Assessment of factors affecting the quality of life in hemodialysis patients in Saudi Arabia
49 Pages10503 Words238 Views
Added on 2020-02-24
About This Document
In this document, the concept of quality of life or health-related quality of life is used as a patient-specific outcome measure in different healthcare settings. It has been measured and conceptualized by using several validated instruments in the scientific community.
Assessment of factors affecting the quality of life in hemodialysis patients in Saudi Arabia
Added on 2020-02-24
ShareRelated Documents
Running head: QUALITY OF LIFE ASSESSMENTResearch Proposal- Assessment of factors affecting quality of life in hemodialysispatients in Saudi ArabiaName of the StudentName of the UniversityAuthor Note
1QUALITY OF LIFE ASSESSMENTExecutive summaryThe concept of quality of life (QoL) or health-related quality of life (HRQoL) is used as a patientspecific outcome measure in different healthcare settings. It has been measured andconceptualised by using several validated instruments in the scientific community. However, inmost literature, the true meaning of this concept is still not clear. The aim of this researchproposal is to formulate a study that will explore the gap in present literature and will define theconcept of HRQoL, identify the key domains and eventually conceptualise it as perceived bypatients with end stage renal failure and those undergoing haemodialysis in a healthcare centre atSaudi Arabia.
2QUALITY OF LIFE ASSESSMENTTable of ContentsIntroduction..........................................................................................................................3Literature review..................................................................................................................6Methodology......................................................................................................................14Plan for data analysis.........................................................................................................18Probable findings...............................................................................................................19Conclusions........................................................................................................................20References..........................................................................................................................22APPENDIX A....................................................................................................................28APPENDIX B....................................................................................................................29APPENDIX C....................................................................................................................30APPENDIX D....................................................................................................................49
3QUALITY OF LIFE ASSESSMENTIntroductionThe term quality of life (QoL) is a multidimensional concept that encompasses an arrayof negative and positive indicators related to psychological, physical, environmental and socialdomains (Fayers & Machin, 2013). Health related quality of life (HRQoL) assessment is not justlimited to the verification of the health status of any individual, it analyses the physical, socialand mental wellness and life satisfaction of the person as well. According to the TheWorldHealth Organization Quality of Life Group, Quality of life is the perception of an individual ofpositions in their life with respect to value and culture systems where they live and in accordanceto their expectations, goals, concerns and standards (Frisch, 2014). HRQoL is defined as thefunctional consequence of a disease and its related therapy administered on the patient, as thepatient perceives. Over the last decade, research on quality of life has emerged as a valuable toolto assess therapeutic intervention outcomes of several chronic diseases (Michalos, 2017). End-stage renal failure/disease (ESRD) is one type of a chronic disease form ofirreversible decline in the functions of the kidneys, which require kidney transplantation ordialysis to sustain our life (Coresh et al., 2014). The impacts of ESRD in human are severe. Theaggregate costs of dialysis, co-morbid conditions and recurrent hospitalizations overwhelm thepatients and affect their health plans. In 2011, the total Medicare cost for ESRD in 2011 was$34.3 billion. PPPY health costs (per person per year) for patients on hemodialysis were $87,945in the same year (Collins et al., 2015). The fifth stage of chronic kidney disease progressionmanifests itself in the form of end stage renal disease. It is measured by the rate ofglomerularfiltration (GFR).
4QUALITY OF LIFE ASSESSMENTCauses- Certain conditions or disease responsible for end stage renal disease arehypertension, type 1 and type 2 diabetes, glomerulonephritis, polycystic kidneys, urinal tractobstruction form kidney stones or enlarged prostate and interstitial nephritis.Symptoms- The common symptoms observed as the disease progresses are vomiting,nausea, loss of appetite, muscle twitch, swelling of ankles and feet, chest pain, hypoxia andhypertension. Hemodialysis, peritoneal dialysis and kidney transplantation are the commontreatment methods.ESRD patients are subjected to hemodialysis treatment that removes the salt, wastes andextra water from their body to prevent waste accumulation in the blood (Robinson et al., 2014).It also ensures a safe level of specific chemicals in the blood and regulates blood pressure. Renalreplacement therapy reduces symptom severity and increase survival rates of ESRD patients.Hemodialysis is expensive, time intensive and restricts the amount of fluid and dietary intakes.Prolonged therapy leads to dependence on healthcare givers, freedom loss and disruption ofsocial and family life. It also affects financial stability.Objective- Frequent hospitalizations increase morbidity and mortality risks in patientsexacerbates social and emotional stress. This affects the patient HRQo (Kang et al., 2015)L.Literature based evidence indicate association of low QoL scores with death in such patients.HRQoL assessment will help in improving treatment and prognosis (Birren et al., 2014). Themain aim of this study is assessing QoL in hemodialysis patients with respect to theirpsychological, physical, environmental and social health domains. Moreover, the study willanalyse effects of sex, age, education level, income, disease duration and treatment on the QoL(Martinson et al., 2014).
