ABSTRACT
Abstract Background: Peritoneal dialysis (PD) is gaining track as an efficient/affordable therapy in poor settings. Yet, there is little data regarding differences in quality of life (QoL) of primary caregivers (PCG) of patients in PD and hemodialysis (HD). Aim: To compare the QoL of PCG of patients in PD and HD from an upper middle-income population in a Mexican city. Methods: Cross-sectional study was carried out with PCG of patients in PD (n=42) and HD (n=95) from 4 hospitals (response rate=70.2%). The SF 36-item QoL questionnaire, the Zarit burden interview, and the Goldberg anxiety/depression scale were used. Mean normalized scores for each QoL domain were compared by dialysis type. Adjusted odds were computed using logistic regression to determine the probability of low QoL (<70% of maximum possible score resulting from the added scores of the 8 dimensions). Results: The PD group had higher mean scores for emotional role functioning (+10.6; p=0.04), physical functioning (+9.2; p=0.002), bodily pain (+9.2; p=0.07), social functioning (+5.7; p=0.25), and mental health (+1.3; p=0.71); the HD group had higher scores for physical role functioning (+7.9, p=0.14), general health perception (+6.1; p=0.05), and vitality (+3.3; p=0.36). A non-significant OR was seen in multivariate regression (1.51; 95% CI 0.43-5.31). Zarit scores were similar, but workload levels were lower in the PD group (medium/high: PD 7.2%, HD 14.8%). Anxiety (HD 50.5%, PD 19%; p<0.01) and depression (HD 49.5%, PD 16.7%; p<0.01) were also lower in the PD group. Conclusion: Adjusted analysis showed no differences in the probability of low QoL between the groups. These findings add to the value of PD, and strengthen its importance in resource-limited settings.
Resumo Histórico: A diálise peritoneal (DP) vem ganhando terreno como terapia eficiente/acessível em ambientes pobres. Contudo, há poucos dados sobre diferenças na qualidade de vida (QV) dos cuidadores primários (CP) de pacientes em DP e hemodiálise (HD). Objetivo: Comparar QV dos CP de pacientes em DP e HD de uma cidade mexicana de renda média. Métodos: Estudo transversal com CP de pacientes em DP (n=42) e HD (n=95) de 4 hospitais (taxa resposta=70,2%). Aplicou-se o questionário QV-36 itens, entrevista de sobrecarga de Zarit e escala de ansiedade/depressão Goldberg. Escores médios normalizados para cada domínio de QV foram comparados por tipo de diálise. Probabilidades ajustadas foram calculadas usando regressão logística para determinar a probabilidade de baixa QV (<70% da pontuação máxima possível resultante das pontuações adicionadas das 8 dimensões). Resultados: O grupo DP apresentou escores médios mais altos para aspectos emocionais (+10,6; p=0,04), capacidade funcional (+9,2; p=0,002), dor (+9,2; p=0,07), aspectos sociais (+5,7; p=0,25), saúde mental (+1,3; p=0,71); o grupo HD teve pontuação maior para aspectos físicos (+7,9, p=0,14), estado geral de saúde (+6,1; p=0,05), vitalidade (+3,3; p=0,36). Uma probabilidade não significativa foi observada na regressão multivariada (OR=0,66; 95% IC 0,18-2,31). Os escores de Zarit foram semelhantes, mas os níveis da sobrecarga foram menores na DP (médio/alto: DP 7,2%, HD 14,8%). Ansiedade (50,5% vs 19%; p<0,01) e depressão (49,5% vs 16,7%; p<0,01) foram menores na DP. Conclusão: O risco de baixa QV entre grupos não foi diferente na análise ajustada. Estes achados fortalecem a importância da DP em ambientes com recursos limitados.
