title: Quality of life and its determinants of hemodialysis patients in Taiwan measured with WHOQOL-BREF(TW).
abstract: BACKGROUND
  In 1991, the World Health Organization (WHO) initiated a cross-cultural project to develop a quality-of-life (QOL) questionnaire (WHOQOL); soon after this, the clinically applicable short form was developed and named WHOQOL-BREF, followed by a Taiwanese version (WHOQOL-BREF[TW]).
  
  
  METHODS
  We first administered the WHOQOL-BREF(TW) and symptom/problem scale to 376 patients with end-stage renal disease on regular hemodialysis therapy in Taiwan. Analysis with multiple stepwise regressions was conducted to study determinants of QOL domains and items.
  
  
  RESULTS
  The WHOQOL-BREF(TW) was reliable and valid from various validation studies. The 4 domains (physical, psychological, social relations, and environment) and global items (overall quality of life and general health) of the WHOQOL-BREF(TW) each differentiated symptoms/problems of hemodialysis patients from age-, sex-, and education-matched healthy referents. The 4 domains, except for environment and global items of the WHOQOL-BREF(TW), each differentiated erythropoietin dosage from age-, sex-, and education-matched healthy referents. After adjusting for age, sex, marriage, and education, the prominent associated factors of various QOL domains and items were age, area (Taipei or Keelung), hemoglobin level, normalized protein catabolic rate, and symptom/problem scale.
  
  
  CONCLUSIONS
  The WHOQOL-BREF(TW) is reliable and valid for long-term study of hemodialysis patients, and hemodialysis had negative impacts on QOL, especially in patients with more severe disease with greater symptom/problem scores, lower hemoglobin levels, and lower normalized protein catabolic rates.
authors.affiliation: Institutes of Health Care Organization Administration and Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Shu-Chang
authors.initials: SC
authors.lastname: Yang
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Kuo
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
authors.forename: Ming-I
authors.initials: MI
authors.lastname: Lin
authors.forename: Syi
authors.initials: S
authors.lastname: Su
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D002118:Calcium / Q000097:blood; D015897:Comorbidity; D003469:Culture; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology*; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014944:World Health Organization
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin; D004921:Erythropoietin; D010758:Phosphorus; D002118:Calcium