Alam M B, Khatoon F, Begum S A, Alam M M, Faraji A H, Mahmud M A, Tarafder P, Mekhola M H
Dr Md Babrul Alam, Associate Professor, Department of Nephrology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh.
Mymensingh Med J. 2019 Oct;28(4):906-913.
Chronic kidney disease and the methods of its treatment play an important part in shaping the Quality of Life QOL of patients receiving dialysis. KDQOL™-36 is the most widely used instrument to evaluate health related quality of life of chronic kidney disease patients. The aim of the study was the subjective assessment of the quality of life (QOL) of patients treated with hemodialysis and also to understand the distribution of component scores of the scale with distribution of responses to individual items of the scale among the selected sample. This cross sectional study was conducted among randomly selected 151 patients of chronic kidney disease receiving hemodialysis with pre-dialysis proper education at Inpatient Department in National Institute of Kidney Diseases and Urology (NIKDU), Dhaka, Bangladesh during the period of June 2018 to December 2018. The instrument to measure the QOL was Kidney Disease and Quality of Life Bangla version 36 (KDQOL™-36). Recruited patients were interviewed with questionnaire technique to collect data with the scale which is a structured questionnaire comprised of four subscales. Mean scores ±SD of the domain of the physical and mental component summary, burden of kidney disease, symptoms and problems of kidney disease and effects of kidney disease subscales were 29.3±16.03, 16.93±13.0, 81.09±13.14 and 61.67±13.84 respectively. The mean ±SD of the combined score for all the four domains was 47.24±11.52. The rate of those with impaired QOL (mean score <66.7) was 96.7%. The most bothersome domain was burden of the kidney disease domain, where the mean scores of all the items were below 66.7. The study provides information that regular pre-dialysis attendance helps to provide the patient with proper education and thereby achieve better QOL among patients of chronic kidney disease receiving hemodialysis. By using the KDQOL™-36 scale this study finds that the domain of symptom of the kidney disease appeared to have least effect on the quality of life as the mean scores ranged higher from other subscales and in most cases the scores were above 66.7.
慢性肾脏病及其治疗方法在塑造接受透析治疗患者的生活质量（QOL）方面起着重要作用。KDQOL™-36是评估慢性肾脏病患者健康相关生活质量最广泛使用的工具。本研究的目的是对接受血液透析治疗的患者的生活质量进行主观评估，并了解该量表各分量表得分的分布情况以及所选样本中对量表各单项回答的分布情况。这项横断面研究于2018年6月至2018年12月期间，在孟加拉国达卡国立肾脏病与泌尿外科研究所（NIKDU）住院部，对随机选取的151例接受血液透析且接受过透析前适当教育的慢性肾脏病患者进行。用于测量生活质量的工具是孟加拉语版36项肾脏病与生活质量量表（KDQOL™-36）。采用问卷调查技术对招募的患者进行访谈，以收集由四个分量表组成的结构化问卷量表的数据。身体和心理综合分量表、肾脏病负担、肾脏病症状和问题以及肾脏病影响分量表的平均得分±标准差分别为29.3±16.03、16.93±13.0、81.09±13.14和61.67±13.84。四个领域综合得分的平均值±标准差为47.24±11.52。生活质量受损（平均得分<66.7）的比例为96.7%。最困扰患者的领域是肾脏病负担领域，该领域所有项目的平均得分均低于66.7。该研究提供的信息表明，定期进行透析前检查有助于为患者提供适当的教育，从而使接受血液透析的慢性肾脏病患者获得更好的生活质量。通过使用KDQOL™-36量表，本研究发现肾脏病症状领域对生活质量的影响似乎最小，因为其平均得分高于其他分量表，且在大多数情况下得分高于66.7。
