > 50 reflected better HRQOL. Data were analysed using the software statistical package for Social Sciences version 25.0. Statistical significance was set at a p value < 0.05. Results The study included 434 patients. The mean age was 48.33 (13.55) years, 65.7% (285/434) were male, 62.3% (269/434) had no monthly income, and the mean dialysis vintage was 3.74 (3.83) years. The mean HRQOL score was 44.34 (9.77), and 76.2% (325/434) had HRQOL scores < 50). Overall HRQOL was associated with older age (aOR: 2.344, CI 1.089–5.04). After the initiation of maintenance haemodialysis, 67.1% (49/73) of students dropped out of school. The main reason for school absenteeism and unemployment was physical insufficiency, with 82.4% (19/24) and 52.4% (75/144), respectively. There were no promotions or marriages after initiation; 51% (221/434) of relationships with relatives and friends were affected negatively, while 83.3% (66/79) of those of marriageable ages could not find suitors. The social participation score was poor in 61.5% (267/434) of participants. There was an association between low QOL and social participation (p = 0.009). Conclusion The HRQOL of patients on maintenance hemodialysis is greatly reduced, especially their physical health status. Older age was a determinant of low QOL. Additionally, social reinsertion remains poor due to adverse changes that occur to these patients and their families after dialysis initiation.