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

TLDR: 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.