Vol 11, Issue 4, 2018
Online - 2455-3891
Print - 0974-2441
QUALITY OF LIFE OF PATIENTS UNDERGOING HEMODIALYSIS
THENMOZHI P*
Research Scholar, Department of Nursing, Saveetha College of Nursing, Saveetha Institute of Medical and Technical Sciences, Chennai,
Tamilnadu, India. Email: thenmozhi.sethu@gmail.com
Received: 29 November 2017, Revised and Accepted: 01 January 2017
ABSTRACT
Objective: The objective of the study was to assess the quality of life (QOL) of patients undergoing hemodialysis (HD). The QOL of HD patients was
found to be considerably impaired when compared to that of healthy individuals of the general population. The careful assessment of QOL helps to
guide and achieve medical management to optimize their health experience.
Methods: Cross-sectional research design was adopted with 130 samples who met the inclusion criteria to conduct the study in the dialysis unit,
India. The instrument used for the study was to collect the data are demographic variable and kidney disease QOL - short form version 1.3 scale.
Results: The mean total score of QOL was 48.73±22.65, the highest score was for dialysis staff encouragement scale (84.04±14.89) followed by
social support scale (80.38±20.38) and quality of social interaction (71.52±18.74). However, role limitation caused by physical health problems, role
limitation caused by emotional health, and burden of kidney disease scales yielded the lowest scores (22.12±18.05, 26.92±24.15, and 38.03±12.81,
respectively).
Conclusion: The present study findings concluded that patients on HD were not having adequate QOL in all domains except patient satisfaction due
to changes in the physiological, chemical changes occur in the kidney.
Key words: Quality of life, Hemodialysis, Chronic renal failure, End-stage renal disease, Health related quality of life.
INTRODUCTION
Chronic diseases have become a major public health problem and the
leading cause of morbidity and mortality [1]. Global status report on
non-communicable diseases (2010) stated that 80% of chronic disease
deaths worldwide occur in low- and middle-income countries [2]. End-
stage renal disease (ESRD) is one among the chronic diseases which
possess great threat globally and increased burden in the healthcare
system and leads to increased morbidity and mortality and decreased
the quality of life (QOL) [3]. According to the World Health Organization,
Global Burden of Disease project, diseases of the kidney and urinary
tract contribute to global burden with approximately 8,50,000 deaths
every year and 11,50,10,107 disability-adjusted life years. Chronic
kidney disease (CKD) is the 12
th
leading cause of death and 17
th
cause
of disability. The global increase in CKD is being driven by the global
increase in of diabetes mellitus, hypertension, obesity, and aging [4].
CKD is associated with increased incidences of cardiovascular mortality
and loss of disability-adjusted QOL years [5]. CKD in India cannot be
assessed accurately. The approximate prevalence of CKD is 800 pmp
and incidence of ESRD is 150–200 pmp [1].
ESRD is the final stage of CKD in which the kidneys no longer function
well enough to meet the needs of daily life. During this stage, renal
replacement therapy is required to stay live, and hemodialysis (HD) is
considered as the most widely used therapy and playing an essential
role in increasing patients’ lifetime. The QOL of HD patients was found to
be considerably impaired when compared to that of healthy individuals
of the general population as well as of renal transplant patients [6].
QOL is an overall assessment of a person’s well-being, which may
include physical, emotional, and social dimensions, as well as stress
level, sexual function, and self-perceived health status. End-stage
renal failure is a chronic disease that exerts a great negative impact
on patients’ health-related QOL mainly due to the accompanied
impairment or to the imposed limitations in almost all domains of their
daily lives. Despite remarkable advances in the treatment of HD, the
patients encounter certain physical, psychological, economic, and social
problems which affect their QOL.
HD consist a complex procedure for patients that require frequent
hospital or dialysis centers visits, mainly 3 times a week, thus implying
substantial changes in the normal way of patients’ living. 92% of HD
patients may endure a high symptom burden and may experience
troubling symptoms such as fatigue, decreased appetite, trouble
concentrating, swelling in their feet and hands, and muscle cramps,
and, all of which cause daily distress and negatively affects their QOL
[7]. HD is a time consuming, and costly treatment and it needs more
restrictions for diet and fluid, and long run dialysis causes a loss of
freedom, reliance on caregiver, disturbance of marriage, family, social
live, and reduction or lack of income. All these factors impair QOL [6,8].
Many studies found that CKD patients complain of depression, and other
mental symptoms. On the other hand, little is known about patients and
caregivers’ health problems and their QOL [9]. HD-dependent patients
with chronic renal failure, must cope with severe restrictions such as
strict adherence to dialysis and medication regimens, dietary and fluid
limitations, and minimal physical activities [10]. Problems with sleep
are very common in ESRD (up to 40%–80%) and range from insomnia
and sleep apnea to restless leg syndrome. Indeed, poor sleep is itself
a predictor of mortality and QOL [11,12]. Continuous education and
providing patient counseling could enhance adherence to therapies
and thus could improve the QOL [13]. The careful assessment of health-
related QOL (HRQOL) can help guide provision of medical management
to optimize their health experience [14]. HRQOL is recognized as
an essential health outcome for studies assessing the quality of
healthcare, evaluating the impact of illness, and analyses of cost-
effectiveness [12,15,16]. In addition, it has been shown that HRQOL is
clinically important for improving dialysis outcome in patients on HD
[17,18]. With this background, the researcher interested to assess the
QOL among ESRD patients who have undergone HD with respect to
© 2018 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.
org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2018.v11i4.24007
Research Article