The Exploration of Life Attitudes, Depression and Quality of Life for Patients with End-Stage Renal Disease

Thursday, 15 July 2010

Shu-Ya Chen, MS, RN
Nursing department, Changhua Christian Hospital, Chanuhua, Taiwan
Yu Yang
Nephrology division, Changhua Christian Hospital, Changhua City, Taiwan
Wen-Yu Hu, PhD, RN
School of Nursing, School of Nursing, College of medicine, National Taiwan University, Taipei, Taiwan
Chia-Chu Chang, MD
Division of Nephrology, Changhua Christian Hospital, Changhua City, Taiwan
Hus-Chen Wu, MD
Division of Nephrology, Erlin Branch Hospital, Changhua Christian Hospital, Changhua Country, Taiwan
Chiu-Yueh Chen, BA
Department of Nursing, Erlin Branch Hospital, Changhua Christian Hospital, Changhua Country, Taiwan

Learning Objective 1: Evaluate challenges of inadequate life attitude and the consequence of depression as barriers to quality of life in patients with end stage renal disease.

Learning Objective 2: Explore the effect of independent variables on eight domains- related quality of life in patients with end stage renal disease in a primary care setting.

Purpose: The purpose of this study was to examine barriers to health-related quality of life (HRQOL)  in 49 patients with end- stage renal disease(ESRD), including activity restrictions, low index of estimated glomerular filtration rate, co-morbidities, inadequate life attitudes and change of emotion status, and to test the relationship between barriers to HRQOL .

Methods: A cross-sectional, descriptive correlational design with self-administered questionnaires was conducted in two hospitals in central Taiwan. The measurement tools were used as follows:demographic information, life attitude scale, Taiwanese depression questionnaire, Medical Outcomes Study  Short-Form 36   (SF-36) which consists of eight dimensions, namely physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE) and mental health (MH). 

Results: (1)In patients with ESRD who were more positive life attitude, HRQOL  was significantly better(p<0.05). (2)Few number of samples was in the level of mild, moderate and severe depression (14.3%)Higher TDQ scores were strongly inversely associated with lower scores of all eight dimensions of the SF-36 (P<0.01). (3)After adjusting for demographic and clinical factors, multiple linear regression analyses showed that educational background, marriage, age, estimated glomerular filtration rate, freedom and independence, the feeling of being, and attitude toward death accounted for 13.5 % to 44 % variance in all eight dimensions of the SF-36.

Conclusion: The results can be as references to provide the health interventions of adjustment and positive life attitudes in patients with ESRD. Developing the multidisciplinary education from health-care providers to individualized plans of care is a continuing need.