Haikel A Lim1,2, Zhenli Yu2, Augustine W C Kang2, Marjorie W Y Foo3, Konstadina Griva4. 1. Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore. 2. Department of Psychology, National University of Singapore, Block AS4, #02-07, 9 Arts Link, Singapore, 117570, Singapore. 3. Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856, Singapore. 4. Department of Psychology, National University of Singapore, Block AS4, #02-07, 9 Arts Link, Singapore, 117570, Singapore. psygk@nus.edu.sg.
Abstract
BACKGROUND: Quality of life (QOL) impairments are common in patients undergoing dialysis, and have been strongly associated with significant clinical outcomes like mortality and morbidity. Despite this, little is known about the course of QOL over time, especially for patients on peritoneal dialysis (PD). PURPOSE: This prospective study was set to explore course and determinants of QOL over 12 months in PD patients. METHODS: A total of 115 PD patients completed the SF-12 and Kidney Disease Quality of Life Short Form (KDQOL-SF) at baseline and 12 months later. Intra-individual changes in physical (physical component summary, PCS), mental (mental component summary, MCS), and Kidney Disease Component Summary scores (KDCS) were identified based on the minimally important clinical difference threshold. Clinical information was extracted from medical records. RESULTS: Of the patients, 74-80 % reported physical QOL impairments, as compared to 29-33 % who reported mental/emotional QOL impairments. PCS and MCS scores remained stable across 12 months. Significant deterioration was noted in the domains of patient satisfaction, staff encouragement, and social support, while there were significant increases in the perceived effects of kidney disease. Intra-individual trajectory analyses indicated that one in three patients reported deteriorating QOL. No sociodemographic or clinical variables were found to be associated with course of outcomes. CONCLUSIONS: Although PD offers the convenience of home-based care, it is associated with persisting QOL impairments and diminishing QOL over time, especially in domains related to quality of care and support. This highlights the need for improving or maintaining standards of care and support for PD patients as they become increasingly established on their regimes.
BACKGROUND: Quality of life (QOL) impairments are common in patients undergoing dialysis, and have been strongly associated with significant clinical outcomes like mortality and morbidity. Despite this, little is known about the course of QOL over time, especially for patients on peritoneal dialysis (PD). PURPOSE: This prospective study was set to explore course and determinants of QOL over 12 months in PDpatients. METHODS: A total of 115 PDpatients completed the SF-12 and Kidney Disease Quality of Life Short Form (KDQOL-SF) at baseline and 12 months later. Intra-individual changes in physical (physical component summary, PCS), mental (mental component summary, MCS), and Kidney Disease Component Summary scores (KDCS) were identified based on the minimally important clinical difference threshold. Clinical information was extracted from medical records. RESULTS: Of the patients, 74-80 % reported physical QOL impairments, as compared to 29-33 % who reported mental/emotional QOL impairments. PCS and MCS scores remained stable across 12 months. Significant deterioration was noted in the domains of patient satisfaction, staff encouragement, and social support, while there were significant increases in the perceived effects of kidney disease. Intra-individual trajectory analyses indicated that one in three patients reported deteriorating QOL. No sociodemographic or clinical variables were found to be associated with course of outcomes. CONCLUSIONS: Although PD offers the convenience of home-based care, it is associated with persisting QOL impairments and diminishing QOL over time, especially in domains related to quality of care and support. This highlights the need for improving or maintaining standards of care and support for PDpatients as they become increasingly established on their regimes.
Entities:
Keywords:
Asia; End-stage kidney disease; Peritoneal dialysis; Quality of life
Authors: J Thumboo; S P Chan; D Machin; C H Soh; P H Feng; M L Boey; K H Leong; S T Thio; K Y Fong Journal: Ann Acad Med Singapore Date: 2002-05 Impact factor: 2.473
Authors: Allison Tong; Brian Lesmana; David W Johnson; Germaine Wong; Denise Campbell; Jonathan C Craig Journal: Am J Kidney Dis Date: 2012-11-21 Impact factor: 8.860
Authors: Miquel Sitjar-Suñer; Rosa Suñer-Soler; Afra Masià-Plana; Emilia Chirveches-Pérez; Carme Bertran-Noguer; Concepció Fuentes-Pumarola Journal: Int J Environ Res Public Health Date: 2020-06-14 Impact factor: 3.390