Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study
The increasing prevalence of treated end-stage renal disease and low transplant rates in Africa leads to longer durations on dialysis. Dialysis should not only be aimed at prolonging lives but also improve quality of life (QOL). Using mixed methods, we investigated the QOL of patients on chronic hae...
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| creator | Tannor, Elliot K Archer, Elize Kapembwa, Kenneth van Schalkwyk, Susan C Davids, M Razeen |
| description | The increasing prevalence of treated end-stage renal disease and low transplant rates in Africa leads to longer durations on dialysis. Dialysis should not only be aimed at prolonging lives but also improve quality of life (QOL). Using mixed methods, we investigated the QOL of patients on chronic haemodialysis (HD) and peritoneal dialysis (PD).
We conducted a cross-sectional study at Tygerberg Hospital in Cape Town, South Africa. All the PD patients were being treated with continuous ambulatory peritoneal dialysis. The KDQOL-SF 1.3 questionnaire was used for the quantitative phase of the study. Thereafter, focus-group interviews were conducted by an experienced facilitator in groups of HD and PD patients. Electronic recordings were transcribed verbatim and analysed manually to identify emerging themes.
A total of 106 patients completed questionnaires and 36 of them participated in the focus group interviews. There was no difference between PD and HD patients in the overall KDQOL-SF scores. PD patients scored lower with regard to symptoms (P = 0.005), energy/fatigue (P = 0.025) and sleep (P = 0.023) but scored higher for work status (P = 0.005) and dialysis staff encouragement (P = 0.019) than those on HD. Symptoms and complications were verbalised more in the PD patients, with fear of peritonitis keeping some housebound. PD patients were more limited by their treatment modality which impacted on body image, sexual function and social interaction but there were less dietary and occupational limitations. Patients on each modality acknowledged the support received from family and dialysis staff but highlighted the lack of support from government. PD patients had little opportunity for interaction with one another and therefore enjoyed less support from fellow patients.
PD patients experienced a heavier symptom burden and greater limitations related to their dialysis modality, especially with regards to social functioning. The mixed-methods approach helped to identify several issues affecting quality of life which are amenable to intervention. |
| doi_str_mv | 10.1186/s12882-016-0425-1 |
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We conducted a cross-sectional study at Tygerberg Hospital in Cape Town, South Africa. All the PD patients were being treated with continuous ambulatory peritoneal dialysis. The KDQOL-SF 1.3 questionnaire was used for the quantitative phase of the study. Thereafter, focus-group interviews were conducted by an experienced facilitator in groups of HD and PD patients. Electronic recordings were transcribed verbatim and analysed manually to identify emerging themes.
A total of 106 patients completed questionnaires and 36 of them participated in the focus group interviews. There was no difference between PD and HD patients in the overall KDQOL-SF scores. PD patients scored lower with regard to symptoms (P = 0.005), energy/fatigue (P = 0.025) and sleep (P = 0.023) but scored higher for work status (P = 0.005) and dialysis staff encouragement (P = 0.019) than those on HD. Symptoms and complications were verbalised more in the PD patients, with fear of peritonitis keeping some housebound. PD patients were more limited by their treatment modality which impacted on body image, sexual function and social interaction but there were less dietary and occupational limitations. Patients on each modality acknowledged the support received from family and dialysis staff but highlighted the lack of support from government. PD patients had little opportunity for interaction with one another and therefore enjoyed less support from fellow patients.
PD patients experienced a heavier symptom burden and greater limitations related to their dialysis modality, especially with regards to social functioning. The mixed-methods approach helped to identify several issues affecting quality of life which are amenable to intervention.</description><identifier>ISSN: 1471-2369</identifier><identifier>EISSN: 1471-2369</identifier><identifier>DOI: 10.1186/s12882-016-0425-1</identifier><identifier>PMID: 28056851</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Aged ; Care and treatment ; Chronic kidney failure ; Cost of Illness ; Cross-Sectional Studies ; Employment ; Female ; Health aspects ; Health Status ; Hemodialysis patients ; Humans ; Interpersonal Relations ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - psychology ; Kidney Failure, Chronic - rehabilitation ; Male ; Middle Aged ; Mixed methods research ; Nephrology ; Peritoneal dialysis ; Peritoneal Dialysis, Continuous Ambulatory - psychology ; Peritoneal Dialysis, Continuous Ambulatory - utilization ; Prevalence ; Psychological aspects ; Quality of life ; Quality of Life - psychology ; Sex Distribution ; South Africa - epidemiology ; Surveys ; Surveys and Questionnaires ; Treatment Outcome</subject><ispartof>BMC nephrology, 2017-01, Vol.18 (1), p.4-4, Article 4</ispartof><rights>COPYRIGHT 2017 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2017</rights><rights>The Author(s). 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-f8963c0eb995f3fe724c4368df88c26cc9414d65ec49c37d953ab85bf82b81de3</citedby><cites>FETCH-LOGICAL-c494t-f8963c0eb995f3fe724c4368df88c26cc9414d65ec49c37d953ab85bf82b81de3</cites><orcidid>0000-0003-4900-0231</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217650/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217650/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,27913,27914,53780,53782</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28056851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tannor, Elliot K</creatorcontrib><creatorcontrib>Archer, Elize</creatorcontrib><creatorcontrib>Kapembwa, Kenneth</creatorcontrib><creatorcontrib>van Schalkwyk, Susan C</creatorcontrib><creatorcontrib>Davids, M Razeen</creatorcontrib><title>Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study</title><title>BMC nephrology</title><addtitle>BMC Nephrol</addtitle><description>The increasing prevalence of treated end-stage renal disease and low transplant rates in Africa leads to longer durations on dialysis. Dialysis should not only be aimed at prolonging lives but also improve quality of life (QOL). Using mixed methods, we investigated the QOL of patients on chronic haemodialysis (HD) and peritoneal dialysis (PD).
