Quality of life and duration of hemodialysis in patients with chronic kidney disease (CKD): a cross-sectional study

Psychometric properties of the Greek simplified medication adherence questionnaire among Iranian hemodialysis patients

Patients suffering from chronic kidney failure ultimately need kidney replacement therapies, such as hemodialysis. Adherence to treatment in these patients can play a central role in improving health levels and feelings of well-being. The aim of this study was to determine the psychometric properties of the Persian version of the modified version of the Greek Simplified Medication Adherence Questionnaire in hemodialysis patients. In a methodological study carried out in 2024, a sample of 411 hemodialysis patients was selected using a convenience sampling method. The GR-SMAQ-HD utilized in the study was translated, and its psychometric properties were evaluated through assessments of construct validity, including exploratory and confirmatory factor analysis, convergent validity, and divergent validity. Furthermore, the study examined the internal consistency of the scale to ensure its reliability. The mean age of the participants was 59.37 (SD = 12.99) years. The results of the tetrachoric correlation matrix with Varimax with Kaiser Normalization rotation using the first random dataset (n = 205) extracted three factors accounting for 74.4% of the variance comprising 8 items. The results of CFA showed that the data fit the model. As for construct reliability, Cronbach's alpha, CR, AIC, and MaxR for all constructs were greater than 0.7, demonstrating good internal consistency and construct reliability. In the overall population, the mean score for treatment Adherence was 5.61 (SD = 1.95, 95% CI 5.42, 5.80). Invariance analysis shows that the model has strong measurement invariance between sex ($ΔCFI= - 0.001, ΔRMSEA= - 0.004$). The findings affirm the appropriateness of employing the Persian iteration of the GR-SMAQ-HD as a dependable and valid instrument for assessing adherence to treatment in hemodialysis patients. GR-SMAQ-HD is crucial for ensuring that patients follow their prescribed treatment regimens effectively.

Health-related quality of life among patients with end-stage renal disease undergoing hemodialysis in Ethiopia: a cross-sectional survey

BACKGROUND

Measurement of health-related quality of life (HRQOL) enables identification of treatment-related side effects of a disease. Such aspects may negatively impact on patients' lives and should be taken into consideration in medical decision-making. In sub-Saharan Africa, research from the perspective of patients with chronic kidney disease is scarce, and it is almost non-existent in patients undergoing hemodialysis. We aimed to determine HRQOL among end-stage renal disease patients undergoing maintenance hemodialysis in Ethiopia and to identify factors associated with HRQOL.

METHODS

A multi-center cross-sectional study was conducted in Addis Ababa, Ethiopia directed to all patients receiving hemodialysis due to kidney failure at 11 randomly-selected government and private hospitals/dialysis centers in the capital of Ethiopia. Data were collected by trained nurses using the KDQOL-36 instrument with five subscales measuring generic and disease-specific HRQOL. Study-specific items were used to collect socio-demographic and clinical data. Factors associated with HRQOL were examined using multivariable linear regression models.

RESULTS

Four hundred eighty-one patients completed the survey through face-to-face interviews (response rate 96%; mean age 45.34 ± 14.67). The mean scores of the subscales ranged from 25.6 to 66.68 (range 0-100), with higher scores reflecting better health. Factors associated with low HRQOL included older age, female sex, no formal education, poor medication adherence, > 2 hemodialysis sessions/week, lower body mass index (< 18.5), longer duration of hemodialysis treatment (≥ 12 months), and poor social support.

CONCLUSION

Patients with kidney failure undergoing hemodialysis in Addis Ababa, Ethiopia, had low HRQOL across all subscales compared to previous studies. Therefore, the implementation of guidelines is crucial to improve patients' adherence to their prescribed medications. Furthermore, establishing patient support groups and encouraging patients to use the available support resources from family members, neighbors, and friends have the potential to improve patients' HRQOL.

Psychometric properties of the kidney disease quality of life-36 (KDQOL-36) in Ethiopian patients undergoing hemodialysis

Background

Health-related quality of life (HRQOL) has a direct association with increased morbidity and mortality among end stage renal disease patients. Valid and reliable instruments to measure the HRQOL of patients with end stage renal disease are therefore required. This study aimed to translate, culturally adapt and evaluate the psychometric properties of the Amharic version of the Kidney Disease Quality of Life-36 (KDQOL-36) instrument in Ethiopian patients with end stage renal disease undergoing hemodialysis.

Methods

The KDQOL-36 instrument was developed for individuals with kidney disease who are being treated with dialysis and includes both generic and disease-specific components. The KDQOL-36 was translated to Amharic language and distributed to a cross-sectional sample of 292 hemodialysis patients. The psychometric evaluation included construct validity through corrected item-total correlation, confirmatory factor analysis and known group analysis. Convergent validity was evaluated by correlations between each of the three kidney disease targeted scales (symptoms/problems list, burden of kidney disease and effects of kidney diseases) and the European Quality of Life 5D-5L and Visual Analog Scales. Regarding reliability, internal consistency and test–retest reliability were assessed.

