title: Quality of life and emotional distress in patients and burden in caregivers: a comparison between assisted peritoneal dialysis and self-care peritoneal dialysis.
abstract: OBJECTIVE
  Assisted peritoneal dialysis (PD) involving caregivers allows more patients to get started on home-based dialysis with good clinical outcomes, but evidence on patient-reported and caregiver-reported outcomes is lacking. This study aimed to compare assisted PD versus self-care PD on quality of life (QoL) and psychosocial outcomes for patients and caregivers. The effect of PD modality [automated PD (APD); continuous ambulatory PD (CAPD)] in relation to self-care or assisted care was also examined.
  
  
  METHODS
  A cross-sectional sample of 231 PD patients [142 self-care (57 APD/85 CAPD) and 89 assisted care PD (45 APD/44 CAPD)], 72 caregivers of assisted PD patients and 39 family members of self-care PD patients completed the Kidney Disease Quality of Life Short Form (KDQOL-SF), World Health Organisation Quality of Life Instrument-brief and the Hospital Anxiety and Depression Scale. Caregivers and family members completed the Lay Care-Giving for Adults Receiving Dialysis questionnaire and Zarit Burden Interview.
  
  
  RESULTS
  Case-mix-adjusted comparisons indicated comparable QoL in all dimensions with the exception of physical SF-12 (p = .001) and the KDQOL effects of kidney disease in favour of self-care PD. Levels of anxiety (9.72 ± 4.90; 8.25 ± 5.22) and depression (8.63 ± 3.80; 6.35 ± 4.76) were equivalent in assisted PD and self-care PD, respectively. Assisted PD caregivers reported more task-orientated duties (p = .007), yet levels of perceived burden were equal to those reported by family members of self-care PD.
  
  
  CONCLUSIONS
  Our findings of mostly comparable patient and caregiver outcomes in assisted PD and self-care PD suggest that caregiver burden and QoL should not be a barrier to using assisted PD.
authors.affiliation: Department of Psychology, National University of Singapore, 9 Arts Link AS402/28, Singapore, 117570, Singapore. psygk@nus.edu.sg.|Health Services Research Group, City University, London, UK. psygk@nus.edu.sg.
authors.forename: K
authors.initials: K
authors.lastname: Griva
authors.affiliation: Department of Psychology, National University of Singapore, 9 Arts Link AS402/28, Singapore, 117570, Singapore.
authors.forename: C S
authors.initials: CS
authors.lastname: Goh
authors.affiliation: Department of Psychology, National University of Singapore, 9 Arts Link AS402/28, Singapore, 117570, Singapore.
authors.forename: W C A
authors.initials: WCA
authors.lastname: Kang
authors.affiliation: Department of Psychology, National University of Singapore, 9 Arts Link AS402/28, Singapore, 117570, Singapore.
authors.forename: Z L
authors.initials: ZL
authors.lastname: Yu
authors.affiliation: Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
authors.forename: M C
authors.initials: MC
authors.lastname: Chan
authors.affiliation: Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
authors.forename: S Y
authors.initials: SY
authors.lastname: Wu
authors.affiliation: Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
authors.forename: T
authors.initials: T
authors.lastname: Krishnasamy
authors.affiliation: Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
authors.forename: M
authors.initials: M
authors.lastname: Foo
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Assisted peritoneal dialysis; Burden; Caregiver; Quality of life; Self-care peritoneal dialysis