title: Clinical and psychosocial factors predicting health-related quality of life in hemodialysis patients.
abstract: Many patients with end-stage renal disease have significant impairment in health-related quality of life (HRQoL). Most previous studies have focused on clinical factors; however, quality of life can also be affected by psychosocial factors. The aim of this study was to identify the possible predictors of HRQoL among clinical and psychosocial factors in hemodialysis (HD) patients. The study included 101 patients who were undergoing HD. Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also assessed laboratory and clinical factors, including albumin, Kt/V as a marker of dialysis adequacy, normalized protein catabolic rate, and duration of HD. The Euro Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D) was used to evaluate HRQoL. The mean EQ-5D index score was 0.704 ± 0.199. The following variables showed a significant association with the EQ-5D index: age (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), support from friends (P < 0.001), cognitive function (P < 0.001), duration of HD (P = 0.034), triglyceride (P = 0.031), total iron-binding capacity (P = 0.036), and phosphorus (P = 0.037). Multiple regression analysis showed that age (95% confidence interval [CI] -0.008 to -0.002), anxiety (95% CI -0.025 to -0.009), and support from friends (95% CI 0.004 to 0.018) were independent predictors of impaired HRQoL. This study explored determinants of impaired HRQoL in HD patients. We found that impaired HRQoL was independently associated with age, anxiety, and support from friends. We should consider psychosocial as well as clinical factors when evaluating ways to improve HRQoL in HD patients.
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors: Gun Woo
authors: GW
authors: Kang
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors: In Hee
authors: IH
authors: Lee
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors: Ki Sung
authors: KS
authors: Ahn
authors: Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors: Jonghun
authors: J
authors: Lee
authors: Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors: Yunmi
authors: Y
authors: Ji
authors: Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea.
authors: Jungmin
authors: J
authors: Woo
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Health-related quality of life; end-stage renal disease; hemodialysis