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Journal Article

Quality of life of individuals with end stage renal disease: perceptions of patients, nurses, and physicians

01 Jun 1997-American Nephrology Nurses' Association journal (ANNA J)-Vol. 24, Iss: 3, pp 325-336
TL;DR: Findings are not generalizable and it may be advisable for nurses to be aware that patients and physicians may not share their perceptions of patients' QOL, and different factors explained the perceptions of QOL of each group.
Abstract: OBJECTIVE The objectives of this study were to describe the perceptions of physicians, nurses, and patients regarding the quality of life (QOL) of individuals with end stage renal disease (ESRD), to identify differences in ratings of QOL, and to identify predictors of perceptions of QOL for each group. DESIGN A cross-sectional, descriptive comparative design was used. Three measures of QOL, the Self-Anchoring Striving Scale, Index of Well-Being, and Time Trade-Off were used. SAMPLE/SETTING The subjects included 215 patients with ESRD (including dialysis and transplant), and 42 nurses and 7 physicians who cared for them. All were from a major tertiary care hospital renal program in western Canada. METHODS Patients were interviewed and asked to complete questionnaires relating to quality of life, health status, functional status, outlook, support, medical, and demographic characteristics. Three measures of QOL, the Self-Anchoring Striving Scale, Index of Well-Being, and the Time Trade-Off were used. Primary physicians and nurses were asked to complete the same questionnaires within one week of the patients. RESULTS It was found that there were significant differences in the ratings among the groups. The nurses' ratings of patients' QOL were significantly lower than were patients (T2 = 21.89, df = 5, 377, p < .001). Physicians' mean ratings were higher than patients' ratings (T2 = 14.24, df = 5, 338, p < .05). Correlations among patients', nurses', and physicians' ratings of QOL ranged between .19 and .49. It was also found that different variables explained the perceptions of each group regarding the patients' QOL. CONCLUSIONS In this study, nurses, physicians, and patients rated the QOL of individual patients differently, and different factors explained the perceptions of QOL of each group. Although findings of the study are not generalizable, it may be advisable for nurses to be aware that patients and physicians may not share their perceptions of patients' QOL.
Citations
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Journal ArticleDOI
TL;DR: Quality-of-life assessment should be integrated in clinical practice and can be helpful to estimate the well-being of patients, in addition to traditional clinical markers.

313 citations


Cites result from "Quality of life of individuals with..."

  • ...0 Molzahn [50] 1997 Index of No End-stage renal disease Adult/doctor 215 171 18–86 Yes well-being Sneeuw [48] 1997 Coop/Wonca No Cancer (inpatient and Adult/doctor 378 295 19–80 Yes outpatient chemotherapy) Sneeuw [47] 1999 Coop/Wonca No Cancer (inpatient Adult/doctor 115 90 19–75 Yes chemotherapy)...

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  • ...In the adult population, one study described patients with esophagus cancer [46], two studies described patients with cancer [47,48], two studies described patients with endstage renal disease [49,50], and one study described adults living in a nursing home [51]....

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Journal ArticleDOI
TL;DR: A checklist of questions for selecting a measure for use in economic evaluation; a list of circumstances in which non-preference-based measures can be used; and recommendations surrounding the use of health state valuation techniques and multi-attribute utility scales are provided.
Abstract: Objective:To review the use of measures of health status in the assessment of benefits in economic evaluation, whether or not the measures were designed for this purpose.Methods:The review was base...

289 citations

Journal ArticleDOI
TL;DR: QOL’s relationship with disability is complex, displaying non-linearity and interacting with patient characteristics, which has implication for QOL research methodology and provides insight into factors affecting patients’ perceptions of well-being.
Abstract: Objectives: (1) Evaluate the impact of the patient charateristics of disability, gender and employment status on health-related quality of life (HRQOL) in multiple sclerosis (MS) and (2) Characterize the functional relationship between HRQOL and disability overall, and by gender and employment status. Methods: We assessed the HRQOL of 215 MS outpatients in our clinic using the MSQOL-54 and Fatigue Severity Scale (FSS), and that of 172 healthy controls, using the SF-36 (a subset of MSQOL-54). We compared QOL between MS subgroups defined by disability, gender and employment, and computed the linear and non-linear relationships between disability level measured by the Expanded Disability Status Scale (EDSS) and MSQOL-54 dimensions. Results: QOL of MS patients measured by SF-36 is lower than controls, varying by QOL dimension with the greatest difference emerging for physical aspects of the disease. The relationship of physical disability, measured by EDSS, and all 14 MSQOL-54 dimensions and FSS is negative; for 12 of the 14 dimensions and FSS it is also non-linear. Non-linearity is most pronounced among women, who show a weak EDSS/QOL relatioship at higher levels of physical disability, suggesting women better able to “psychologically buffer” the debilitating aspects of MS. While employed have higher QOL than unemployed, the former are more affected by physical disability. Conclusions: Multiple attributes, including disability, gender and employment status, affect QOL. QOL’s relationship with disability is complex, displaying non-linearity and interacting with patient characteristics. This has implication for QOL research methodology and provides insight into factors affecting patients’ perceptions of well-being.

268 citations


Cites background from "Quality of life of individuals with..."

  • ...Yet patients’ subjective view of their state is not always apparent, as evidenced by discrepancies between physician and patient perceptions regarding success of medical and surgical tratments [1], health status [2], and quality of life (QOL) [3, 4]....

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Journal ArticleDOI
TL;DR: The results suggest that general population samples, using EQ-5D(index) values, may be more able to discriminate between patient groups than the patients themselves are.
Abstract: The literature was studied on the existence of differences in valuation for hypothetical and actual health states between patients and other-rater groups. It was found that nine different study designs have been used to study this question and two of these designs were applied in a study involving dialysis patients and other rater groups. In the first study, both dialysis patients and students had to value hypothetical health states with Standard Gamble (SG) and Time Trade Off (TTO). Patients assigned higher values to hypothetical health states than students did. In the second study, dialysis patients who were being treated with four different dialysis modalities were asked to value their own health state with SG, TTO and a visual analogue scale (EQVAS), and to describe their health state on the EQ-5Dprofile. Several EQ-5Dindex values (health index values derived from general population samples) were calculated for the four dialysis treatment groups, based on the EQ-5Dprofile. These health indexes could discriminate between treatment groups, according to clinical impressions. Treatment groups could not be differentiated based on patients' valuations of own health state. The results suggest that general population samples, using EQ-5Dindex values, may be more able to discriminate between patient groups than the patients themselves are. The implications of this finding for valuation research and policy-making are discussed. Copyright © 2000 John Wiley & Sons, Ltd.

238 citations


Cites background from "Quality of life of individuals with..."

  • ...(6) Patients and proxies (familiar with the patient, such as caregiver, nurse or doctor) value the actual health state of the patient involved [13,20,30–34]...

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  • ...Thirtyfive different publications aimed at answering the question whether experience with illness influences the valuation of health were found [6,10–43]....

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