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A Correlational Study on Quality of Life and Coping Strategy Among Dialysis Patients in Selected Hospital at Mangalore
Address for correspondence: Latha S., Nitte Usha Institute of Nursing Sciences, Nitte University, Mangalore - 575 018, India E-mail: rrsharma1967@yahoo.com
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher.
Abstract
A descriptive study was conducted on the Quality of life and coping strategy of dialysis patients from 01.08.2011 to 01.10.2011. The purpose of this study was to describe the Quality of life and Coping strategy among dialysis patients in selected hospital. Rating scales were used to measure the Quality of life & Coping strategy of 60 dialysis patients selected by Purposive sampling technique. The findings of the study showed that majority of the dialysis patients 68.3 % (41) had average quality of life. Highest percentage 81.7 %(49) had satisfactory coping. 31.7 %(19) of dialysis patients were in the age group of 61–70 yrs, majority of the dialysis patients were males 68.3 %(41), 85 % of the subjects were married, 46.7 %(28) of them had completed secondary & higher secondary education, 55 %(33) of them were unemployed, 60 %(36) of them had an income less than 5000 Rupees/month, 83.3 %(50) of the subjects were Hindus,57 %(37) were undergoing dialysis for a duration of 0–12 months. The correlation coefficient value of Quality of life and Coping strategy was 0.431 (p<.05) & hence there is positive correlation between Quality of life and Coping strategy. Study findings also revealed that there is significant association between the Quality of life and religion.
Keywords
Quality of life
Coping strategy
Dialysis patients
Introduction
End stage renal disease (ESRD) is a chronic and life-threatening illness. It implies that the kidneys are permanently damaged and the person can no longer survive independently without renal replacement therapy. Individuals undergoing long-term haemodialysis have been found to be subjected to multiple physiological and psychosocial stressors and experience personal losses and lifestyle changes1.
When individuals with CRF have to undergo long-term haemodialysis, it not only impacts their QOL, but also their family's QOL. Coping has been found to be an important factor closely associated with QOL. Effective coping strategies play an essential role in maintaining one's physical and psychological wellbeing when dealing with life stressors. Effective coping helps to lessen stress, resolve uncomfortable feelings, preserve ability to effectively function in relationships and maintain a positive self-concept that promotes good QOL.3
Long-term dialysis therapy itself often results in loss of freedom, dependence on caregivers, disruption of marital, family, and social life, and reduced financial income. Due to these reasons, the physical, psychological, socioeconomic, and environmental aspects of life are negatively affected, leading to compromised QOL6.
‘Adding life to years and not just years to life’ is as true for ESRD patients as for any other individuals. ESRD is a chronic disease causing high levels of disability in different domains of the patient's life, leading to impaired QOL. Thus it is a challenge for nurses as well as for other health care providers to help& promote QOL of dialysis patients, despite their health problems.
A cross-sectional study conducted to assess the QOL in haemodialysis patients using the WHO QOL-BREF questionnaire showed that the QOL in haemodialysis patients was found to be considerably impaired when compared to that of healthy individuals of the general population as well as of renal transplant patients.2
Materials and methods
The descriptive correlational approach was adopted as study design. Population comprised of dialysis patients of selected hospitals at Mangalore. Purposive sampling technique was used for the selection of 60 samples.
QOL of dialysis patients was assessed by rating scale on quality of life and expressed in terms of descriptive statistics. Coping strategies were identified by rating scale on coping strategy & interpreted in terms of frequency and percentage. Association between QOL & coping strategy was analysed by Karl Pearson coefficient of correlation.
A formal written permission was obtained from Medical Superintendent & Dept. of Nephrology of K.S. Hegde Charitable Hospital. An informed consent was taken from all the subjects individually after explaining the objectives and purpose of the study. Confidentiality was assured to the entire subjects to get their co-operation. Subjects were instructed to answer the Demographic proforma, Rating Scale on QOL and the Rating scale on coping strategy.
Results
Major findings are discussed under the following headings.
SECTION 1: DESCRIPTION OF DEMOGRAPHIC CHARACTERISTICS.
