Quality Of Life Among Hemodialysis Patients And Its Related Factors

Objectives: To analyze the health-related quality of life(QOL) among patients with End Stage Renal Disease(ESRD) undergoing hemodialysis(HD). therapy in Macau SAR and to evaluate the relationship between quality of life and dialysis adequacy, so as to provide scientific evidence for clinical psychological treatment. Methods: A cross-sectional analysis of the hemodialysis patients in Macau SAR who met the surveyed standard was made, using the Chinese version of Kidney Disease Quality of Life Short Form 1.3 (KDQOL-SFTM1.3) questionnaire. Different statistical methods such as t-test, One-way Anova, Kruscal-Walis rank test and Multiple linear regression were used to assess the questionnaire with demographic, clinical and dialysis-related factors for their contribution to the QOL in this population; Reliability analysis(Cronbach a), Correlation analysis and Factor analysis were used to assess the reliability and validity of the questionnaire.Results: There were totally 187 HD patients in Macau SAR in December 2002. The questionnaire was completed by 151 of the 165 HD patients who met the surveyed standard(reponse rate of 91.5%). (1) The QOL of HD patients in Macau SAR was significantly worse than that of the healthy populations(Hangzhou-China citizens, Americans and American Chinese) in some other areas. It was also significantly worse than that of the African Americans with hypertension and mild to moderate kidney disease and the Austrialian 1-year stroke survivors. But HD patients in Macau SAR and United State experienced a similar quality of life. (2) By univariate analysis, high educational level, employed and high hemocrit(HCT) level had significant association with Kidney Disease Component Summary (KDCS). Young, male, high educational level, employed, primary disease as non-diabetes and high hemoglobin level had significant association with Physical Component Summary(PCS). High educational level, unmarried/divorce, employed, primary disease as chronic glomemlonephritis/ non-diabetes/hypertension and high hemoglobin level had significant association with Mental Component Summary(MCS). No significant association was found between the QOL of HD patients in Macau SAR and dialysis adequacy Kt/V. (3) Multiple linear regression analysis demonistrated that educational level, age, sex, primary disease as diabetes mellitus/ hypertension/ chronic glomerulonephritis were found to be the most important determinants of the QOL for this population. (4) Reliability and validity of the form were preliminarily assured. Conclusions: The QOL of HD patients in Macau SAR is worse than that of the healthy population and patients with chronic diseases in some other areas. The health-related factors mainly include educational level, employment, sex, age, marital status, primary disease as diabetes mellitus/ hypertension/ chronic glomerulonephritis, hemoglobin level and hemocrit level. High educational level, employed, young, male, unmarried/divorce, primary disease as non-diabetes/ hypertension/ chronic glomerulonephritis and high HCT are considered to have positive effect on QOL. This study is to provide scientific evidence for clinical psychological treatment. It is hoped to arouse the concern of the society and develop some intervention strategies, enabling HD patients to face their problems and acknowledge their disease. They can then return to normal life.