Changes in health-related quality of life in patients of self-care vs. in-center dialysis during the first year.
OBJECTIVE
In the Lorraine area (France), dialysis centers propose an educational program to improve patient's ability to perform dialysis by themselves. The objective was to assess changes in health-related quality of life (HRQoL) during the first year of dialysis, comparing independent patients with patients on in-center dialysis.


METHODS
All patients aged between 18 and 70 and having started their first dialysis between June 1997 and June 1999 in the Lorraine area were included. Socio-demographic, medical data and HRQoL (KDQoL) were assessed for each patient at enrollment, at 6 and 12 months.


RESULTS
At 12 months, 195 patients were in dialysis, 147 were non-autonomous, and 48 were autonomous. Independent patients were younger, were more often in occupational activity, had a lower body mass index and had fewer comorbidities. Several dimensions of the HRQoL were significantly higher in autonomous patients at baseline: physical functioning (60.4 vs. 50.7) and work status (30.9 vs. 18.4); and at 12 months: less burden of kidney disease (51.7 vs. 37.3), fewer effects of kidney disease (65.9 vs. 54.0), cognitive function (72.0 vs. 62.7) and role-emotional (53.0 vs. 34.5).


CONCLUSIONS
These results show improved HRQoL among independent patients. Our regional care network may be a particularly useful model for undertaking actions motivating the healthcare teams and for enhancing the human resources devoted to patient education.
Nancy Université, EA 4003, CHU-Nancy, Epidémiologie et évaluation cliniques, Centre d'Epidémiologie Clinique INSERM CIEC6, Hôpital Marin, Avenue du Maréchal de Lattre de Tassigny, Nancy Cedex, France. c.loos@chu-nancy.fr
Carole
C
Loos-Ayav
Luc
L
Frimat
Michèle
M
Kessler
Jacques
J
Chanliau
Pierre-Yves
PY
Durand
Serge
S
Briançon
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005602:France; D006304:Health Status; D006437:Hemodialysis, Home; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires