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慢性肾脏病患者健康相关生活质量评估:一项基于医院的横断面研究。

Assessment of Health-Related Quality of Life in Chronic Kidney Disease Patients: A Hospital-Based Cross-Sectional Study.

机构信息

Department of Pharmacy Practice, M.M. College of Pharmacy, Maharishi Markandeshwar University, Ambala 133207, India.

Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30S 2000E, Salt Lake City, UT 84112, USA.

出版信息

Medicina (Kaunas). 2023 Oct 8;59(10):1788. doi: 10.3390/medicina59101788.

Abstract

Health-related quality of life is rapidly becoming recognized as an important indicator of how a disease affects patient lives and for evaluating the quality of care, especially for chronic conditions such as chronic kidney disease (CKD). This study is an attempt to assess the quality of life in patients with chronic kidney disease at MMIMSR and also identify characteristics that may be associated with their worsening quality of life. This cross-sectional investigation was conducted at the in-patient department (IPD) of the MMIMSR hospital. This study included 105 CKD patients and used a systematic random sampling method for quantitative analysis. This study utilized a 36-item short-form SF-36 (v1.3) questionnaire to assess HRQoL in CKD patients. Descriptive statistics were employed at the baseline. Chi square and ANOVA were used to draw comparisons between two groups or more than two groups, respectively. Logistic regression analysis was utilized to identify the potential QoL determinants. A value of 0.05 or lower was used to determine statistical significance. Among a total of 105 participants, the mean (±standard deviation) age was found to be 54.53 ± 13.47 years; 48 were male patients, and 57 were female patients. Diabetes Mellitus (61.9%), hypertension (56.2%), chronic glomerulonephritis (7.6%), chronic pyelonephritis (6.7%), and polycystic kidney disease (5.7%) were identified to be the most frequent disorders associated with CKD. The current study also demonstrated that the HRQoL score domains such as symptom problem list, the effect of kidney disease, and the burden of kidney disease decline significantly and progressively as the patient advances into higher stages of CKD ( = 0.005). A similar pattern was observed in work status, sleep, and general health ( < 0.005). Additionally, a statistically significant difference was noted for cognitive function, quality of social interaction, overall health, dialysis staff encouragement, patient satisfaction, social support, physical functioning, role of physical health, pain, emotional well-being, role of emotional health, social functioning, and energy fatigue ( < 0.005). The mean difference for PCS and MCS based on CKD stages was found to be statistically significant ( < 0.005). The PCS and MCS showed a positive correlation with GFR (r = 0.521), and Hb (r = 0.378), GFR (r = 0.836), and Hb (r = 0.488), respectively. The findings of this study demonstrated that a significant decrease in HRQoL was observed among CKD patients, with a progressive deterioration of HRQoL dimensions as the patient advances to end-stage renal disease. This study also revealed that CKD imposes various restrictions on patients' day-to-day lives, particularly in terms of their physical and mental functioning, even in the initial stages of the disease.

摘要

健康相关的生活质量正在迅速成为评估疾病如何影响患者生活和评估护理质量的重要指标,尤其是对于慢性肾脏病(CKD)等慢性疾病。本研究旨在评估 MMIMSR 慢性肾脏病患者的生活质量,并确定可能与生活质量恶化相关的特征。这是一项横断面调查,在 MMIMSR 医院的住院部(IPD)进行。本研究纳入了 105 名 CKD 患者,并采用系统随机抽样方法进行定量分析。本研究使用 36 项简短式健康调查量表 SF-36(v1.3)问卷评估 CKD 患者的 HRQoL。基线时采用描述性统计。卡方检验和方差分析分别用于两组或多组之间的比较。逻辑回归分析用于确定潜在的 QoL 决定因素。 值为 0.05 或更低表示具有统计学意义。 在总共 105 名参与者中,发现平均(±标准差)年龄为 54.53 ± 13.47 岁;48 名男性患者,57 名女性患者。糖尿病(61.9%)、高血压(56.2%)、慢性肾小球肾炎(7.6%)、慢性肾盂肾炎(6.7%)和多囊肾病(5.7%)是与 CKD 相关的最常见疾病。本研究还表明,随着患者进入 CKD 更高阶段,HRQoL 评分领域(如症状问题清单、肾脏疾病的影响和肾脏疾病负担)显著且逐渐下降( = 0.005)。工作状态、睡眠和一般健康状况也呈现出类似的模式( < 0.005)。此外,认知功能、社会互动质量、整体健康、透析人员鼓励、患者满意度、社会支持、身体功能、身体健康角色、疼痛、情绪健康、情绪健康角色、社会功能和能量疲劳方面也存在统计学显著差异( < 0.005)。基于 CKD 阶段的 PCS 和 MCS 的平均差异具有统计学意义( < 0.005)。PCS 和 MCS 与 GFR(r = 0.521)和 Hb(r = 0.378)、GFR(r = 0.836)和 Hb(r = 0.488)呈正相关。 本研究结果表明,CKD 患者的 HRQoL 显著下降,随着患者进展为终末期肾病,HRQoL 维度逐渐恶化。本研究还表明,CKD 对患者的日常生活造成了各种限制,尤其是在身体和精神功能方面,即使在疾病的早期阶段也是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d809/10608694/5fcc752548aa/medicina-59-01788-g001.jpg

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