title: Quality of life and emotional distress between patients on peritoneal dialysis versus community-based hemodialysis.
abstract: OBJECTIVE
  Patient-reported outcomes are important endpoints to evaluate new models of renal delivery. This is the first study to compare Quality of Life (QOL) and emotional adjustment outcomes between patients on community-based hemodialysis (HD) and those on peritoneal dialysis (PD).
  
  
  METHODS
  Data were collected between 2009 and 2011 from a cross-sectional sample of 232 HD patients and 201 PD patients recruited through community dialysis centers and outpatient PD clinics in Singapore. Participants completed the Hospital Anxiety and Depression Scale, World Health Organization Quality of Life Brief and the Short form for the Kidney Disease Quality of Life. Measures of ESRD severity, comorbidity and biochemistry were also collected.
  
  
  RESULTS
  Physical and emotional QOL impairments were noted for both dialysis groups. Case-mix-adjusted comparisons indicated higher symptoms of depression (p = 0.027), and poorer physical health yet higher satisfaction with care (p = 0.001) in PD relative to community-based HD.
  
  
  CONCLUSIONS
  Peritoneal dialysis regimes offer flexibility and autonomy under the support of PD teams. Although outcomes for most QOL domains measured were equivalent, PD patients are more satisfied with care but are at risk for emotional distress and provide poor ratings of physical health. Further research is needed to explore the expansion of standards of care to address psychosocial needs in PD populations.
authors.affiliation: Department of Psychology, National University of Singapore, 9 Arts Link AS402/28, Singapore, 117570, Singapore, PSYGK@NUS.EDU.SG.
authors.forename: K
authors.initials: K
authors.lastname: Griva
authors.forename: A W
authors.initials: AW
authors.lastname: Kang
authors.forename: Z L
authors.initials: ZL
authors.lastname: Yu
authors.forename: N K
authors.initials: NK
authors.lastname: Mooppil
authors.forename: M
authors.initials: M
authors.lastname: Foo
authors.forename: Choong Meng
authors.initials: CM
authors.lastname: Chan
authors.forename: S P
authors.initials: SP
authors.lastname: Newman
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000523:psychology* / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012846:Singapore; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome