Poor sleep and reduced quality of life were associated with symptom distress in patients receiving maintenance hemodialysis

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Abstract

Background

The quality of life in patients receiving chronic hemodialysis is compromised despite of the substantial achievements in treatments. Quality of life in hemodialysis patients have been shown to be associated with decreased survival and increased hospitalization. Therefore, it is necessary to incorporate the managements of symptoms and patient self-perceived well-being as measurements of effective treatments for these patients.

Methods

A survey of symptom distress, quality of sleep and quality of life was performed in 301 maintenance hemodialysis patients using Dialysis Symptom Index, Short Form-36, and Pittsburgh Quality of Sleep Index table. Patients were recruited from five hospitals in Guangdong area of China by convenience sampling.

Results

The prevalence of various symptoms in maintenance hemodialysis patients was between 23.3 and 80.4 %. These patients had compromised sleep and poor quality of life. Moreover, poor quality of sleep and impaired quality of life were associated with high symptom burden of these patients.

Conclusion

The patients receiving chronic hemodialysis generally have heavy symptom distress, which could contribute to the disturbed sleep and impaired quality of life of these patients. Measurements of clinical outcomes for hemodialysis patients should include the management of symptoms and morbidity. The ultimate goal of treatments is to improve patient self-perceived quality of life.

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Most cited references 19

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The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups.

C A McHorney, J E Ware, J Lu … (1994)

The widespread use of standardized health surveys is predicated on the largely untested assumption that scales constructed from those surveys will satisfy minimum psychometric requirements across diverse population groups. Data from the Medical Outcomes Study (MOS) were used to evaluate data completeness and quality, test scaling assumptions, and estimate internal-consistency reliability for the eight scales constructed from the MOS SF-36 Health Survey. Analyses were conducted among 3,445 patients and were replicated across 24 subgroups differing in sociodemographic characteristics, diagnosis, and disease severity. For each scale, item-completion rates were high across all groups (88% to 95%), but tended to be somewhat lower among the elderly, those with less than a high school education, and those in poverty. On average, surveys were complete enough to compute scales scores for more than 96% of the sample. Across patient groups, all scales passed tests for item-internal consistency (97% passed) and item-discriminant validity (92% passed). Reliability coefficients ranged from a low of 0.65 to a high of 0.94 across scales (median = 0.85) and varied somewhat across patient subgroups. Floor effects were negligible except for the two role disability scales. Noteworthy ceiling effects were observed for both role disability scales and the social functioning scale. These findings support the use of the SF-36 survey across the diverse populations studied and identify population groups in which use of standardized health status measures may or may not be problematic.

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Symptom burden, depression, and quality of life in chronic and end-stage kidney disease.

Tammy Unruh, Khaled Abdel-Kader, Steven Weisbord (2009)

While many patients with end-stage renal disease (ESRD) have impaired physical and psychologic well-being, less is known about these health domains in patients with advanced chronic kidney disease (CKD). The authors sought to compare symptoms, depression, and quality of life in patients with ESRD and those with CKD. Patients with ESRD and subjects with advanced CKD were enrolled. Patients' symptoms, depression, and quality of life were assessed using the Dialysis Symptom Index (DSI), Patient Health Questionnaire-9 (PHQ-9), and Short Form 36 (SF-36), respectively, and these health domains were compared between patient groups. Ninety patients with ESRD and 87 with CKD were enrolled. There were no differences in the overall number of symptoms or in the total DSI symptom-severity score. Median scores on the PHQ-9 were similar, as was the proportion of patients with PHQ-9 scores >9. SF-36 Physical Component Summary scores were comparable, as were SF-36 Mental Component Summary scores. The burden of symptoms, prevalence of depression, and low quality of life are comparable in patients with ESRD and advanced CKD. Given the widely recognized impairments in these domains in ESRD, findings of this study underscore the substantial decrements in the physical and psychologic well-being of patients with CKD.

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Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients.

Jayanth R Arnold, Linda F. Fried, Eli J. Fine … (2005)

The prevalence, severity, and clinical significance of physical and emotional symptoms in patients who are on maintenance hemodialysis remain incompletely characterized. This study sought to assess symptoms and their relationship to quality of life and depression. The recently developed Dialysis Symptom Index was used to assess the presence and the severity of 30 symptoms. The Illness Effects Questionnaire and Beck Depression Inventory were used to evaluate quality of life and depression, respectively. Correlations among symptom burden, symptom severity, quality of life, and depression were assessed using Spearman correlation coefficient. A total of 162 patients from three dialysis units were enrolled. Mean age was 62 y, 48% were black, 62% were men, and 48% had diabetes. The median number of symptoms was 9.0 (interquartile range 6 to 13). Dry skin, fatigue, itching, and bone/joint pain each were reported by > or =50% of patients. Seven additional symptoms were reported by >33% of patients. Sixteen individual symptoms were described as being more than "somewhat bothersome." Overall symptom burden and severity each were correlated directly with impaired quality of life and depression. In multivariable analyses adjusting for demographic and clinical variables including depression, associations between symptoms and quality of life remained robust. Physical and emotional symptoms are prevalent, can be severe, and are correlated directly with impaired quality of life and depression in maintenance hemodialysis patients. Incorporating a standard assessment of symptoms into the care provided to maintenance hemodialysis patients may provide a means to improve quality of life in this patient population.

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Author and article information

Contributors

Raoping Wang:

ORCID: http://orcid.org/0000-0003-1085-5056

011-86-20-87731989 , raopingwang66@126.com

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 8 September 2016

Publication date PMC-release: 8 September 2016

Publication date Collection: 2016

Volume: 14

Issue: 1

Electronic Location Identifier: 125

Affiliations

[1 ]The Blood Purification Center, Department of Nephrology, First Affiliated Hospital, Sun Yat-sen University, No.74 Zhongshan Rd.2, 510080 Guangzhou, Guangdong People’s Republic of China

[2 ]College of Public Health, Sun-yat Sen University, Guangzhou, Guangdong 510089 People’s Republic of China

Author information

Raoping Wang http://orcid.org/0000-0003-1085-5056

Article

Publisher ID: 531

DOI: 10.1186/s12955-016-0531-6

PMC ID: 5016869

PubMed ID: 27608683

SO-VID: 83cd7ab8-e8a7-486b-a0b6-28f8d51477a3

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 4 April 2016

Date accepted : 6 September 2016

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ScienceOpen disciplines: Health & Social care

Keywords: maintenance hemodialysis,symptom distress,quality of life,quality of sleep

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: maintenance hemodialysis, symptom distress, quality of life, quality of sleep

Poor sleep and reduced quality of life were associated with symptom distress in patients receiving maintenance hemodialysis

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Abstract

Background

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Conclusion

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Asian Journal of Quality of Life (AjQoL)

Most cited references 19

The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups.

Symptom burden, depression, and quality of life in chronic and end-stage kidney disease.

Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients.

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