Predictors of quality of life in the chronic hemodialysis patient
This was a descriptive, correlational, predictive study designed to investigate the relationships between treatment-related stress, satisfaction with nursing care, and depression in the chronic hemodialysis patient and to determine which were predictive of quality of life (QoL). Demographic variables and selected clinical indicators were also assessed for their ability to predict QoL. The study sample of 45 adults included 18 males and 27 females. Most were Black, low income, with a high school or less educational background.
Five self-report instruments and researcher-developed demographic and medical data questionnaires were used to test six study hypotheses. The instruments included: the Hemodialysis Stressor Scale (HSS), Simmons Hemodialysis Stressor Scale (SHSS), Caring Satisfaction Scale (CARE/SAT), CES-Depression Scale (CES-D), and Quality of Life Index (QLI). Each of the instruments demonstrated internal reliability of.80 or above.
Six hypotheses were tested. Multiple regression analysis did not reveal a predictive relationship between treatment-related stress, depression, satisfaction with nursing care, and QoL. Pearson correlation, however, revealed significant relationships between QoL, treatment-related stress and depression. There was no demonstrated relationship between QoL and satisfaction with nursing care, demographic variables or clinical indicators, nor was there a predictive relationship observed between selected clinical laboratory indicators and QoL or depression. No difference in depression scores was detected between subjects whose predialysis weight gain was $\geq$2 kg as compared to those whose predialysis weight gain was $\leq$2 kilograms. Except for income, demographic variables failed to demonstrate a significant relationship with treatment-related stress, satisfaction with nursing care, or depression. This study supported previous findings suggesting that patients on chronic hemodialysis perceive themselves to have a sufficient QoL.