Romano-Zelekha Orly, Golan Eliezer, Ifrah Anneke, Weinstein Talia, Shohat Tamy
Israel Center for Disease Control, Ministry of Health, Tel Hashomer, 52621, Israel.
Hemodialysis Unit, Meir Medical Center, Kfar Saba, Israel.
Qual Life Res. 2017 Dec;26(12):3343-3352. doi: 10.1007/s11136-017-1661-y. Epub 2017 Aug 8.
Higher health-related quality of life (HRQOL) in dialysis patients has been associated with fewer hospitalizations and lower mortality. Since Arab patients on dialysis have better survival rates than Jewish patients, we hypothesized that they would have higher HRQOL. We also studied the impact of several risk factors on HRQOL in each population.
Based on a national dialysis registry, patients from 64 hemodialysis units were recruited to participate. Patients who consented were interviewed face-to-face, using the Kidney Disease Quality of Life Short Form (KDQOL-SF36) questionnaire.
Five hundred and fifty-eight (50.6%) Jewish and 544 (49.4%) Arab patients participated in the study. For Arab patients mean crude scores for the "mental component summary" and KDQOL scores were significantly lower than for Jewish patients [31.6 (95% Cl 30.0-33.3) vs. 38.0 (95% Cl 36.1-39.9), p < 0.0001 and 55.6 (95% Cl 54.5-56.7) vs. 59.8 (95% Cl 58.6-60.9), p < 0.0001, respectively]. Much lower scores were observed for Arabs in the "emotional role" and "work status" subscales. The two populations had similar general health assessments and albumin level. For both, HRQOL was positively associated with higher educational level, higher albumin level, and dialysis connection by fistula or graft; and negatively associated with low income and diabetes. HRQOL was negatively associated with previous cerebrovascular accident among Arabs and with female gender among Jews.
Differences between Jews and Arabs in subscales related to psychosocial factors suggest that cultural differences in the perceptions of sickness and health may be relevant here. Future studies should explore such possibility and focus on the large gap in the "work status" subscale.
透析患者较高的健康相关生活质量（HRQOL）与较少的住院次数和较低的死亡率相关。由于接受透析治疗的阿拉伯患者的生存率高于犹太患者，我们推测他们的HRQOL会更高。我们还研究了几种风险因素对各人群HRQOL的影响。
基于全国透析登记系统，招募了来自64个血液透析单位的患者参与研究。同意参与的患者采用肾脏病生活质量简表（KDQOL-SF36）问卷进行面对面访谈。
558名（50.6%）犹太患者和544名（49.4%）阿拉伯患者参与了研究。阿拉伯患者的“心理成分总结”和KDQOL得分的平均原始分数显著低于犹太患者[31.6（95%可信区间30.0-33.3）对38.0（95%可信区间36.1-39.9），p<0.0001；55.6（95%可信区间54.5-56.7）对59.8（95%可信区间58.6-60.9），p<0.0001]。在“情感角色”和“工作状态”子量表中，阿拉伯人的得分要低得多。这两个人群的总体健康评估和白蛋白水平相似。对于这两个人群，HRQOL与较高的教育水平、较高的白蛋白水平以及通过动静脉内瘘或移植物进行透析连接呈正相关；与低收入和糖尿病呈负相关。HRQOL与阿拉伯人之前的脑血管意外以及犹太女性呈负相关。
犹太人和阿拉伯人在与心理社会因素相关的子量表上的差异表明，疾病和健康认知方面的文化差异可能与此有关。未来的研究应探索这种可能性，并关注“工作状态”子量表中的巨大差距。