n=60
| Sl.no | Sample characteristics | Frequency | Percentage |
|---|---|---|---|
| 1. | Age (yrs) | ||
| 21–30 | 9 | 15 | |
| 31–40 | 6 | 10 | |
| 41–50 | 13 | 21.6 | |
| 51–60 | 13 | 21.7 | |
| 61–70 | 19 | 31.7 | |
| 2. | Gender | ||
| Male | 41 | 68.3 | |
| Female | 19 | 31.7 | |
| 3. | Marital status | ||
| Married | 51 | 85 | |
| Single | 7 | 11.7 | |
| Divorced | 0 | 0 | |
| separated | 0 | 0 | |
| Widow/widower | 2 | 2.3 | |
| 4 | Education | ||
| No formal education | 8 | 13.3 | |
| Primary School | 16 | 26.7 | |
| Secondary and higher secondary | 28 | 46.7 | |
| Graduate | 8 | 13.3 | |
| Post-Graduate | 0 | 0 | |
| 5. | Occupation | ||
| Unemployed | 33 | 55 | |
| Unskilled | 14 | 23.3 | |
| Skilled | 4 | 6.7 | |
| Professional employee | 9 | 15 | |
| 6. | Income | ||
| <5000 | 36 | 60 | |
| 5001–10,000 | 15 | 23 | |
| 10001–15,000 | 7 | 11.7 | |
| >15000 | 2 | 3.3 | |
| 7. | Religion | ||
| Hindu | 50 | 83.3 | |
| Christian | 5 | 8.3 | |
| Muslim | 4 | 6.7 | |
| Others | 1 | 1.7 | |
| 8. | Duration of dialysis | ||
| 0–12month | 37 | 61.7 | |
| 1–3yrs | 21 | 35 | |
| 3–5yrs | 2 | 3.3 | |
| 5–7yrs | 0 | 0 |
SECTION 2:- QUALITY OF LIFE OF DIALYSIS PATIENTS
60 dialysis patients were selected from K.S. Hegde Charitable Hospital through purposive sampling technique based on inclusion criteria. The data were analyzed in terms of frequency and percentage to determine the level of quality of life of dialysis patients.
n=60
| QOL | Score range | Frequency | Percentage (%) |
|---|---|---|---|
| Poor QOL | 26–60 | 19 | 31.7 |
| Average QOL | 61–95 | 41 | 68.3 |
| Good QOL | 96–130 | 0 | 0 |
| Total | 60 | 100 |
SECTION 3:- COPING STRATEGIES USED BY THE DIALYSIS PATIENTS.
Coping strategies of the samples were assessed with a 3 point rating scale.
n=60
| Coping Strategy | Score range | Frequency | Percentage (%) |
|---|---|---|---|
| Poor coping | 23–38 | 0 | 0 |
| Satisfactory coping | 39–53 | 49 | 81.7 |
| Good coping | 54–69 | 11 | 18.3 |
| Total | 60 | 100 |
SECTION 4:-CORRELATION BETWEEN THE QUALITY OF LIFE AND COPING STRATEGIES AMONG DIALYSIS PATIENTS
In order to determine the relationship between the quality of life and coping strategy Karl Pearson's coefficient of Correlation was calculated.
| VARIABLES | CORRELATION (r value) | LEVEL OF SIGNIFICANCE |
|---|---|---|
| QOL(59) | 0.431 | 0.001 |
| COPING(41) | (P<0.05) | |
| S |
The Karl Pearson correlation co-efficient value of Quality of life and coping strategy is 0.431 (p<.05) & it was concluded that there exist a positive correlation between Quality of life and coping strategy.
SECTION 5:- ASSOCIATION BETWEEN QUALITY OF LIFE AND SELECTED DEMOGRAPHIC VARIABLES.
This section dealt with the analysis of association between quality of life and selected demographic variables by using Chi-square test. In order to find out the association between quality of life and selected variables the following hypothesis was formulated.
H2: There will be significant association between quality of life and selected variables.
The study shows that the calculated χ2 value (χ2 cal=9.81,p<0.05) of the variable religion is greater than the χ2 table value (χ2 tab = 5.99) & hence the research hypothesis is accepted & it is concluded that there is a significant association between Quality of life & religion of dialysis patients.
Since the χ2 calculated value of other variables is less than the χ2 table value the research hypothesis is rejected and it is concluded that there is no significant association between Quality of life and selected variables such as age, gender, marital status, education, occupation, income & duration of dialysis.
Discussion
Majority of dialysis patients experienced average Quality of life (68.3 %). A similar descriptive correlational study done to assess the relationship between Quality of life and stress in the Haemodialysis patients revealed that there exist a relationship with Quality of life and degree of tension(r = 0.802) i.e. with increase of tension, Quality of life declines (p < 0.001)4.
In another cross-sectional study done to assess the QOL in Haemodialysis patients using the WHO QOL-BREF questionnaire, the result showed that QOL of Haemodialysis patients was found to be considerably impaired when compared to that of healthy individuals of the general population as well as of renal transplant patients5.
Majority of the dialysis patients had satisfactory coping. This finding is supported by another study on coping strategies and stressors in patients with Haemodialysis which showed that, coping strategies used by patients were emotion-oriented strategy, avoidance, and isolated thoughts. The choice of coping strategy depended on the types of stressor2.
The findings of the study showed that there is correlation between Quality of life and coping strategy. Another correlational study by Lindqvist & Sjoden on Haemodialysis patients in Brazil showed that patients with high emotion-oriented coping scores were seen at risk for poor QOL6.
Conclusion
The findings of the study revealed that majority of dialysis patients had average Quality of life & satisfactory coping. There is a significant relationship between the Quality of life & coping strategies of dialysis patients.
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