NDT Advance Access originally published online on January 8, 2008
Nephrology Dialysis Transplantation 2008 23(5):1713-1719; doi:10.1093/ndt/gfm830
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Quality of life of caregivers and patients on peritoneal dialysis
Department of Renal Medicine and Transplantation, The Royal London and St Bartholomew's Hospitals, London, UK
Correspondence and offprint requests to: Stanley FAN, Renal Unit, The Royal London Hospital, Whitechapel, E1 1BB, UK. Tel: +44-20-73777480; Fax: +44-20-72777003; E-mail: s.fan{at}qmul.ac.uk
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Abstract |
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Peritoneal dialysis is the archetypal home-based therapy and is often favoured by patients. However, as patients with end-stage renal failure become more elderly, with more co-morbidity, their dependence on carers to provide physical, emotional and logistical support increases. The effect of this chronic burden has not been systematically studied. We have prospectively studied patients with end-stage renal failure starting peritoneal dialysis and their carers over a 1-year period.
We selected a cohort of caregivers that are actively involved with the care of their partners’ dialysis. Quality of Life (QoL) assessed by SF-36 questionnaires showed the patients and carers had impairment of QoL at the start of dialysis. As expected, the baseline QoL Physical Component Scores highly correlated with co-morbidity and assessment of functional capacity. Scores of all QoL domains improved after 1 year and this reached statistical significance for social functioning for both patients and carers. When we compared carers of highly dependent patients (required to perform daily dialysis) with carers of less dependent patients, we noted that the former had a statistically significant worsening of their mental health but other parameters were not different.
We have shown that despite increasing the burden for caregivers, with careful selection, education and support, we did not adversely impact on the QoL of carers whilst there was some evidence of improvement, especially in social functioning. This gives reassurance that establishing dependent patients on PD is compatible with a holistic approach to the patients and their families.
Keywords: CAPD; caregivers; peritoneal dialysis; quality of life; SF-36
Received for publication: 3. 9.07
Accepted in revised form: 24.10.07
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