Analysis Of Quality Of Life And Its Influencing Factors In Patients With End-stage Renal Disease Undergoing Maintenance Hemodialysis

ObjectiveTo investigate the quality of life of maintenance hemodialysis patients in blood purification centers of three hospitals in Shenyang,analyze the factors affecting the quality of life score,and provide reference for improving the quality of life of maintenance hemodialysis patients with end-stage renal disease based on the results of the study.MethodsIn this study,a questionnaire survey was conducted on patients with regular maintenance hemodialysis for more than 3 months in the blood purification centers of three hospitals in Shenyang.The k DQOL-SFTM1.3 scale was used to score the quality of life of patients with end-stage maintenance blood of renal disease.At the same time,a self-made questionnaire was used to collect the general data of the subjects,laboratory examination indicators,hemodialyzation-related indicators,etc.Combined with the above indicators,the factors influencing the quality of life score of patients with end-stage renal disease maintenance hemodialysis were analyzed.Excel2007 was used to complete original data entry and summary,SPSS 23.0 software was used for statistical analysis,mean ± standard deviation（?X±S）was used for measurement data,T or T ’was used for comparison between two groups,analysis of variance was used for comparison between multiple groups,LSD and SNK test was used for comparison between multiple groups.Counting data were expressed in frequency and percentage,chi-square test was used for comparison between groups,and multiple regression analysis was used to analyze the independent influencing factors of quality of life in maintenance hemodialysis patients.Results1.A total of 377 questionnaires were sent out in this survey,and 343 were effectively received with effective recovery of 90.1%.There were 211 males and 132 females,with a male to female ratio of 1.60:1 and an average age of 59.5±13.3 years.2.In this study,glomerulonephritis（41.0%）accounted for the highest proportion of primary morbidity in MHD patients,followed by diabetic nephropathy（34.7%）,hypertensive nephropathy（16.1%）and other primary morbidity（8.2%）.There was no significant difference in primary morbidity between males and females.In different age groups,compared with middle-aged（45-59 years old）,young elderly（60-74 years old）and elderly group（≥75 years old）,young group（≤44 years old）had higher composition ratio of glomerulonephritis（40.6%,37.6%,33.3%,57.7%,respectively）.The composition ratio of diabetic nephropathy and hypertensive nephropathy was lower（P< 0.05）.3.In the blood routine of MHD patients,the white blood cell count was（6.87±5.21）109/L,the normal rate was 87.71%;Hemoglobin level was（98.58±19.66）g/L,mild anemia was 56.70%,moderate anemia was 29.55%,and normal rate was 13.75%.The mean erythrocyte volume was（90.92±8.18）fl,the normal rate was 87.03%.The mean RBC hemoglobin level was（29.50±7.19）pg,the normal rate was 82.94%.The average RBC hemoglobin concentration was（307.0±65.00）g/L,and the normal rate was55.29%.Platelet count was（181.75±70.51）109/L,the normal rate was 76.98%.Neutrophil count was（6.52±11.11）109/L,the normal rate was 82.82%.Lymphocyte count（1.52±3.12）109/L,normal rate 39.93;The monocyte count was（0.60±1.10）109/L,and the normal rate was 89.76%.Eosinophil count was（0.40±0.93）109/L,the normal rate was 82.59%.Basophil count was（0.11±0.77）109/L,normal rate 85.16%.In the blood biochemical indexes of MHD patients,urea level was（29.577±35.603）μmol/L,reaching the standard rate of 5.54%.Serum creatinine（953.15±412.27）μmol/L,up to the standard rate of 5.50%;Serum potassium（4.99±0.88）μmol/L,up to standard rate of 74.56%;Serum calcium（2.18±0.28）μmol/L,up to the standard rate of59.93%;Blood phosphorus（2.15±0.70）μmol/L,21.35%;Whole parathyroid hormone（340.16±423.96）μmol/L,24.07%;4.Among the comprehensive indicators in this study,renal dialysis-related quality of life（KDTA）score was 60.03±11.86,general health quality of life（SF-36）score was50.58±26.84,and physical health（PCS）score was 46.99±21.53.Mental health（MCS）score was 52.37±22.12.In the subdivision dimension of the scale,the scores of physiological function（RP）,emotional function（RE）,general health status（GH）,burden of kidney disease（BKD）,impact of kidney disease on life（EKD）,work status（WS）and other dimensions were lower（less than 50 points）.Patient satisfaction（PS）and dialysis staff encouragement（DSE）were higher（above 70 points）.5.Analysis of variance,T test and Spearman related results showed that Gender,age,marriage,education level,medical insurance type,per capita income of family,primary disease,duration of disease before dialysis,dialysis age,weekly and weekly times of dialysis,anticoagulant mode,monocytes,platelets,serum creatinine,and blood phosphorus were the influencing factors of comprehensive quality of life index of MHD patients.Among them,age,marriage,primary disease,platelet count and serum creatinine were independent influencing factors of SF-36 score.Marriage,percapita income of family,duration of disease before dialysis,age of dialysis and monocytes were independent influencing factors of PCS score.Marriage and platelet count were independent influencing factors of MENTAL health（MCS）score.Marriage,duration of dialysis,percapita family income and serum creatinine were the independent influencing factors of nephropathy dialysation-related quality of life（KDTA）score.Conclusion1.Among the MHD patients in this survey,males accounted for a relatively high proportion（61.54%）,the incidence of anemia was high（86.25%）,and the treatment compliance rate of dialysis-related biochemical indicators such as urea,creatinine,and serum phosphorus was insufficient.2.Increased age,primary disease of diabetic nephropathy,poor marital status,low percapita family income,increased predialysis course and dialysis age,less than 3dialysis sessions per week,increased platelet,white blood cell,monocyte,eosinophil counts are risk factors for decreased quality of life in MHD patients.