Volume 29, Issue 3-4 pp. 613-625

ORIGINAL ARTICLE

A health-related quality of life model for patients undergoing haemodialysis

Hye Min Jung PhD, RN,

Hye Min Jung PhD, RN

Assistant Professor

Department of Nursing, Chunnam Techno University, Gokseong County, Korea

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Hye Young Kim PhD, RN,

Corresponding Author

Hye Young Kim PhD, RN

Assistant Professor

[email protected]

orcid.org/0000-0002-1593-3933

College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea

Correspondence

Hye Young Kim, College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, Korea.

Email: [email protected]

Search for more papers by this author

Hye Min Jung PhD, RN,

Hye Min Jung PhD, RN

Assistant Professor

Department of Nursing, Chunnam Techno University, Gokseong County, Korea

Search for more papers by this author

Hye Young Kim PhD, RN,

Corresponding Author

Hye Young Kim PhD, RN

Assistant Professor

[email protected]

orcid.org/0000-0002-1593-3933

College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea

Correspondence

Hye Young Kim, College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, Korea.

Email: [email protected]

Search for more papers by this author

First published: 26 November 2019

https://doi.org/10.1111/jocn.15113

Citations: 8

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Abstract

Aims and objectives

This study aimed to construct and verify a model that explains and predicts the health-related quality of life in patients undergoing haemodialysis.

Background

Individual and disease-related characteristics, social support, physical and emotional symptoms, patient role adherence and perceived health status may be interrelated and might affect the health-related quality of life of patients undergoing haemodialysis directly or indirectly.

Design

A correlational, cross-sectional research design was used.

Methods

Participants were 202 patients undergoing haemodialysis at one of the seven nephrology clinics specified in this study. A structured questionnaire was used to collect data from September–November 2017. The collected data were analysed using spss version 25.0^® and amos 23.0. This study adhered to the STROBE guideline.

Results

The hypothetical model with 13 of the 15 analysed paths showed a good fit to the empirical data: χ² = 85.67 (p < .001), normed χ² = 2.14, GFI = 0.94, CFI = 0.97, NFI = 0.94, TLI = 0.94, RMSEA = 0.08, and RMSR = 0.04. Symptoms (fatigue, quality of sleep, and depression), environmental (social support) and individual (age) characteristics and general health perception had a direct effect on health-related quality of life. Additionally, individual and environment characteristics affected health-related quality of life through biological functions, symptoms, functional status and general health perception. These variables explained 78.6% of the variation in health-related quality of life.

Conclusions

To improve health-related quality of life in patients undergoing haemodialysis, systematic and integrated intervention programmes need to be developed and applied considering a variety of factors related to health-related quality of life.

Relevance to clinical practice

Individual and environment characteristics, biological functions, symptoms, functional status and general health perception should be systematically monitored to improve the health-related quality of life of patients on haemodialysis. It is also necessary to develop detailed interventions that consider all these factors.

CONFLICT OF INTEREST

The authors declare that they have no conflict of interest.

