Quality of Life in End-Stage Renal Disease Patients after Successful Kidney Transplantation: Development of the ESRD Symptom Checklist – Transplantation Module (original) (raw)
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Nephron, 1999
The End-Stage Renal Disease Symptom Checklist-Transplantation Module (ESRD-SCL ®) was developed to assess the specific physical and psychological quality of life of renal transplant recipients, with a special focus on side effects of immune system suppression therapy. A list of potentially relevant items was administered to 458 transplant recipients. The symptoms present in 1 20% of patients were chosen, and factor analysis was used to create the final questionnaire which consists of 43 items in six dimensions: (1) limited physical capacity (10 items; internal consistency: Cronbach's • = 0.85); (2) limited cognitive capacity (8 items, • = 0.82); (3) cardiac and renal dysfunction (7 items, • = 0.76); (4) side effects of corticosteroids (5 items, • = 0.77); (5) increased growth of gum and hair (5 items, • = 0.78), and (6) transplantationassociated psychological distress (8 items, • = 0.80). All questions are scored on a five-point Likert scale. Validity was demonstrated in correlation with corresponding SF-36 scales and in a stepwise hierarchical regression model predicting the subscales of the ESRD-SCL by sociodemographic and medical data. The ESRD-SCL was found to have adequate reliability, test-retest correlations in a subsample of 88 stable patients after 1 year, and construct validity.
Health related quality of life in renal transplantation: 2 years of longitudinal follow-up
Medicina Clínica (english Edition), 2017
Background and objective: Health related quality of life (HRQoL) is recognised as an outcome measure in kidney transplantation. In this study was assessed changes on HRQoL and kidney-specific symptoms, also was evaluated the effect of socio-demographic and clinical parameters on patient's perceived HRQoL. Patients and method: A longitudinal study was done, at 5 time-points over 2 years after transplantation. To evaluate HRQoL the Kidney Disease Quality of Life Questionnaire Short Form was administrated, and Hospital Anxiety and Depression Scale was used to assess psychological distress. Results: At 6 months after transplantation, patients had similar HRQoL scores compared to the general population. The improvement on effects of kidney disease domain could be considered as large (Á 2 = 0.29), and medium on burden of kidney disease domain (Á 2 = 0.12), work status domain (Á 2 = 0.12), and sexual function domain (Á 2 = 0.13). Psychological distress, depressive symptoms, haemoglobin, and serum creatinine had significant influence on patient's perceived HRQoL over 2 years after transplantation. Conclusions: An improvement of HRQoL was observed on general and specific-targeted symptoms over 2 years after renal transplantation.
Quality of Life Research, 2009
Introduction Kidney transplantation improves the quality of life of end-stage renal disease patients. The quality of life benefits, however, pertain to patients on average, not to all transplant recipients. The aim of this study was to identify factors associated with health-related quality of life after kidney transplantation. Methods Population-based study with a cross-sectional design was carried out and quality of life was assessed by SF-36 Health Survey Version 1. A multivariate linear regression model was constructed with sociodemographic, clinical and laboratory data as independent variables. Results Two hundred and seventy-two kidney recipients with a functioning graft were analyzed. Hypertension, diabetes, higher serum creatinine and lower hematocrit were independently and significantly associated with lower scores for the SF-36 oblique physical component summary (PCSc). The final regression model explained 11% of the PCSc variance. The scores of oblique mental component summary (MCSc) were worse for females, patients with a lower income, unemployed and patients with a higher serum creatinine. The regression model explained 9% of the MCSc variance. Conclusions Among the studied variables, comorbidity and graft function were the main factors associated with the PCSc, and sociodemographic variables and graft function were the main determinants of MCSc. Despite comprehensive, the final regression models explained only a little part of the heath-related quality of life variance. Additional factors, such as personal, environmental and clinical ones might influence quality of life perceived by the patients after kidney transplantation.
