Mi-Kyung Song1, Sudeshna Paul2, Sandra E Ward3, Constance A Gilet4, Gerald A Hladik4. 1. Center for Nursing Excellence in Palliative Care, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. Electronic address: mi-kyung.song@emory.edu. 2. Center for Nursing Excellence in Palliative Care, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. 3. University of Wisconsin-Madison, School of Nursing, Madison, WI. 4. UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
BACKGROUND: This study evaluated 1-year linear trajectories of patient-reported dimensions of quality of life among patients receiving dialysis. STUDY DESIGN: Longitudinal observational study. SETTING & PARTICIPANTS: 227 patients recruited from 12 dialysis centers. FACTORS: Sociodemographic and clinical characteristics. MEASUREMENTS/OUTCOMES: Participants completed an hour-long interview monthly for 12 months. Each interview included patient-reported outcome measures of overall symptoms (Edmonton Symptom Assessment System), physical functioning (Activities of Daily Living/Instrumental Activities of Daily Living), cognitive functioning (Patient's Assessment of Own Functioning Inventory), emotional well-being (Center for Epidemiologic Studies Depression Scale, State Anxiety Inventory, and Positive and Negative Affect Schedule), and spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale). For each dimension, linear and generalized linear mixed-effects models were used. Linear trajectories of the 5 dimensions were jointly modeled as a multivariate outcome over time. RESULTS: Although dimension scores fluctuated greatly from month to month, overall symptoms, cognitive functioning, emotional well-being, and spiritual well-being improved over time. Older compared with younger participants reported higher scores across all dimensions (all P<0.05). Higher comorbidity scores were associated with worse scores in most dimensions (all P<0.01). Nonwhite participants reported better spiritual well-being compared with their white counterparts (P<0.01). Clustering analysis of dimension scores revealed 2 distinctive clusters. Cluster 1 was characterized by better scores than those of cluster 2 in nearly all dimensions at baseline and by gradual improvement over time. LIMITATIONS: Study was conducted in a single region of the United States and included mostly patients with high levels of function across the dimensions of quality of life studied. CONCLUSIONS: Multidimensional patient-reported quality of life varies widely from month to month regardless of whether overall trajectories improve or worsen over time. Additional research is needed to identify the best approaches to incorporate patient-reported outcome measures into dialysis care.
BACKGROUND: This study evaluated 1-year linear trajectories of patient-reported dimensions of quality of life among patients receiving dialysis. STUDY DESIGN: Longitudinal observational study. SETTING & PARTICIPANTS: 227 patients recruited from 12 dialysis centers. FACTORS: Sociodemographic and clinical characteristics. MEASUREMENTS/OUTCOMES: Participants completed an hour-long interview monthly for 12 months. Each interview included patient-reported outcome measures of overall symptoms (Edmonton Symptom Assessment System), physical functioning (Activities of Daily Living/Instrumental Activities of Daily Living), cognitive functioning (Patient's Assessment of Own Functioning Inventory), emotional well-being (Center for Epidemiologic Studies Depression Scale, State Anxiety Inventory, and Positive and Negative Affect Schedule), and spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale). For each dimension, linear and generalized linear mixed-effects models were used. Linear trajectories of the 5 dimensions were jointly modeled as a multivariate outcome over time. RESULTS: Although dimension scores fluctuated greatly from month to month, overall symptoms, cognitive functioning, emotional well-being, and spiritual well-being improved over time. Older compared with younger participants reported higher scores across all dimensions (all P<0.05). Higher comorbidity scores were associated with worse scores in most dimensions (all P<0.01). Nonwhite participants reported better spiritual well-being compared with their white counterparts (P<0.01). Clustering analysis of dimension scores revealed 2 distinctive clusters. Cluster 1 was characterized by better scores than those of cluster 2 in nearly all dimensions at baseline and by gradual improvement over time. LIMITATIONS: Study was conducted in a single region of the United States and included mostly patients with high levels of function across the dimensions of quality of life studied. CONCLUSIONS: Multidimensional patient-reported quality of life varies widely from month to month regardless of whether overall trajectories improve or worsen over time. Additional research is needed to identify the best approaches to incorporate patient-reported outcome measures into dialysis care.
Authors: Steven D Weisbord; Maria K Mor; Jamie A Green; Mary Ann Sevick; Anne Marie Shields; Xinhua Zhao; Bruce L Rollman; Paul M Palevsky; Robert M Arnold; Michael J Fine Journal: Clin J Am Soc Nephrol Date: 2012-09-27 Impact factor: 8.237
Authors: Claire F Snyder; Neil K Aaronson; Ali K Choucair; Thomas E Elliott; Joanne Greenhalgh; Michele Y Halyard; Rachel Hess; Deborah M Miller; Bryce B Reeve; Maria Santana Journal: Qual Life Res Date: 2011-11-03 Impact factor: 4.147
Authors: H B Bosworth; L A Bastian; M N Kuchibhatla; D C Steffens; C M McBride; C S Skinner; B K Rimer; I C Siegler Journal: Psychosom Med Date: 2001 Jul-Aug Impact factor: 4.312
Authors: Mark Unruh; Guofen Yan; Milena Radeva; Ron D Hays; Robert Benz; Nicolaos V Athienites; John Kusek; Andrew S Levey; Klemens B Meyer Journal: J Am Soc Nephrol Date: 2003-08 Impact factor: 10.121
Authors: J M Valderas; A Kotzeva; M Espallargues; G Guyatt; C E Ferrans; M Y Halyard; D A Revicki; T Symonds; A Parada; J Alonso Journal: Qual Life Res Date: 2008-01-04 Impact factor: 4.147
Authors: Nanna von der Lippe; Bård Waldum; Fredrik B Brekke; Amin A G Amro; Anna Varberg Reisæter; Ingrid Os Journal: BMC Nephrol Date: 2014-12-02 Impact factor: 2.388
Authors: Namiko A Goto; Ismay N van Loon; Franciscus T J Boereboom; Marielle H Emmelot-Vonk; Hanna C Willems; Michiel L Bots; Laila E Gamadia; Eric F H van Bommel; Peter J G Van de Ven; Caroline E Douma; Hieronymus H Vincent; Yvonne C Schrama; Joy Lips; Ellen K Hoogeveen; Machiel A Siezenga; Alferso C Abrahams; Marianne C Verhaar; Marije E Hamaker Journal: Clin J Am Soc Nephrol Date: 2019-06-27 Impact factor: 8.237
Authors: Patricia Bonilla-Sierra; Ana Magdalena Vargas-Martínez; Fatima Leon-Larios; Joselin Valeria Arciniega Carrión; Tatiana Cecibel Jiménez Alverca; María de Las Mercedes Lomas-Campos; José Rafael González-López Journal: Int J Environ Res Public Health Date: 2021-05-16 Impact factor: 3.390