Supporting Information

REFERENCES

Ahrari, S., Moshki, M., & Bahrami, M. (2014). The relationship between social support and adherence of dietary and fluids restrictions among hemodialysis patients in Iran. Journal of Caring Sciences, 3(1), 11–19.
PubMed Google Scholar
Almutary, H., Bonner, A., & Douglas, C. (2013). Symptom burden in chronic kidney disease: A review of recent literature. Journal of Renal Care, 39, 140–150. https://doi.org/10.1111/j.1755-6686.2013.12022.x
10.1111/j.1755-6686.2013.12022.x
CAS PubMed Google Scholar
Almutary, H., Douglas, C., & Bonner, A. (2017). Towards a symptom cluster model in chronic kidney disease: A structural equation approach. Journal of Advanced Nursing, 73(10), 2450–2461.
10.1111/jan.13303
PubMed Web of Science® Google Scholar
Bae, B.R. (2014). Structural equation modeling with Amos 21: Principles and practice. Seoul, Korea: Chungram Publishing Co.
Google Scholar
Bonner, A., Wellard, S., & Caltabiano, M. (2010). The impact of fatigue on daily activity in people with chronic kidney disease. Journal of Clinical Nursing, 19(21–22), 3006–3015. https://doi.org/10.1111/j.1365-2702.2010.03381.x
10.1111/j.1365-2702.2010.03381.x
CAS PubMed Web of Science® Google Scholar
Cha, J.E., & Yi, M.S. (2013). The influence of cognitive coping on hope, depression and satisfaction with life in hemodialysis patients. Korean Journal of Adult Nursing, 25(4), 389–399. https://doi.org/10.7475/kjan.2013.25.4.389
10.7475/kjan.2013.25.4.389
Google Scholar
Cha, J.E., & Yi, M.S. (2014). Symptom clusters and quality of life in patients on HD. Journal of Korean Clinical Nursing Research, 20(1), 123–133.
Google Scholar
Chen, C.-K., Tsai, Y.-C., Hsu, H.-J., Wu, I.-W., Sun, C.-Y., Chou, C.-C., … Wang, L.-J. (2010). Depression and suicide risk in hemodialysis patients with chronic renal failure. Psychosomatics, 51(6), 528–528. https://doi.org/10.1016/S0033-3182(10)70747-7
10.1016/S0033-3182(10)70747-7
PubMed Web of Science® Google Scholar
Chilcot, J., Wellsted, D., & Farrington, K. (2010). Illness representations are associated with fluid nonadherence among hemodialysis patients. Journal of Psychosomatic Research, 68(2), 203–212. https://doi.org/10.1016/j.jpsychores.2009.08.010
10.1016/j.jpsychores.2009.08.010
PubMed Web of Science® Google Scholar
Choi, Y.S. (2008). Social support and compliance with sick role behavior in elderly hemodialysis patients (Unpublished master's thesis). Hanyang University, Seoul.
Google Scholar
Choi-Kwon, S., Han, S.W., Kwon, S.U., & Kim, J.S. (2005). Poststroke fatigue: Characteristics and related factors. Cerebrovascular Diseases, 19(2), 84–90. https://doi.org/10.1159/000082784
10.1159/000082784
PubMed Web of Science® Google Scholar
Davies, S.J., Phillips, L., Naish, P.F., & Russell, G.I. (2002). Quantifying comorbidity in peritoneal dialysis patients and its relationship to other predictors of survival. Nephrology Dialysis Transplantation, 17(6), 1085–1092. https://doi.org/10.1093/ndt/17.6.1085
10.1093/ndt/17.6.1085
PubMed Web of Science® Google Scholar
Ekramzadeh, M., Mazloom, Z., & Sagheb, M. (2015). Association of depression with selenium deficiency and nutritional markers in the patients with end-stage renal disease on hemodialysis. Journal of Renal Nutrition, 25(4), 381–387. https://doi.org/10.1053/j.jrn.2014.12.005
10.1053/j.jrn.2014.12.005
CAS PubMed Web of Science® Google Scholar
End Stage Renal Disease Registry Committee (2018). Current renal replacement therapy in Korea-Insan memorial dialysis registry 2017. Retrieved from http://ghdx.healthdata.org/record/current-renal-replacement-therapy-korea-insan-memorial-dialysis-registry-2015
Google Scholar
Ferrans, C.E., Zerwic, J.J., Wilbur, J.E., & Larson, J.L. (2005). Conceptual model of health-related quality of life. Journal of Nursing Scholarship, 37(4), 336–342. https://doi.org/10.1111/j.1547-5069.2005.00058.x
10.1111/j.1547-5069.2005.00058.x
CAS PubMed Web of Science® Google Scholar
Friedman, A.N., & Fadem, S.Z. (2010). Reassessment of albumin as a nutritional marker in kidney disease. Journal of the American Society of Nephrology, 21(2), 223–230. https://doi.org/10.1681/ASN.2009020213
10.1681/ASN.2009020213
CAS PubMed Web of Science® Google Scholar
Hair, J.F. Jr, Black, W.C., Babin, B.J., & Anderson, R.E. (2010). Multivariate data analysis ( 7th ed .). Upper Saddle River, NJ: Pearson Prentice Hall.
Google Scholar
