| Abstract: |
SUMMARYChronic renal failure is a worldwide public health problem with increasing prevalence, high costs and poor outcomes. CRF and its treatment can severely compromise QOL of people affected by disease. QOL is becoming increasingly important as an outcome measAim of the study:The aims of this study were to assess quality of life for chronic renal failure patients, compare between quality of life for both hemodialysis and peritoneal dialysis patients, and suggestion of rehabilitation solutions based on patients’ needs to improvA descriptive research design was used to reach the aims of the study.Methodology:Setting:The study was conducted at the dialysis units in Zagazig University Hospitals, Bilbease Central Hospital, and El- Zawamel Central Hospital.Subjects:A sample of convenience of 150 patients divided to 75 patients maintained on HD and 75 patients maintained on PD.Tools used to accomplish the aim of the study:A questionnaire sheet including 104 questions covering the following items:1- Sociodemographic characteristics of the subjects.2- Subjects past and present medical history.3- Quality of Life Scale.The main results of the study revealed that:• The most common causes of ESRD in the study subjects were hypertension (33.3%), chronic interstitial nephritis (28%), and obstructive uropathy (11.4%).• The highest equal percentage for past medical history was 19% for hypertension, angina/MI, and colitis, and hepatosplenomegaly (14.3%) while the highest percentage for past surgical history was 13.2% for ureterolithotomy, 11.3% for appendectomy, and 9.4• Approximately three quarters (74.7%) of the studied subjects had complications, 37.5% of them delt with complications by having prescribed medications, 6.7% of HD subjects had vascular access problems, the most common cause of it was thrombus formation • Majority of subjects maintained on PD had abdominal/back pain (83.3%) while few of them (4.2%) had colic and bleeding from peritoneal catheter.• Majority (82%) of subjects had blood transfusion, 49.3% of them had problems of having blood unit.• There was a statistically significant difference between HD and PD subjects regarding protein intake followed in dietary regimen (P-value <0.05).• There were statistically significant differences between pre and post dialysis vital signs in HD subjects regarding systolic blood pressure, respiratory rate, and subject’s weight ( P-value < 0.05).• There were statistically significant differences between pre and post dialysis vital signs in PD subjects regarding blood pressure, pulse, respiratory rate, and subjects’ weight ( P-value < 0.05).• There were statistically significant differences of pre dialysis vital signs between PD and HD subjects regarding diastolic blood pressure, and subjects’ weight ( P-value < 0.05).• There were statistically significant differences of post dialysis vital signs between PD and HD subjects regarding diastolic blood pressure, pulse and subjects’ weight ( P-value < 0.05).• Majority of studied subjects had satisfactory knowledge about precautions followed to prevent complications of dialysis, while 22% of studied subjects had satisfactory knowledge about treatment strategies• Majority of subjects had satisfactory psychological QOL while 18% of subjects had satisfactory physical QOL and about two third of subjects had total satisfactory QOL.• There were highly statistically significant differences between knowledge of HD and PD subjects regarding treatment strategies, complications, precautions and total knowledge ( P-value < 0.05).• Statistically significant differences were found between QOL of HD and PD subjects regarding psychological condition and total satisfactory QOL (P-value < 0.05).• There was a statistically significant difference among total QOL and subjects sociodemographic characteristics regarding skilled worker subjects (P-value < 0.05).• There were statistically significant relations between HD subject’s knowledge and QOL satisfaction regarding complications and total knowledge (P-value < 0.05).• There was a statistically significant relation between QOL satisfaction and PD subjects knowledge regarding precaution they followed (P-value < 0.05).• A statistically significant difference was found between QOL and subjects’ sociodemographic characteristics regarding female subjects (P-value < 0.05).• There weren’t statistically significant relations between subjects’ sociodemographic characteristics and psychological, social, and spiritual QOL (p-value > 0.05).CONCLUSIONQuality of life of dialysis patients was affected, majority of them had impaired physiological QOL while majority of them had normal psychological QOL and QOL for HD patients had been more satisfying than PD patients. The total knowledge of most dialysis RECOMMENDATIONSThe current study projects the following recommendations:1- The need for continuous educational programs for ESRD patients and their families about the renal failure disease, management strategies, complications and ways to alleviate it.2- There is a need for continuous monitoring and evaluating QOL of dialysis patients to early detecting and solving any problem.3- Supply dialysis units with psychotherapists, social workers, and dietitians to assess patients needs and intervene with them.4- Establish a rehabilitation program for dialysis patients to improve HRQOL.5- Continuous educational program for health team to increase their knowledge about the importance of improving QOL through improving quality of care.6- Encourage social agencies to support these patients who suffer from chronic illness.
|
|
|