Changes in quality of life after renal transplantation
American Journal of Kidney Diseases, 1998
The objective of this study was to evaluate the modifications that renal transplantation produces on the quality of life (QOL) of patients with chronic renal failure (CRF) previously undergoing hemodialysis (HD) and to analyze the possible factors implicated. A multicenter study of QOL was performed on 1,023 patients undergoing dialysis, using as QOL indicators the Karnofsky Scale (KS) and the Sickness Impact Profile (SIP). Among this group, 93 patients received a renal transplant and QOL was re-studied in them; each subject, therefore, was his own control. In the 88 patients with a functioning graft, an improvement in QOL indices was globally observed; this improvement was much more marked in men than in women, for unclear reasons. Older age and greater prior comorbidity diminished the beneficial effects of transplantation. (Am J Kidney Dis 1998 Jul;32(1):93-100)
Quality of life and its related factors in kidney transplant recipients
2019
Patients undergoing transplantation, experience significant changes in their quality of life. The aim of this study was to determine the quality of life and related factors in kidney transplant recipients. This descriptive-analytic cross-sectional study was performed on 136 kidney transplant recipients referring to nephrology clinic of Imam Khomeini Hospital in Ardabil through convenience sampling method in 2016. Data was collected by using a demographic form, Short Form Health Survey (SF36), physical stress index, Kidney Transplantation Self-Management Scale, Kidney Transplantation Self-Care Self-Efficacy Scale and Beck's Depression Inventory. Data were analyzed by SPSS software version 16 using descriptive and analytical methods. The mean score of physical health (55.01 ±19.48) was slightly higher than the mental health (42.86 ± 20.91). Self-efficacy (β = 0.29), depression symptoms (β = -0.34), age (β = -0.36) and gender (β = 0.15) were as predictors of the physical health com...
Does Perceived Health Status Influence Quality of Life after Renal Transplantation
Organ transplantation aims to restore physical health status and overall QoL. This longitudinal was carried out to find out how most renal transplant recipients (RTRs) in Pakistan, perceive their health status and overall QoL after a successful kidney transplant. Renal transplant recipients (RTRs) were studied at three waves over 15 months. QoL was assessed using Ferrens & Powers QoL Index-Kidney Transplant Version that evaluated four major domains of life post-transplant. These included; health functioning scale (HF), psychological and spiritual scale (PS), social and economic scale (SE) and family subscale (FS). Perceived Health Status was measured using a self-developed questionnaire assessing frequency and severity common immunosuppressant side effects. The findings revealed that most RTRs were satisfied with their QoL and had positive perceptions of their health status. A significant positive correlation among QoL and PHS was found. A cross lagged correlation analysis to find if perceived health status influences perceptions of QoL or vice versa showed that it cannot be claimed whether, QoL always influences how recipients perceive their health status due to an inconsistent pattern at wave 1 and 2 where the data suggest the relationship is working in the opposite direction.
Journal of Transplantation, 2011
Little is known on long-term outcomes in kidney transplantation. This study evaluated changes and predictors of generic and transplantation-specific health-related quality of life (HQoL) over six years in N = 102 kidney transplant survivors using the Short-form Health Survey-36 and the Transplant Effects questionnaire. Mixed models analysis was used to determine long-term outcomes. Emotional HQoL improved over time: Mental Component score, Mental Health, Energy (Ps = .000). Physical HQoL deteriorated: Physical Component Score (P = .001), Pain (P = .002). LRD transplant recipients had greater decline in physical functioning (P = .003) and PCS (P = .000) compared to cadaver recipients. Worry about the transplant (P = .036) and feelings of responsibility (P = .008) increased significantly over time. Worry about the transplant and perceived ability to work predicted 12.7% and 31.1% in variance in MCS and PCS, respectively. Efforts should be made to maintain HQoL and emotional outcomes with ongoing monitoring and support programs throughout the course of posttransplant care.