We conducted a cross-sectional study at Tygerberg Hospital in Cape Town, South Africa. All the PD patients were being treated with continuous ambulatory peritoneal dialysis. The KDQOL-SF 1.3 questionnaire was used for the quantitative phase of the study. Thereafter, focus-group interviews were conducted by an experienced facilitator in groups of HD and PD patients. Electronic recordings were transcribed verbatim and analysed manually to identify emerging themes.
A total of 106 patients completed questionnaires and 36 of them participated in the focus group interviews. There was no difference between PD and HD patients in the overall KDQOL-SF scores. PD patients scored lower with regard to symptoms (P = 0.005), energy/fatigue (P = 0.025) and sleep (P = 0.023) but scored higher for work status (P = 0.005) and dialysis staff encouragement (P = 0.019) than those on HD. Symptoms and complications were verbalised more in the PD patients, with fear of peritonitis keeping some housebound. PD patients were more limited by their treatment modality which impacted on body image, sexual function and social interaction but there were less dietary and occupational limitations. Patients on each modality acknowledged the support received from family and dialysis staff but highlighted the lack of support from government. PD patients had little opportunity for interaction with one another and therefore enjoyed less support from fellow patients.
PD patients experienced a heavier symptom burden and greater limitations related to their dialysis modality, especially with regards to social functioning. The mixed-methods approach helped to identify several issues affecting quality of life which are amenable to intervention.</description><subject>Adult</subject><subject>Aged</subject><subject>Care and treatment</subject><subject>Chronic kidney failure</subject><subject>Cost of Illness</subject><subject>Cross-Sectional Studies</subject><subject>Employment</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health Status</subject><subject>Hemodialysis patients</subject><subject>Humans</subject><subject>Interpersonal Relations</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Kidney Failure, Chronic - psychology</subject><subject>Kidney Failure, Chronic - rehabilitation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mixed methods research</subject><subject>Nephrology</subject><subject>Peritoneal dialysis</subject><subject>Peritoneal Dialysis, Continuous Ambulatory - psychology</subject><subject>Peritoneal Dialysis, Continuous Ambulatory - utilization</subject><subject>Prevalence</subject><subject>Psychological aspects</subject><subject>Quality of life</subject><subject>Quality of Life - psychology</subject><subject>Sex Distribution</subject><subject>South Africa - epidemiology</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><issn>1471-2369</issn><issn>1471-2369</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkltrFTEUhYMo9qI_wBcJ-OLL1Nwn8UE4FKtCQUR9DplcelJmkmMyU3r-vRlOra1IHhKyv7U2O1kAvMLoDGMp3lVMpCQdwqJDjPAOPwHHmPW4I1Sopw_OR-Ck1muEcC8Zeg6OiERcSI6PwfBtMWOc9zAHOMbgYUxwZ-bo01xhTtBuS07RQhfNuK-xrvXveZm3cBNKtOY9NNDmaWdKE914OMVb7-Dk5212FdZ5cfsX4FkwY_Uv7_ZT8PPi44_zz93l109fzjeXnWWKzV2QSlCL_KAUDzT4njDLqJAuSGmJsFYxzJzgvuGW9k5xagbJhyDJILHz9BR8OPjulmHyzrYRihn1rsTJlL3OJurHlRS3-irfaE5wLzhqBm_vDEr-tfg66ylW68fRJJ-XqrHkgiuqmGrom3_Q67yU1MZrlKCKYyblX-rKjF7HFHLra1dTvWHtC7hCaqXO_kO15fwUbU4-xHb_SIAPAltyrcWH-xkx0msw9CEYugVDr8HQuGleP3yce8WfJNDfxtKzaw</recordid><startdate>20170105</startdate><enddate>20170105</enddate><creator>Tannor, Elliot K</creator><creator>Archer, Elize</creator><creator>Kapembwa, Kenneth</creator><creator>van Schalkwyk, Susan C</creator><creator>Davids, M Razeen</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4900-0231</orcidid></search><sort><creationdate>20170105</creationdate><title>Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study</title><author>Tannor, Elliot K ; Archer, Elize ; Kapembwa, Kenneth ; van Schalkwyk, Susan C ; Davids, M Razeen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-f8963c0eb995f3fe724c4368df88c26cc9414d65ec49c37d953ab85bf82b81de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Care and treatment</topic><topic>Chronic kidney failure</topic><topic>Cost of Illness</topic><topic>Cross-Sectional Studies</topic><topic>Employment</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health Status</topic><topic>Hemodialysis patients</topic><topic>Humans</topic><topic>Interpersonal