Horigan, A.E. (2012). Fatigue in HD patients: A review of current knowledge. Journal of Pain and Symptom Management, 44(5), 715–724.
10.1016/j.jpainsymman.2011.10.015
PubMed Web of Science® Google Scholar
Inker, L.A., Astor, B.C., Fox, C.H., Isakova, T., Lash, J.P., Peralta, C.A., … Feldman, H.I. (2014). KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. American Journal of Kidney Diseases, 63(5), 713–735. https://doi.org/10.1053/j.ajkd.2014.01.416
10.1053/j.ajkd.2014.01.416
PubMed Web of Science® Google Scholar
Jardine, M.J., Zuo, L.I., Gray, N.A., de Zoysa, J.R., Chan, C.T., Gallagher, M.P., … Perkovic, V. (2017). A trial of extending hemodialysis hours and quality of life. Journal of the American Society of Nephrology, 28(6), 1898–1911. https://doi.org/10.1681/ASN.2015111225
10.1681/ASN.2015111225
PubMed Web of Science® Google Scholar
Kang, G.W., Lee, I.H., Ahn, K.S., Lee, J., Ji, Y., & Woo, J. (2015). Clinical and psychosocial factors predicting health-related quality of life in hemodialysis patients. Hemodialysis International, 19(3), 439–446. https://doi.org/10.1111/hdi.12271
10.1111/hdi.12271
PubMed Web of Science® Google Scholar
Kaptein, A.A., van Dijk, S., Broadbent, E., Falzon, L., Thong, M., & Dekker, F.W. (2010). Behavioral research in patients with end-stage renal disease: A review and research agenda. Patient Education and Counseling, 81(1), 23–29.
10.1016/j.pec.2009.10.031
PubMed Web of Science® Google Scholar
Kim, H.W., & Choi-Kwon, S. (2012). Structural equation modeling on quality of life in pre-dialysis patients with chronic kidney disease. Journal of Korean Academy of Nursing, 42(5), 699–708. https://doi.org/10.4040/jkan.2012.42.5.699
10.4040/jkan.2012.42.5.699
PubMed Web of Science® Google Scholar
Kim, K.S. (1994). The effect of preparatory audiovisual information with videotape influencing on sleep and anxiety of abdominal surgical patients. Journal of Korean Academy of Fundamentals of Nursing, 1(1), 19–36.
Google Scholar
Klaric, D., & Klaric, V. (2012). Depression in end stage renal disease: Comparison between patients treated with hemodialysis and peritoneal dialysis. Journal of Life Sciences, 6(5), 582–586.
Google Scholar
Kring, D.L., & Crane, P.B. (2009). Factors affecting quality of life in persons on hemodialysis. Nephrology Nursing Journal, 36(1), 15–24.
PubMed Google Scholar
Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46(10), 1121–1123. https://doi.org/10.1001/archneur.1989.00520460115022
10.1001/archneur.1989.00520460115022
CAS PubMed Web of Science® Google Scholar
Lacson, E., Xu, J., Lin, S.F., Dean, S.G., Lazarus, J.M., & Hakim, R.M. (2010). A comparison of SF-36 and SF-12 composite scores and subsequent hospitalization and mortality risks in long-term dialysis patients. Clinical Journal of the American Society of Nephrology, 5(2), 252–260. https://doi.org/10.2215/CJN.07231009
10.2215/CJN.07231009
PubMed Web of Science® Google Scholar
Levy, J., Brown, E., & Lawrence, A. (2016). Oxford handbook of dialysis. Oxford, UK: Oxford University Press.
10.1093/med/9780199644766.001.0001
Google Scholar
Molzahn, A.E., Northcott, H.C., & Hayduk, L. (1996). Quality of life of patients with end stage renal disease: A structural equation model. Quality of Life Research, 5(4), 426–432. https://doi.org/10.1007/BF00449917
10.1007/BF00449917
CAS PubMed Web of Science® Google Scholar
Nabolsi, M.M., Wardam, L., & Al-Halabi, J.O. (2015). Quality of life, depression, adherence to treatment and illness perception of patients on haemodialysis. International Journal of Nursing Practice, 21(1), 1–10. https://doi.org/10.1111/ijn.12205
10.1111/ijn.12205
PubMed Web of Science® Google Scholar
National Kidney Foundation Kidney Disease Outcome Quality Initiative (2015). KDOQI clinical practice guideline for HD: 2015 Update. Retrieved from https://www.kidney.org/professionals/guidelines/HD2015
Google Scholar
Oh, J.H., & Yi, M.S. (2014). Structural equation modeling on quality of life in older adults with osteoarthritis. Journal of Korean Academy of Nursing, 44(1), 75–85. https://doi.org/10.4040/jkan.2014.44.1.75
10.4040/jkan.2014.44.1.75
PubMed Web of Science® Google Scholar
Oh, S.M., Min, K.J., & Park, D.B. (1999). A study on the standardization of the hospital anxiety and depression scale for Koreans: A comparison of normal, depressed and anxious groups. Journal of Korean Neuropsychiatric Association, 38(2), 289–296.
Web of Science® Google Scholar
