A trial of objective comparison of quality of life between chronic renal failure patients treated with hemodialysis and renal transplantation.
An interesting issue is a hemodialysis patients' and renal transplant recipients' subjective assessment of their QOL as a basic sociological criterion of treatment efficacy. The aim of the study is an estimation and comparison of QOL between these patients with a questionnaire the WHOQOL-100 as a trial of objective comparison of quality of life between these two groups of patients. A method of diagnostic probing with use of the questionnaire in its Polish language version was employed. A number of 400 (in total) questionnaires (200 in each group) were given to randomly chosen CRF patients. Fulfilled questionnaires were obtained from 144 (36%) patients who underwent the study: 61 from HD group (30.5%) and 83 from TX group (41.5%).


RESULTS
Regarding sex and education, differences between groups were not significant statistically. As for the age and marital status, differences between groups were significant (p = 2.5 E-13 and p = 0.0045 respectively). In the both groups, (living from the health pension from the Government Health Insurance--ZUS) was overwhelming (HD--96.12% and TX--77.11%). A difference in amount of 'having a job' patients between groups was not significant (p = 0.153). In QOL estimation, significant differences between group HD and TX were assessed in overall QOL (p = 1.04 E-07), in physical domain (p = 0.00053) and social relationships domain (p = 0.0004). In the rest of domains, scores were approximate in both groups and did not differ significantly. Comparing facets scores, some significant differences between HD and TX groups were observed: pain and discomfort (p = 0.032), energy and fatigue (p = 2.2 E-05), positive feelings (p = 0.002), body image and appearance (p = 0.010), mobility (p = 0.031), activities of daily living (p = 0.036), working capacity (p = 0.008), personal relationships (p = 0.004), sexual activity (p = 7.3 E-06) and transport (p = 0.036). Higher scores were stated in TX group in all of those facets excluding body image and appearance and pain and discomfort.


CONCLUSIONS
1) TX patients QOL is better than HD patients' in domains: overall, physical, social relationships and environment and also in facets: pain and discomfort, energy and fatigue, positive feelings, mobility, activities of daily living, working capacity, personal relationships, sexual activity and transport. 2) In the facet body image and appearance, TX patients' QOL is worse than HD patients'. 3) The results point out the WHOQOL-100 to be a useful and reliable instrument for measuring quality of life in different populations making possible to compare it objectively.
Tomasz
Wesołowski
W
Department of Vascular, General and Transplantation Surgery, Medical Academy, Wrocław, Poland. westo@wp.pl
Piotr
Szyber
S
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery* / Q000628:therapy*; D016030:Kidney Transplantation / Q000523:psychology* / Q000534:rehabilitation*; D007899:Leisure Activities; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011788:Quality of Life; D011998:Recreation; D012067:Religion; D006435:Renal Dialysis / Q000523:psychology*; D011795:Surveys and Questionnaires