Quality of life assessment in renal transplant: review and future directions
Clinical Transplantation, 2007
We performed a systematic search of the literature using the MEDLINE (through 2006) database to identify the patient-reported outcome measures of quality of life (QOL) used most often in the renal transplant literature. After applying limits and reviewing references, we identified 338 renal transplant articles with a formal QOL assessment. Among the most frequently cited instruments were generic QOL tools, such as the Short Form-36, the Sickness Impact Profile, and the World Health Organization Quality of Life questionnaire. Other frequently cited instruments were more targeted in nature, such as the End-stage Renal Disease-Symptom Checklist and the Kidney Disease Quality of life questionnaire. In the present article, we review the most commonly used instruments, their use in renal transplant, and suggest future directions to improve QOL assessment in this population.
Health-Related Quality of Life and Clinical Outcomes in Kidney Transplant Recipients
American Journal of Kidney Diseases, 2011
Background: Health-related quality of life (HRQoL) is an important outcome measure in patients with chronic kidney disease. It also has been shown repeatedly to predict mortality in various patient populations. In a prospective cohort study, we assessed the association between HRQoL and long-term clinical outcome in kidney transplant recipients. Study Design: Prospective prevalent cohort study. Setting & Participants: We collected sociodemographic parameters, medical and transplant history, and laboratory data at baseline from 879 prevalent kidney transplant recipients (mean age, 49 Ϯ 13 [standard deviation] years; 58% men; and 17% with diabetes mellitus). Predictor: We assessed HRQoL using the KDQoL-SF (Kidney Disease Quality of Life Short Form) questionnaire and assessed depressive symptoms using the Center for Epidemiologic Studies-Depression Scale. Outcomes: All-cause mortality and death-censored transplant loss or death with functioning transplant. Cox regression models and semiparametric competing-risks regression analyses were used to measure associations between HRQoL scores and outcomes. Results: Most examined HRQoL domains were associated with clinical outcome in unadjusted models. After adjusting for several important confounders, the 36-Item Short Form Health Survey (SF-36) Physical Composite Score and Physical Functioning and General Health Perception subscale scores remained independently associated with clinical outcomes. Every 10-point increase in SF-36 Physical Composite Score and Physical Functioning and General Health Perception scores was associated with 18% (HR, 0.82; 95% CI, 0.71-0.95), 11% (HR, 0.89; 95% CI, 0.84-0.94), and 7% lower risks of mortality (HR, 0.93; 95% CI, 0.88-1.00), respectively. Limitations: Single-center study. Conclusions: We showed that the SF-36 Physical Composite Score and Physical Functioning and General Health Perception KDQoL-SF domain scores are associated independently with increased risk of mortality in kidney transplant patients. Regular assessment of HRQoL may be a useful tool to inform health care providers about the prognosis of kidney transplant recipients. Additional studies are needed to assess whether interventions aimed at improving HRQoL would improve clinical outcomes in this patient population.
Transplantation Proceedings, 2004
Currently, living related donors are involved in approximately 85% of all kidney transplantations performed at our institution. Health-related quality of life (HRQL) is an important outcome factor in chronic disease. Quality of life may be diminished by prolonged illness or certain treatment modalities and by negative, disabling effects on mood. We investigated HRQL and mood in renal transplant recipients, donors, and controls using the Beck Depression Inventory, Beck Anxiety Inventory, and 36-item Short Form Health Survey. Recipient depression scores were significantly higher (indicating more serious depression) than those of donors (P Ͻ .05), but similar to those of the controls. There was no significant difference between the donor and the control subjects' depression scores. The anxiety scores of the recipients and donors were similar; and recipient anxiety scores were significantly higher than those of the control subjects (P Ͻ .05). The recipient scores indicated significantly poorer physical functioning (P Ͻ .001), significantly greater physical limitation on roles (P Ͻ .01), and lower levels of general health (P Ͻ .01) compared to controls. The recipient scores for vitality, pain, social functioning, and emotional limitations on roles were similar to those of the controls. Our results indicate that most recipients and donors experience anxiety after renal transplantation. This study confirms that recipients have favorable outcomes with respect to social functioning and emotional well-being. Overall, the results of this preliminary study are positive, encouraging us to continue to perform living donor kidney transplantation.