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Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town
Background: South Africa [SA] has a growing burden of chronic kidney disease [CKD], with limited health resources. Cape Town offers a PD-First policy due to both limitations on haemodialysis slots and cost saving measures. This study aimed to compare health related quality of life [HRQOL] between ha...
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| Format: | Thesis |
| Language: | English |
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Department of Medicine
2021
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| _version_ | 1867611312916267008 |
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| access_status_str | Open Access |
| author | Welgemoed, Waldo |
| author2 | Wearne, Nicola |
| author_browse | Wearne, Nicola Welgemoed, Waldo |
| author_facet | Wearne, Nicola Welgemoed, Waldo |
| author_sort | Welgemoed, Waldo |
| collection | Thesis |
| description | Background: South Africa [SA] has a growing burden of chronic kidney disease [CKD], with limited health resources. Cape Town offers a PD-First policy due to both limitations on haemodialysis slots and cost saving measures. This study aimed to compare health related quality of life [HRQOL] between haemodialysis [HD] and peritoneal dialysis [PD], given the lack of autonomy in modality choice and socioeconomic challenges our patients face. Methods: This cross-sectional study was performed at Groote Schuur Hospital between July 2015 and December 2016. Demographic, socio-economic variables and perception of safety were collected. HRQOL was assessed using the Kidney Disease Quality of Life-Short Form [KDQOL-SFTM] version 1.3. All data was compared between the two dialysis modalities. Results: 77 HD patients and 33 PD patients were included in the study (Total n=110). There were no significant differences in demographics. The median age was 42.5 years [IQR: 32.4-48.6] and 57.3% were female. HD patients had less pain [p=0.036], better emotional well-being [p=0.020] and better energy/fatigue score [p=0.015]. Both cohorts experienced impairment in physical health, with PD having significant limitation [p=0.05]. The only significant symptoms in the renal domain was that PD experienced more shortness of breath [p=0.0001]. Overall, patients in both groups had very poor socio-economic circumstances. Safety was a major concern with the majority reporting feeling unsafe in their homes. Conclusions: The patients in our dialysis service have very challenging social circumstances with high rates of poverty and profound safety concerns. Patients on PD scored worse in 4 HRQOL domains, possibly due to a lack of autonomy in dialysis modality choice and less frequent contact with dialysis staff to provide encouragement and support. Additional psychological and social support needs to be instituted to help improve our patient's wellbeing on PD. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/33081 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/33081 Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town Welgemoed, Waldo Wearne, Nicola Davidson, Bianca Nephrology and Hypertension Background: South Africa [SA] has a growing burden of chronic kidney disease [CKD], with limited health resources. Cape Town offers a PD-First policy due to both limitations on haemodialysis slots and cost saving measures. This study aimed to compare health related quality of life [HRQOL] between haemodialysis [HD] and peritoneal dialysis [PD], given the lack of autonomy in modality choice and socioeconomic challenges our patients face. Methods: This cross-sectional study was performed at Groote Schuur Hospital between July 2015 and December 2016. Demographic, socio-economic variables and perception of safety were collected. HRQOL was assessed using the Kidney Disease Quality of Life-Short Form [KDQOL-SFTM] version 1.3. All data was compared between the two dialysis modalities. Results: 77 HD patients and 33 PD patients were included in the study (Total n=110). There were no significant differences in demographics. The median age was 42.5 years [IQR: 32.4-48.6] and 57.3% were female. HD patients had less pain [p=0.036], better emotional well-being [p=0.020] and better energy/fatigue score [p=0.015]. Both cohorts experienced impairment in physical health, with PD having significant limitation [p=0.05]. The only significant symptoms in the renal domain was that PD experienced more shortness of breath [p=0.0001]. Overall, patients in both groups had very poor socio-economic circumstances. Safety was a major concern with the majority reporting feeling unsafe in their homes. Conclusions: The patients in our dialysis service have very challenging social circumstances with high rates of poverty and profound safety concerns. Patients on PD scored worse in 4 HRQOL domains, possibly due to a lack of autonomy in dialysis modality choice and less frequent contact with dialysis staff to provide encouragement and support. Additional psychological and social support needs to be instituted to help improve our patient's wellbeing on PD. 2021-03-03T01:37:28Z 2021-03-03T01:37:28Z 2020 2021-03-02T19:17:14Z Master Thesis Masters MMed http://hdl.handle.net/11427/33081 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | Nephrology and Hypertension Welgemoed, Waldo Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town |
| thesis_degree_str | Master's |
| title | Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town |
| title_full | Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town |
| title_fullStr | Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town |
| title_full_unstemmed | Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town |
| title_short | Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town |
| title_sort | impact of socio economic factors and health related quality of life on patients on renal dialysis in cape town |
| topic | Nephrology and Hypertension |
| url | http://hdl.handle.net/11427/33081 |
| work_keys_str_mv | AT welgemoedwaldo impactofsocioeconomicfactorsandhealthrelatedqualityoflifeonpatientsonrenaldialysisincapetown |