Abstract: PO0833
Health-Related Quality of Life During Dialysis Modality Transitions: A Mixed-Methods Study
Session Information
- Dialysis Care: Epidemiology and the Patient Experience
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- MacRae, Jennifer M., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Dumaine, Chance Skylar, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Fox, Danielle E., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Ravani, Pietro, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Santana, Maria Jose, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
Background
Dialysis transitions may have an impact on health related quality of life (HRQOL), a patient defined priority for research and clinical care. We measured HRQOL and explored perceptions of adults who were initiating dialysis for the first time or transitioning to a new dialysis modality in a large urban centre in Canada.
Methods
In this prospective convergent parallel mixed-methods study we recruited eligible patients who were transitioning to dialysis from pre-care (n=9, incident) or undertaking a dialysis modality change (n=10, prevalent) between July and September 2017. Patients completed the five domains of the Kidney Disease Quality of Life-36 (KDQOL-36) survey on their first day of dialysis treatment or first day of home dialysis training and underwent a semi-structured interview and follow up KDQOL-36 survey at 3 months.
Results
19 patients completed KDQOL-36 at baseline and at 3 months; 15 also participated in an interview. Statistically significant increases in all measured domains of the KDQOL-36 were observed from baseline to three months: “Symptoms” [mean difference (MD)=14.9, p<0.01]; “Effects” (MD=14.3, p<0.01); “Burden” (MD=7.3, p=0.04); “PCS” (MD=7.5, p<0.01); “MCS” (MD=7.2, p=0.04). These patterns of change were similar for both incident and prevalent patients and across the different types of transitions. The qualitative interviews identified the following themes: 1) adapting to new circumstances (tackling change, accepting change), 2) adjusting together 3) trade offs, and 4) challenges of chronicity (the impact of dialysis, living with a complex disease, planning with uncertainty.
Conclusion
The transition to a new or different type of dialysis is associated with improvements in HRQOL. In addition, qualitative data provided an in depth understanding of the transition experience, and revealed significant emotional and psychosocial processes that need to be considered during both incident and prevalent dialysis transitions.