Factors influencing the Quality of Life of Individuals with End-Stage Renal Disease

Background: Renal disease is a chronic disease that can have serious effects on the quality of life (QoL) of patients, and particularly on their social, economic and psychological well-being. Consequently, there is increased concern about QoL issues in the context of the treatment of these patients. Aim: To investigate in a group of patients with end-stage renal disease the effects on their QoL of gender, age, education, marital status, self-reported depression and anxiety, and their perceptions of health locus of control. Method: The sample consisted of 144 patients (99% response rate) undergoing in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) in three General Hospitals in Athens. Measurements were made using the following instruments: (a) WHOQOL-BREF, (b) General Health Questionnaire (GHQ-28), (c) Multidimensional Health Locus of Control Scale (MHLC), (d) Trait Anxiety Inventory (STAI 2) and (e) Center for Epidemiologic Studies Depression Scale (CES-D). The samples were collected between March 2005 and February 2006. The effects of gender, age, education and marital status on the WHOQOL scale were examined through a series of regression analysis models. Further regression analyses were conducted in order to investigate the possible relationship of mental health variables with QoL. Results: Increase in age was found to have a negative effect on the physical health (p=0.00) and social relationships (p=0.01) domains of QoL. Higher levels of education had a positive impact on the environmental domain of QoL (p=0.01). A higher level of depression had a negative effect on the patients’ self-assessment of physical health (p=0.02), psychological health (p=0.00), social relationships (p=0.00) and environment (p=0.04). Finally, perceptions of the internal locus of control were found to have a positive association with the patients’ self-assessment of overall QoL (p=0.00). Conclusions: Specific variables, including age, education, marital status, internal health locus of control, depression and anxiety can affect either favourably or adversely the QoL of patients with endstage renal disease.