5QUALITY OF LIFE ASSESSMENTResearch question- Quality of life is an essential issue for healthcare providers. Theresearch questions for this proposal are: 1) “What is the quality of life of hemodialysis patients athealthcare facility in Saudi Arabia?”, 2) “Do symptoms (dialysis, fatigue, anxiety, depression),general health perception, functional status, individual characteristics (gender, age, race),biological function (serum albumin and hemoglobin) and socio-economic factors, marital statusand treatment time affect the quality of life?” (Lowney et al., 2015) and 3) “When individualcharacteristics and environmental characteristics are controlled, do biological factors affect theoverall quality of life?” Little research has been conducted on the broad spectrum of QoL inpatients with ESRD. This research proposal thus aims to explain how factors of satisfaction,dissatisfaction, physical quality, duration of hemodialysis treatment, standard of living andpsychological aspects that are important to a person affect his perception on the quality of life(Bayoumi et al., 2013). Independent variables such as gain in weight, urea reduction ratio, yearsof dialysis treatment and levels of phosphorus, calcium, albumin, parathyroid hormone andserum hemoglobin were considered. The dependent variables were kidney disease burden,symptoms, problems and their effects on daily life of the patients. These variables have beenselected because previous studies have reported lack of theoretical framework in selecting thevariables for the assessment. This failed to establish the relationship between HRQoL and itsphysical and psychological determinants.Scope- The study will help in improving financial and social and support of ESRDpatients. It will provide interventions for promoting physical activity and coping withpsychological distress in the patient population. This might prove effective in eventuallyenhancing their HRQoL. The findings from the study will add to the literature, the underlyingcomplex psychological and biological processes of HRQoL. It will take knowledge acquired
6QUALITY OF LIFE ASSESSMENTthrough statistical analysis in HRQoL of hemodialysis patients to a theoretical level and willprovide insight for the development of appropriate and effective strategies to optimize theirquality of life.Limitations- Limitations of this research proposal include small caregiver sample size,lack of random sampling and low reliability of independent variables. Recruiting samples from asingle institution is another limitation. This will prohibit any form of generalization beyond thesample for this study.Literature reviewQuality of life is a matter of utmost concern in clinical research based on evaluation. Allhealthcare policies expect improvement in the quality of life as a desired outcome. Though,health related quality of life is extensively used for research studies, the term has not beenconceptualized yet and this creates confusion among researchers. Several studies developeddefinitions for quality of life. However, these lacked consensus (Anees et al., 2014). Somestudies focused on the concept of patient reported toxicity to define quality of life. Some globaldefinitions incorporate and encompass the ideas of patient happiness, unhappiness, satisfactionand dissatisfaction. Quality of life is also defined as a feeling of satisfaction and wellbeing thatindicates the way a patient perceives his life to be. Quality of life makes life worthwhile. Otherstudies state that the value and meaning of life are expressed in terms of an individual’s view ofquality of life (Vasilopoulou et al., 2016). However, these definitions fail to provide informationon the components related to quality of life; therefore make it difficult for researchers tooperationalize. The ambiguous definitions can be made research specific if they focus on theconcept of QoL related to research area of interest. Multidimensional concepts that consist of
7QUALITY OF LIFE ASSESSMENTfour life domains such as social and economic, health and functioning, family and psychologicalor spiritual, wellbeing can help in defining HRQoL in a comprehensive way (Rostami et al.,2013). These definitions are generally found in research articles that focus on the term “healthrelated quality of life”. Several studies compared the HRQoL in end stage renal failure in nurses,patients, and physicians. These studies utilized tools to determine the quality of life only relatedto health items (Borzou et al., 2016). Some instruments used to assess HRQoL emphasize on theuse of a single domain like emotional functioning. On the other hand, other studies consider allcomponents to be equally important in affecting health outcomes and therefore include acombination of different factors or components. Moreover, many authors utilized a combination of all the definitions (Lopes et al., 2014).Some research studies revealed health related quality of life as an essential cultural concept.They evaluated the differences in association between clinical compliance of the patient, rates ofpatient survival, health outcomes and the life quality (Cukor et al., 2014). For the purpose of thisproposed study, review of the literature will focus specifically on health realted quality of life inhemodialysis patients who have been admitted to healthcare centres or hospital. Health relatedquality of life evaluation and determination can be attempted by researchers and clinicians eitherby designing objective assessments for the patients which are generally undertaken by aninterviewer or by designing subjective assessments which are done by the patients themselves.Both these assessment methods report different findings. A particular study used more than 250patients as sample and had collected data based on a reliable questionnaire. The questions in thesurvey were framed based on the clinical history of the patients and several social anddemographic factors (Ayoub & Hijjazi, 2013). The health status of the patients was determinedby using the EQ-5D-5L dimensions. The obtained results suggested that low rates of HRQoL
End of preview
Want to access all the pages? Upload your documents or become a member.
Related Documents
Research Method - Chronic kidney diseaselg...
|6
|1148
|31
Critical Evaluation Of Litraturelg...
|12
|2855
|21
Tertiary Hospital in Chinalg...
|9
|2372
|15
Health related quality of lifelg...
|4
|622
|40
Scoping Literature Review Incorporating Critical Appraisal of Researchlg...
|14
|3988
|50
Death during Dialysis – A serious Concernlg...
|16
|565
|381