Assessment of health status in chronic hemodialysis patients.
BACKGROUND
We compared three ways of assessing health status in chronic hemodialysis patients: generic questionnaire compared with population norms, disease-specific questionnaire, and open questions.


METHODS
Hemodialysis patients (n=83) treated in Geneva canton, Switzerland, answered the Kidney Disease Quality of Life (KDQOL-SF) questionnaire, which combines 12 disease-specific scales with the generic Short-Form 36 (SF36) health survey, and open questions about the most disturbing and most positive aspects of having end-stage renal disease. SF36 scores were compared with those of the general population, and generic health scales were correlated with dialysis-specific scales.


RESULTS
Hemodialysis patients had significantly lower scores than general population controls on 7 of 8 SF36 scales, especially physical functioning (-1.2 standard deviation (SD) units, p<0.001) and general health (-1.2 SD, p<0.001), but their mental health was similar (-0.2 SD, p=0.13). All 12 KDQOL dialysis-specific scores correlated significantly with the SF36 mental summary score, but only 6 correlated significantly with the SF36 physical summary score. Open comments suggested that dialysis itself is the chief problem confronting dialysis patients, but also that the predicament of end-stage renal disease may have a positive impact on the lives of some patients.


CONCLUSIONS
While physical problems are the biggest difference between dialysis patients and controls, disease-specific scales and open comments highlighted the importance of psychosocial and treatment-related problems among hemodialysis patients. Generic and disease-specific questionnaires, and open comments provide different information about the health status of dialysis patients.
Perneger
Thomas V
TV
Division of Nephrology, Quality Care Unit, Geneva University Hospitals, CH-1211 Geneva 14, Switzerland. thomas.perneger@hcuge.ch
Leski
Michel
M
Chopard-Stoermann
Catherine
C
Martin
Pierre-Yves
PY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000628:therapy*; D008134:Long-Term Care; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010358:Patient Participation; D011336:Probability; D011379:Prognosis; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013557:Switzerland