Anees Muhammad, Batool Shazia, Imtiaz Marium, Ibrahim Muhammad
Prof. Dr. Muhammad Anees, Department of Nephrology, King Edward Medical University, Lahore, Pakistan.
Ms. Shazia Batool, Department of Nephrology, King Edward Medical University, Lahore, Pakistan.
Pak J Med Sci. 2018 Jul-Aug;34(4):811-816. doi: 10.12669/pjms.344.15284.
Many factors affect quality of life (QOL) of dialysis patients. This study was conducted to determine the effect of socio-economic factors effecting QOL of hemodialysis patients.
This descriptive multi-centric, follow up study was conducted at Department of Nephrology, Mayo Hospital, Lahore, from February 2015 to August 2017. All patients who were on regular maintenance hemodialysis (MHD) for more than three months and able to read and understand Urdu version of Kidney Disease Quality Of Life (KDQOL) tool were included in the study. Patients were included from hemodialysis units of Mayo Hospital (MH), Shalamar Hospital (SH), and Shaikh Zayed hospital (SZH), Lahore. Patients with less than three-month duration on dialysis, with cognitive impairment, dementia, active psychosis, non-Urdu readers/speakers were excluded. Demographic data and lab data was collected on predesigned pro forma. Patients were divided into different groups on the basis of education, monthly income, source of funding for treatment and employment. Patients were followed up for two years to determine the effect of QOL on mortality.
One hundred and thirty-five patients were included in the study. Socio-economic factors like education, employment, income, funding was compared with KDQOL sub scales and were found statistically significant (p-value (<0.05). We found that patients with higher income had better work status (p=0.039) but social (0.04) and sexual function (p=0.029) were relatively better in patients with low income. Employed patients had better work status (p=0.01), ability to do social function (p=0.027) but they had more pain (0.049), symptoms/problems of disease (p=0.05) and effect of kidney disease (p=0.015). Those patients whose dialysis were funded by their family could socially interact (p=0.012) better and deal more efficiently with effect of kidney disease (p=0.007). Higher education was associated with better emotional well being (p=0.045), patient satisfaction (p=0.046) and staff encouragement (p=0.045) then patient with lower level of education. QOL had no effect on mortality.
The socio-economic factors consisting of education, employment, income and funding are important parameters affecting QOL of kidney patients. QOL does not affect mortality of the dialysis patients.
许多因素会影响透析患者的生活质量（QOL）。本研究旨在确定社会经济因素对血液透析患者生活质量的影响。
本描述性多中心随访研究于2015年2月至2017年8月在拉合尔梅奥医院肾脏病科进行。所有接受定期维持性血液透析（MHD）超过三个月且能够阅读和理解乌尔都语版《肾脏病生活质量（KDQOL）》工具的患者均纳入研究。患者来自拉合尔梅奥医院（MH）、沙勒马医院（SH）和谢赫扎耶德医院（SZH）的血液透析单元。透析时间少于三个月、有认知障碍、痴呆、活动性精神病、非乌尔都语读者/使用者的患者被排除。根据预先设计的表格收集人口统计学数据和实验室数据。根据教育程度、月收入、治疗资金来源和就业情况将患者分为不同组。对患者进行了两年的随访，以确定生活质量对死亡率的影响。
135名患者纳入研究。将教育、就业、收入、资金等社会经济因素与KDQOL子量表进行比较，发现具有统计学意义（p值<0.05）。我们发现，收入较高的患者工作状态较好（p=0.039），但低收入患者的社交（0.04）和性功能（p=0.029）相对较好。就业患者的工作状态较好（p=0.01），社交功能能力较强（p=0.027），但他们有更多疼痛（0.049）、疾病症状/问题（p=0.05）和肾脏疾病影响（p=0.015）。那些透析费用由家庭承担的患者社交互动能力更好（p=0.012），应对肾脏疾病影响的能力更强（p=0.007）。与教育程度较低的患者相比，高等教育与更好的情绪健康（p=0.045）、患者满意度（p=0.046）和工作人员鼓励（p=0.045）相关。生活质量对死亡率没有影响。
由教育、就业、收入和资金组成的社会经济因素是影响肾病患者生活质量的重要参数。生活质量不影响透析患者的死亡率。