Results

Two hundred ninety-two patients with a mean age of 48 (SD ± 14.7) completed the questionnaire. Corrected item- total correlation scores were > 0.4 for all items. Confirmatory factor analysis revealed a two χ² /df was 4.4, Root Mean Square Error of Approximation (RMSEA) = 0.108 (90% CI 0.064–0.095), Comparative Fit Index (CFI) = 0.922, Tucker Lewis Index (TLI) = 0.948 and Standardized Root mean-squared residual (SRMR) = 0.058) and three χ² /df = 3.1, RMSEA = 0.085 (90% CI 0.064–0.095), CFI = 0.854, TLI = 0.838 and SRMR = 0.067) factor models for the generic and disease specific components respectively. The mean scores of the three kidney disease targeted domains were correlated to the EQ-5D-5L & VAS with correlation coefficients of large magnitude (0.55–0.81). The reliability of the instrument was satisfactory (Cronbach’s alpha = 0.81–0.91) and Intra-class correlation (ICC) = 0.90–0.96).

Conclusion

The Amharic version of the KDQOL-36 is a reliable and valid instrument recommended for assessment of HRQOL of Ethiopian patients on hemodialysis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-01932-y.

Depression symptoms and quality of life in patients receiving renal replacement therapy in Jordan: A cross-sectional study

Patients with chronic illnesses, such as those with chronic kidney disease (CKD) that are undergoing renal replacement therapy (RRT), face significant psychological changes. This descriptive cross-sectional research was carried out to investigate the factors that influence depressive symptoms and quality of life (QoL) in patients with end-stage renal disease. Data were collected from 70 participants undergoing RRT using a self-reported questionnaire that included sociodemographic information, depressive symptoms, disease status, and QoL. The Beck Depression Inventory-II (BDI-II) screening scale was used to measure depressive symptoms and the SF-36 (Medical Outcome Survey-Short Form 36) was used to assess QoL. Participants in the study rated their depressive symptoms as 'minimum (44.3%), 'mild' (20%), 'moderate' (21.4%), and 'severe (14.3%). Furthermore, a shorter duration of dialysis and comorbid conditions were significantly associated with the development of depressive symptoms. Patients on RRT for a longer period of time had lower physical activity scores than patients on dialysis for a shorter period of time. Male participants have a higher mental QoL than female participants, suggesting that the mental aspect of renal disease is less impaired than the physical aspect. The findings of this study are expected to increase awareness of RRT therapy targets and enhance patient outcomes.

Relationship between health literacy and quality of life among hemodialysis patients, Tehran, Iran, 2019

BACKGROUND

Chronic kidney disease and dialysis are associated with various complications.

OBJECTIVE

This study aimed to determine the relationship between health literacy and quality of life among patients receiving hemodialysis in hospitals affiliated with Tehran University of Medical Sciences.

METHODS

In this study, a descriptive - correlational study design with 138 sample size was used. Convenience sampling was used to select the study participants. We collected the data on May-September 2019. Data collection was done using the HELIA and KDQOL SF™.

RESULTS

In this study, 133 respondents fully completed the questioners. The mean score of health literacy of the respondents was 49.03 (± 22.37) while the average score of quality of life of the respondents in this study was 53.01 (± 14.86).

CONCLUSION

Based on the findings, patients receiving haemodialysis had insufficient health literacy and a better quality of life. In order to address the health literacy needs of the patients, consideration of continuous health education and assessment in this patient subpopulation could gradually improve their health literacy and quality of life. Health care providers such as nurses could improve Health Literacy and substantially Quality of Life through interventions aimed at determining existing literacy needs in the long and short term treatment course for individual dialysis patients.

The relationship between health literacy and quality of life among hemodialysis patients: An integrative review

BACKGROUND

Various studies have highlighted the correlates to health literacy and quality of life among patients receiving hemodialysis therapy. However, evidence of how these two outcomes could influence each other is not clear.

OBJECTIVE

This study aimed to assess the correlation between health literacy and quality of life among patients receiving hemodialysis.

METHODS

This is an integrative review of correlational studies. This study conforms to the preferred reporting items for integrative reviews described by Whitemore and Knafl. We search for studies reporting on the correlation of health literacy and quality of life among patients receiving hemodialysis in six databases, that is PubMed, Web of Science/Knowledge, Scopus and Embase, Google Scholar and Ovid MEDLINE.

RESULTS

In this review five studies were included after screening them against the inclusion criteria. Two studies were identified from Iran, and one study was identified each from Australia, Turkey, and the USA. Most studies were descriptive comparative in nature, while two studies were experimental. Shayan's study had the highest number of participants. This study reports on 1,063 patients receiving dialysis. Most studies were conducted at different centers. Findings from three studies showed that there was a significant relationship between health literacy and quality of life among patients receiving hemodialysis.

CONCLUSION

There is a relationship between health literacy and quality of life among patients receiving hemodialysis. Conclusively, addressing health literacy may improve the quality of life among patients receiving hemodialysis.