DETERMINANTS OF HEALTH RELATED QUALITY OF LIFE IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITAL COMPLEX, ILE-IFE

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Date
2015
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Abstract
The studyassessed the Quality of Life of patients with chronic kidney disease (CKD) in OAUTHC, Ile-Ife and identified the factors that affect the Quality of Life of patients with CKD. It alsoexamined the relationship between patients’ Quality of Life and their age, gender, literacy level and financial status with a view to contribute to existing knowledge on the Health-Related Quality of Life (HRQoL) of patients with CKD patients in Nigeria. The study employed a descriptive design. Purposive sampling technique was used to select 60 subjects with CKD receiving treatments at OAUTHC, Ile-Ife. Inclusion criteria are: Subjects must have been diagnosed with CKD and must have been receiving treatment for not less than three months; and should be 18 years and above. Generic instruments SF-36 questionnaire was used to assess the HRQoL of the subjects. SF-36 instrument includes 36 items that measure eight domains of functioning and well-being on a 100-point scale. These domains are: - physical functioning, role limitations caused by physical problems, bodily pain, general health, energy/fatigue, emotional well-being, role limitations caused by emotional problems and social function. Results from the eight domains were further summarized into Physical Health Components (PHC) score and Mental Health Components (MHC) score using the RAND scoring algorithm. In-depth interview was also carried out on fifteen subjects to identified factors affecting HRQoL. Results showed that the HRQoL of the subjects were low in five domains: role limitation due to physical (42.5±39.4), role limitation due to emotional problem (47.2±38.5), social function (49.5±17.4), energy/fatigue (48.2±14.5), and general health (34.5±17.7). In the remaining three domains the subjects recorded a fair score: physical function (58.5±29.7), emotional well-being (61.6±17.8) and pain (60.25±30.90). When coalesced into the two major components (PHC and MHC), result showed a PHC score of 48.1±17.7 and the MHC score of 61.6±17.8. The qualitative data revealed that economic burden; burden of time investment; family support; stress of travelling; and hospital factors like faulty machine, lack of electricity and water, industrial dispute by hospital staff as factors affecting HRQoL of the subjects. At P<0.05, age had significant relationship with HRQoL (Exp β = 4.5 for age 35-64). Males have higher HRQoL when compared with females (Exp β = 3.14); Result equally showed that the higher the income, the better the HRQoL particularly with PHC. Further analysis revealed no relationship between literacy level and HRQoL (p=0.066). The study concluded that the HRQoL of the subjects were generally low, though the MHC score were fairer. In addition economic burden, burden of time investment, family support, stress of travelling and hospital factors like faulty machine, lack of electricity and water, industrial dispute by hospital staff were identified as factors associated with HRQoL.
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xiii, 104p
Keywords
determinant of health related, Chronic kidney disease, quality of life in patient, Physical Health Components (PHC), Mental Health Components
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