Ojelabi, A.O., Graham, Y., Haighton, C., & Ling, J. (2017). A systematic review of the application of Wilson and Cleary health-related quality of life model in chronic diseases. Health and Quality of Life Outcomes, 15(1), 241. https://doi.org/10.1186/s12955-017-0818-2
10.1186/s12955-017-0818-2
PubMed Web of Science® Google Scholar
Park, O.L., Jang, Y.J., Jung, J.H., & Kim, S.R. (2016). Factors affecting malnutrition in hemodialysis patients. Korean Journal of Adult Nursing, 28(2), 226–236. https://doi.org/10.7475/kjan.2016.28.2.226
10.7475/kjan.2016.28.2.226
Google Scholar
Rizk, D., Jurkovitz, C., Veledar, E., Bagby, S., Baumgarten, D.A., Rahbari-Oskoui, F., … Chapman, A.B. (2009). Quality of life in autosomal dominant polycystic kidney disease patients not yet on dialysis. Clinical Journal of American Society of Nephrology, 4(3), 560–566. https://doi.org/10.2215/CJN.02410508
10.2215/CJN.02410508
PubMed Web of Science® Google Scholar
Shin, J.S., & Lee, Y.B. (1999). A study on the effect of social support on the psychosocial wellbeing of the unemployed. Korean Academy of Social Welfare, 37(37), 241–269.
Google Scholar
Snyder-Halpern, R., & Verran, J.A. (1987). Instrumentation to describe subjective sleep characteristics in healthy subjects. Research in Nursing & Health, 10, 155–163. https://doi.org/10.1002/nur.4770100307
10.1002/nur.4770100307
CAS PubMed Web of Science® Google Scholar
Teles, F., Azevedo, V.F.D.D., Miranda, C.T.D., Miranda, M.P.D.M., Teixeira, M.D.C., & Elias, R.M. (2014). Depression in hemodialysis patients: The role of dialysis shift. Clinics, 69(3), 198–202. https://doi.org/10.6061/clinics/2014(03)10
10.6061/clinics/2014(03)10
PubMed Web of Science® Google Scholar
Twomey, J.C., Parfrey, P.J., Barrett, B.J., Churchill, D., & Way, C.Y. (2014). Responsiveness of the patient's perception of life on hemodialysis scale. Canadian Association of Nephrology Nurses Technologist, 24, 33–44.
Google Scholar
Wang, S.-Y., Zang, X.-Y., Fu, S.-H., Bai, J., Liu, J.-D., Tian, L.I., … Zhao, Y. (2016). Factors related to fatigue in Chinese patients with end-stage renal disease receiving maintenance hemodialysis: A multi-center cross-sectional study. Renal Failure, 38(3), 442–450. https://doi.org/10.3109/0886022X.2016.1138819
10.3109/0886022X.2016.1138819
CAS PubMed Web of Science® Google Scholar
Ware, J.E. (1979). Health perception questionnaire, instruments for measuring nursing practices and other health care variables. Hyattsville, MD: DHEW Publication.
Google Scholar
Ware, J.E., Kosinski, M., & Keller, S.D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233. https://doi.org/10.1097/00005650-199603000-00003
10.1097/00005650-199603000-00003
PubMed Web of Science® Google Scholar
Williams, A.G., Crane, P.B., & Kring, D. (2007). Fatigue in African American women on hemodialysis. Nephrology Nursing Journal, 34(6), 610–618.
PubMed Google Scholar
Wilson, I.B., & Cleary, P.D. (1995). Linking clinical variables with health-related quality of life. Journal of the American Medical Association, 273(1), 59–65. https://doi.org/10.1001/jama.1995.03520250075037
10.1001/jama.1995.03520250075037
CAS PubMed Web of Science® Google Scholar
Yamasaki, A., Yoda, K., Koyama, H., Yamada, S., Tsujimoto, Y., Okuno, S., … Inaba, M. (2016). Association of erythropoietin resistance with fatigue in hemodialysis patients: A cross-sectional study. Nephron, 134(2), 95–102. https://doi.org/10.1159/000448108
10.1159/000448108
CAS PubMed Web of Science® Google Scholar
Zigmond, A.S., & Snaith, R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
10.1111/j.1600-0447.1983.tb09716.x
CAS PubMed Web of Science® Google Scholar
Zimet, G.D., Dahlem, N.W., Zimet, S.G., & Farley, G.K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30–41. https://doi.org/10.1207/s15327752jpa5201_2
10.1207/s15327752jpa5201_2
Web of Science® Google Scholar

Citing Literature

Volume29, Issue3-4

February 2020

Pages 613-625

A health-related quality of life model for patients undergoing haemodialysis

Abstract

Aims and objectives

Background

Design

Methods

Results

Conclusions

Relevance to clinical practice

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Information

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A health-related quality of life model for patients undergoing haemodialysis

Abstract

Aims and objectives

Background

Design

Methods

Results

Conclusions

Relevance to clinical practice

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Related

Information