喀麦隆四家政府资助医院维持性血液透析患者的生活质量和社会再融入情况。

Quality of life and social reinsertion of patients on maintenance haemodialysis in four government funded hospitals in Cameroon.

机构信息

Faculty of Health Sciences, University Of Buea, Buea, Cameroon.

Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.

出版信息

BMC Nephrol. 2024 Oct 8;25(1):335. doi: 10.1186/s12882-024-03778-6.

DOI:10.1186/s12882-024-03778-6

PMID:39379842

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11459710/

Abstract

BACKGROUND

Reduced quality of life is associated with shorter survival in chronic illnesses. However, the health-related quality of life (HRQOL) and social reinsertion of patients on maintenance haemodialysis is much more underappreciated in resource-limited countries such as Cameroon.

METHOD

A hospital-based cross-sectional study was carried out from February 22nd to May 20th, 2022, in 4 government-funded haemodialysis centres in three randomly selected regions of Cameroon. Patients received twice-weekly dialysis sessions. Social reinsertion and HRQOL were assessed using a structured questionnaire and the kidney disease quality of life instrument (KDQOL-36™). HRQOL scores < 50 were categorized as low, while scores > 50 reflected better HRQOL. Data were analysed using the software statistical package for Social Sciences version 25.0. Statistical significance was set at a p value < 0.05.

RESULTS

The study included 434 patients. The mean age was 48.33 (13.55) years, 65.7% (285/434) were male, 62.3% (269/434) had no monthly income, and the mean dialysis vintage was 3.74 (3.83) years. The mean HRQOL score was 44.34 (9.77), and 76.2% (325/434) had HRQOL scores < 50). Overall HRQOL was associated with older age (aOR: 2.344, CI 1.089-5.04). After the initiation of maintenance haemodialysis, 67.1% (49/73) of students dropped out of school. The main reason for school absenteeism and unemployment was physical insufficiency, with 82.4% (19/24) and 52.4% (75/144), respectively. There were no promotions or marriages after initiation; 51% (221/434) of relationships with relatives and friends were affected negatively, while 83.3% (66/79) of those of marriageable ages could not find suitors. The social participation score was poor in 61.5% (267/434) of participants. There was an association between low QOL and social participation (p = 0.009).

CONCLUSION

The HRQOL of patients on maintenance haemodialysis is greatly reduced, especially their physical health status. Older age was a determinant of low QOL. Additionally, social reinsertion remains poor due to adverse changes that occur to these patients and their families after dialysis initiation.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

生活质量下降与慢性病患者的生存时间缩短有关。然而，在资源有限的国家，如喀麦隆，患者接受维持性血液透析治疗的健康相关生活质量（HRQOL）和社会重新融入情况则更加被低估。

方法

这是一项 2022 年 2 月 22 日至 5 月 20 日在喀麦隆三个随机选定地区的 4 家政府资助的血液透析中心进行的基于医院的横断面研究。患者每周接受两次透析。使用结构化问卷和肾脏病生活质量量表（KDQOL-36™）评估社会重新融入和 HRQOL。HRQOL 评分<50 分被归类为低，而评分>50 分则反映了更好的 HRQOL。使用社会科学统计软件包 25.0 进行数据分析。统计学意义设定为 p 值<0.05。

结果

该研究纳入了 434 名患者。平均年龄为 48.33（13.55）岁，65.7%（285/434）为男性，62.3%（269/434）无月收入，平均透析龄为 3.74（3.83）年。平均 HRQOL 评分为 44.34（9.77），76.2%（325/434）的 HRQOL 评分<50）。总体 HRQOL 与年龄较大有关（OR：2.344，CI 1.089-5.04）。开始维持性血液透析后，67.1%（49/73）的学生辍学。学业和失业的主要原因是身体不适，分别占 82.4%（19/24）和 52.4%（75/144）。开始透析后没有晋升或结婚；51%（221/434）的亲属和朋友关系受到负面影响，而 83.3%（66/79）的适婚年龄的人找不到对象。61.5%（267/434）的参与者社会参与评分较差。生活质量低与社会参与有关（p=0.009）。