Relations</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Kidney Failure, Chronic - psychology</topic><topic>Kidney Failure, Chronic - rehabilitation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mixed methods research</topic><topic>Nephrology</topic><topic>Peritoneal dialysis</topic><topic>Peritoneal Dialysis, Continuous Ambulatory - psychology</topic><topic>Peritoneal Dialysis, Continuous Ambulatory - utilization</topic><topic>Prevalence</topic><topic>Psychological aspects</topic><topic>Quality of life</topic><topic>Quality of Life - psychology</topic><topic>Sex Distribution</topic><topic>South Africa - epidemiology</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tannor, Elliot K</creatorcontrib><creatorcontrib>Archer, Elize</creatorcontrib><creatorcontrib>Kapembwa, Kenneth</creatorcontrib><creatorcontrib>van Schalkwyk, Susan C</creatorcontrib><creatorcontrib>Davids, M Razeen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tannor, Elliot K</au><au>Archer, Elize</au><au>Kapembwa, Kenneth</au><au>van Schalkwyk, Susan C</au><au>Davids, M Razeen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study</atitle><jtitle>BMC nephrology</jtitle><addtitle>BMC Nephrol</addtitle><date>2017-01-05</date><risdate>2017</risdate><volume>18</volume><issue>1</issue><spage>4</spage><epage>4</epage><pages>4-4</pages><artnum>4</artnum><issn>1471-2369</issn><eissn>1471-2369</eissn><abstract>The increasing prevalence of treated end-stage renal disease and low transplant rates in Africa leads to longer durations on dialysis. Dialysis should not only be aimed at prolonging lives but also improve quality of life (QOL). Using mixed methods, we investigated the QOL of patients on chronic haemodialysis (HD) and peritoneal dialysis (PD).
We conducted a cross-sectional study at Tygerberg Hospital in Cape Town, South Africa. All the PD patients were being treated with continuous ambulatory peritoneal dialysis. The KDQOL-SF 1.3 questionnaire was used for the quantitative phase of the study. Thereafter, focus-group interviews were conducted by an experienced facilitator in groups of HD and PD patients. Electronic recordings were transcribed verbatim and analysed manually to identify emerging themes.
A total of 106 patients completed questionnaires and 36 of them participated in the focus group interviews. There was no difference between PD and HD patients in the overall KDQOL-SF scores. PD patients scored lower with regard to symptoms (P = 0.005), energy/fatigue (P = 0.025) and sleep (P = 0.023) but scored higher for work status (P = 0.005) and dialysis staff encouragement (P = 0.019) than those on HD. Symptoms and complications were verbalised more in the PD patients, with fear of peritonitis keeping some housebound. PD patients were more limited by their treatment modality which impacted on body image, sexual function and social interaction but there were less dietary and occupational limitations. Patients on each modality acknowledged the support received from family and dialysis staff but highlighted the lack of support from government. PD patients had little opportunity for interaction with one another and therefore enjoyed less support from fellow patients.
PD patients experienced a heavier symptom burden and greater limitations related to their dialysis modality, especially with regards to social functioning. The mixed-methods approach helped to identify several issues affecting quality of life which are amenable to intervention.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>28056851</pmid><doi>10.1186/s12882-016-0425-1</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-4900-0231</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Care and treatment Chronic kidney failure Cost of Illness Cross-Sectional Studies Employment Female Health aspects Health Status Hemodialysis patients Humans Interpersonal Relations Kidney Failure, Chronic - epidemiology Kidney Failure, Chronic - psychology Kidney Failure, Chronic - rehabilitation Male Middle Aged Mixed methods research Nephrology Peritoneal dialysis Peritoneal Dialysis, Continuous Ambulatory - psychology Peritoneal Dialysis, Continuous Ambulatory - utilization Prevalence Psychological aspects Quality of life Quality of Life - psychology Sex Distribution South Africa - epidemiology Surveys Surveys and Questionnaires Treatment Outcome |
| title | Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study |
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