Subject(s)
Humans , Peritoneal Dialysis , Kidney Failure, Chronic/therapy , Quality of Life , Cross-Sectional Studies , Renal Dialysis , CaregiversABSTRACT
BACKGROUND: Caregivers of patients with end-stage renal disease (ESRD) in dialysis endure a process of physical/emotional erosion derived from the implications of treatment and permanent care for prolonged periods of time. OBJECTIVE: To assess the quality of life (QoL) of primary caregivers of patients with ESRD in dialysis, and to identify predictors of low QoL. MATERIAL AND METHODS: Cross-sectional multicenter study. From May to September 2019, 137 caregivers and 174 patients, residents of Chihuahua city, were interviewed from four hospitals. Instruments used included: 1) questionnaire for sociodemographic/clinical data, 2) SF-36 and KD-SF to assess QoL of caregivers and patients with ESRD, respectively, 3) Zarit burden interview for caregivers, and 4) Goldberg anxiety/depression scale symptom inventory. RESULTS: Except for mental health, where mean QoL scores were similar between patients, caregivers, and non-caregivers, means were higher in caregivers and non-caregivers for all other domains. Caregivers showed lower summary scores compared with healthy non-caregivers in both physical and mental components. Caregiver's age, anxiety, time in dialysis, and patient's QoL were predictors of low QoL. CONCLUSIONS: Caregivers of patients in dialysis have better QoL compared with patients, but relatively similar to healthy individuals who do not take care of patients.
INTRODUCCIÓN: los cuidadores de pacientes con enfermedad renal crónica terminal (ERCT) en diálisis sufren un proceso de erosión física-emocional derivado de las implicaciones del tratamiento y del cuidado permanente por largos periodos de tiempo. OBJETIVO: evaluar la calidad de vida (CV) de cuidadores primarios de pacientes con ERCT en diálisis, e identificar predictores de baja CV. MATERIAL Y MÉTODOS: estudio multicéntrico transversal. De mayo a septiembre de 2019 se entrevistó a 137 cuidadores y 174 pacientes residentes de la ciudad de Chihuahua de cuatro hospitales. Los instrumentos empleados incluyeron: 1) un cuestionario para datos sociodemográficos/clínicos; 2) cuestionarios SF-36 y KD-SF para evaluar CV en cuidadores y pacientes con ERCT, respectivamente; 3) la escala de sobrecarga de Zarit para cuidadores, y 4) el inventario de síntomas para ansiedad y depresión de Goldberg. RESULTADOS: excepto para salud mental, donde las puntuaciones medias de CV fueron similares entre pacientes, cuidadores y no cuidadores sanos de referencia externa, las medias fueron mayores en cuidadores y no cuidadores para los demás dominios. Los cuidadores tuvieron menores medias para los componentes físico y mental, en comparación con los no cuidadores sanos. La edad del cuidador, la ansiedad, el tiempo en diálisis y la CV del paciente fueron predictores de baja CV. CONCLUSIONES: los cuidadores de pacientes en diálisis tienen mejor calidad de vida que los pacientes, y relativamente similar a la de individuos sanos que no cuidan pacientes.
Subject(s)
Caregivers , Quality of Life , Cross-Sectional Studies , Humans , Mexico , Renal Dialysis , Surveys and QuestionnairesABSTRACT
BACKGROUND: Peritoneal dialysis (PD) is gaining track as an efficient/affordable therapy in poor settings. Yet, there is little data regarding differences in quality of life (QoL) of primary caregivers (PCG) of patients in PD and hemodialysis (HD). AIM: To compare the QoL of PCG of patients in PD and HD from an upper middle-income population in a Mexican city. METHODS: Cross-sectional study was carried out with PCG of patients in PD (n=42) and HD (n=95) from 4 hospitals (response rate=70.2%). The SF 36-item QoL questionnaire, the Zarit burden interview, and the Goldberg anxiety/depression scale were used. Mean normalized scores for each QoL domain were compared by dialysis type. Adjusted odds were computed using logistic regression to determine the probability of low QoL (<70% of maximum possible score resulting from the added scores of the 8 dimensions). RESULTS: The PD group had higher mean scores for emotional role functioning (+10.6; p=0.04), physical functioning (+9.2; p=0.002), bodily pain (+9.2; p=0.07), social functioning (+5.7; p=0.25), and mental health (+1.3; p=0.71); the HD group had higher scores for physical role functioning (+7.9, p=0.14), general health perception (+6.1; p=0.05), and vitality (+3.3; p=0.36). A non-significant OR was seen in multivariate regression (1.51; 95% CI 0.43-5.31). Zarit scores were similar, but workload levels were lower in the PD group (medium/high: PD 7.2%, HD 14.8%). Anxiety (HD 50.5%, PD 19%; p<0.01) and depression (HD 49.5%, PD 16.7%; p<0.01) were also lower in the PD group. CONCLUSION: Adjusted analysis showed no differences in the probability of low QoL between the groups. These findings add to the value of PD, and strengthen its importance in resource-limited settings.
