Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town

dc.contributor.advisorWearne, Nicola
dc.contributor.advisorDavidson, Bianca
dc.contributor.authorWelgemoed, Waldo
dc.date.accessioned2021-03-03T01:37:28Z
dc.date.available2021-03-03T01:37:28Z
dc.date.issued2020
dc.date.updated2021-03-02T19:17:14Z
dc.description.abstractBackground: 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.
dc.identifier.apacitationWelgemoed, W. (2020). <i>Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/33081en_ZA
dc.identifier.chicagocitationWelgemoed, Waldo. <i>"Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2020. http://hdl.handle.net/11427/33081en_ZA
dc.identifier.citationWelgemoed, W. 2020. Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town. . ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/33081en_ZA
dc.identifier.ris TY - Master Thesis AU - Welgemoed, Waldo AB - 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. DA - 2020_ DB - OpenUCT DP - University of Cape Town KW - Nephrology and Hypertension LK - https://open.uct.ac.za PY - 2020 T1 - Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town TI - Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town UR - http://hdl.handle.net/11427/33081 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/33081
dc.identifier.vancouvercitationWelgemoed W. Impact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town. []. ,Faculty of Health Sciences ,Department of Medicine, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/33081en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectNephrology and Hypertension
dc.titleImpact of socio-economic factors and Health Related Quality of Life on patients on renal dialysis in Cape Town
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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