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The overall survival rate of patients undergoing hemodialysis has improved over the past 15-year interval, even with an increased proportion of elderly patients and patients with diabetes because of medical progress, advanced technology, and better patient care. Attention thus needs to be focused not only on how long but also on how well ESRD patients live.
Patients with chronic kidney disease face many challenges which may develop depression or anxiety or worsen their quality of life. These include a general feeling of un-wellness; specific symptoms caused by the disease or the patient’s treatment; major disruptions in lifestyle; the need to comply with treatment regimens, like dialysis schedules, diet prescription, and water restriction in addition to the fear of disability, morbidity, and shortened life span.
This study was conducted among patients with end-stage renal disease on hemodialysis at Ain Shams University Hospitals and their caregivers to measure their health-related quality of life and factors affecting it and to conduct health education program and nutrition program for those patients and their caregiver and measure their effect on changing their quality of life.
This study was divided into three phases, First phase: the patients was divided into intervention and control groups then quality of life was measured and factors affecting it for all patients (the intervention and control groups) and for their caregiver. Second phase, conducting health education and nutritional program for the interventional group only including the patients and their caregivers. Third phase, reassessment of quality of life for the patients and their caregivers after six months
In this study 56 patients and their caregivers participated. The age of the patients was ranging between 18 and 73 years with a mean of 48. About 55.4% of patients were males and only 19.6% of them were employed. The main cause of renal failure in the studied patients was hypertension (44.64%) followed by unknown cause (12.5%). Most of the caregivers (58.9%) were the patients’ partners. The age of the patients’ caregivers was ranging between 9 and 70 years with a mean of 41.93 years.
The most affected summary score among the hemodialysis patients was the physical component summary score (mean=19.05 and SD=15.68) and the least affected summary score was the kidney component summary score (mean =47.86 and SD= 10.84).
After the intervention the patients in the intervention group had significant higher quality of life scores than the patients in the control group after the intervention and these associations were significant in all the domains except cognitive function, sexual function, social support, patient satisfaction and dialysis staff encouragement domains.
As regard to the biochemical parameters of the studied patients after the intervention, the level of serum hemoglobin and serum albumin were higher among the intervention group than the control group and these differences were significant but the differences in the other laboratory data were non-significant.
After the intervention there were statistically significant differences between the studied caregivers in the intervention and control groups, the intervention group reported significant better quality of life scores than the control group in social function, emotional well-being domains and mental component summary score but no statistically significant differences as regard to the physical domains of their quality of life.
So, Provision of information to the patients and their caregivers as regard to their illnesses and its management not only during the initial time of start dialysis but also throughout the disease and development of direct connection between each hemodialysis patient and a renal dietician is very important to improve their quality of life.