Quality of life in end stage renal disease patients

Abstract

AIM: To understand factors associated with quality of life (QOL), examine types of QOL instruments, and determine need for further improvements in QOL assessment.

METHODS: The method used databases (Pubmed, Google scholar) and a bibliographic search using key words QOL, end stage renal disease, Hemodialysis, Peritoneal dialysis, instruments to measure QOL, patients and qualitative/quantitative analysis published during 1990 to June 2014. Each article was assessed for sample size, demographics of participants, study design and type of QOL instruments used. We used WHO definition of QOL.

RESULTS: For this review, 109 articles were screened, out of which 65 articles were selected. Out of 65 articles, there were 19 reports/reviews and 12 questionnaire manuals. Of the 34 studies, 82% were quantitative while only 18% were qualitative. QOL instruments measured several phenomenon such as physical/psychological health, effects and burdens of kidney disease, social support etc. those are associated with QOL. Few studies looked at spiritual beliefs, cultural beliefs, personal concerns, as per the WHO definition. Telemedicine and Palliative care have now been successfully used however QOL instruments seldom addressed those in the articles reviewed. Also noticed was that longitudinal studies were rarely conducted. Existing QOL instruments only partially measure QOL. This may limit validity of predictive power of QOL.

CONCLUSION: Culture and disease specific QOL instruments that assess patients’ objective and subjective experiences covering most aspects of QOL are urgently needed.

Keywords: Quality of Life, Hemodialysis, Peritoneal dialysis, Patient, End stage renal disease, Quality of life instruments

Core tip: Quality of life (QOL) in end stage renal disease patients is an important outcome measure. This study tried to understand the dimensions of various QOL instruments and association of various risk factors with QOL. Since each instrument measures specific aspect of QOL, use of any one of these instruments allows studies to measure QOL only partially compromising on the validity of the predictive power of QOL. Furthermore, less attention has been given on conduct of qualitative and longitudinal studies. There is an urgent need to develop disease and culture specific instrument that covers most aspects of QOL.