Factors Affecting Quality of Life in Patients with End Stage of Renal Disease on Hemodialysis , Ras Al Khaimah-United Arab Emirates

Abstract

Background: Nowadays, a dramatically increase on the incidence and prevalence of End Stage Renal Disease (ESRD) were more than one million ESRD suffer worldwide, thus, ESRD is an important public health concern for it has considerable repercussion on the quality of life (QoL) of patients and the community’s increased social and health care needs.

Purposes: Were to describe the quality of life in patients with end stage of renal disease on hemodialysis and to examine the contributing factors that may affect quality of life.

Methodology: A cross sectional design was used to describe the QoL in patients with ESRD on hemodialysis and to determine the contributing factors that may affect quality of life; and a correlational design was utilized to examine associations among the independent variables (demographic characteristics and biological factors) that may influence the dependent variable (QoL).

Setting of the study: It was at dialysis unit located in Ibrahim Bin Hamad Obaidulla Hospital (IBHOH), affiliated to the Ministry of Health , Medical District in Ras Al-Khaimah Emirate - UAE which provided the medical services to all patients regularly attending the in-patient hemodialysis (Emirates citizens and Non- Emirates citizens) and were managed by medical and paramedical staff working within the same hospital.

Sampling: A purposive sampling was conducted and the accessible population was comprised of 129 regular patients. Out of 129 patients, 74 patients were qualified in the inclusion criteria to participate in the research. Participants were interviewed individually to measure Health Related Quality of Life (HRQoL) using Kidney Disease Quality of Life-36^TM (KDQoL 36^TM) scale and compared KDQoL scores by demographic factors, and biological factors. Results: the overall quality of life of patients with ESRD on hemodialysis was low, with M+SD(39.57+16.13). Increase poor quality was independently associated with female gender, aged >60 years, low educational level, unemployment status have poor QoL. The Physical Component Summary (PCS) domain came in the first rank with the lowest rated and scored with M+SD (32.66+17.30), whereas the mean of the Burden of Kidney Disease domain came in second rank with M+SD (34.61+12.26). Meanwhile, the Symptoms and Problems domain came in third rank with M+SD (38.56+22.8), followed by the Effects of Kidney Disease on Daily Life domain that came in fourth rank with M+SD (42.22+10.56), and then lastly, Mental Component Summary (MCS) domain came in fifth rank with M+SD (49.84+17.73). In this study, the results revealed that the level of serum albumin and gender were the most significant predictors that influence QoL in patients with (ESRD) undergoing hemodialysis at (P>0.05). Conclusion and Recommendation: The results of the present study shown the evidence that patients with ESRD have poor QoL. Lowest score of KDQoL 36TM scale was found in the "PCS , while highest score was MCS. Furthermore , the study revealed that level of the serum albumin was the most significant predictor influence QoL in patients with ESRD and the most modifiable factor which has a strong association with poorer HRQoL was education, whereas non-modifiable factor was female gender. Because of those factors attention should be given to the nurses and other health care providers as formal caregivers for early interventions that prevent further morbidity and minimize the mortality as well as provide the evidence-based for clinical practice that assist the nurses to have a comprehensive assessment of their patients’ lives and integrated all these crucial aspects in inclusive plan for appropriate nursing intervention and improve quality of patient’s life and HRQoL.

Keywords : End stage renal disease, hemodialysis, Quality of life