The influence of different dialysis modalities on the quality of life of patients with end-stage renal disease: A systematic literature review

Objectives: This study aims to generate evidence regarding the relationships of different dialysis modalities with HR-QOL.

Design: A systematic review was conducted to investigate the HR-QOL of patients treated with different dialysis modalities.

Methods: A literature search was conducted for English language articles in the CINAHL, Medline and PubMed databases published from January 1990 through May 2016. Specifically, we sought articles that would compare the HR-QOL of hemodialysis (HD) and peritoneal dialysis (PD) patients in terms of physiological, psychological and social functioning, as well as disease symptoms. Thirty-four articles met the study inclusion criteria and were included into the analysis.

Results: The research results indicated no significant differences in HR-QOL between HD and PD treatment. However, a higher percentage of patients who received PD had a better HR-QOL in terms of physiological, psychological, social and disease symptoms.

Conclusions: Despite the fact that the results of this study showed no difference in HR-QOL between HD and PD treatment, its review of relevant references can serve as a reference for health professionals. However, patients’ conditions must still be taken into account when making suggestions about which dialysis modality a patient should use.     

Marital role strain,illness intrusiveness,and their impact on marital and individual adjustment in end-stage renal disease

Abstract

A marital role theory approach was used to investigate individual psychosocial well-being and marital adjustment in 89 end-stage renal disease (ESRD) patients and their spouses. Four different patient groups were selected according to a continuum of clinical milestones in the treatment of ESRD, including pre-dialysis (n=17), incenter dialysis (n=18), home dialysis (n=19), and posttransplant patients (n=17). A nephrology clinic control group (n=18) was also included. Standardized instruments were employed to investigate marital role strain (Marital Role Questionnaire, KDS-15), marital adjustment (Locke-Wallace Marital Adjustment Test), subjective well-being (Affect Balance Scale, Rosenberg Self-Esteem Inventory), and psychopathology (Symptom Checklist 90-R). Hierarchical multiple regression analyses provided strong and consistent support for the major hypotheses relating elevated marital role strain to compromised marital adjustment and individual well-being. Further analyses demonstrated that increased perceived intrusiveness of ESRD was significantly related to greater marital role strain, poorer marital adjustment, and decreased individual well-being. This is consistent with the idea that perceived intrusiveness may be an important mediator of marital role strain and of coping with chronic illness. “Objective” intrusiveness, defined in terms of patient group, was not significantly related to marital or individual well-being. These findings support a dyadic approach to the psychosocial study of chronic illness.     

Noncompliance in end-stage renal disease: A threat to quality of care and cost containment

Noncompliance to treatment regimen after kidney transplantation is a threat to health outcomes and cost containment. Although there are methodological challenges to obtaining reliable compliance data, the results of noncompliance are increased morbidity and mortality in posttransplant patients. In addition, recent research suggests that patients who incur repeated rejection episodes leading to graft failure have higher levels of medical utilization. Some psychosocial factors related to compliance and medical utilization are potentially modifiable through cognitive-behavioral intervention.     

The factor structure of the Revised Illness Perception Questionnaire (IPQ-R) in end-stage renal disease patients

The purpose of this study was to examine the factor structure of the Revised Illness Perceptions Questionnaire (IPQ-R) in a sample of 374 end-stage renal disease (ESRD) patients. A confirmatory factor analysis of the IPQ-R, including the illness identity subscale, demonstrated adequate model fit for the factor structure as originally defined by (Moss-Morris, R., Weinman, J., Petrie, K. J., Horne, R., Cameron, L. D., & Buick, D. (2002). The revised Illness Perception Questionnaire (IPQ-R). Psychology & Health, 17 (1), 1-16.) Modifying the a-priori IPQ-R factor structure by removing two items with low factor loadings and specifying a path between personal control and item 23 had marginally better fit. A separate exploratory factor analysis of the causal items indicated three factors relating to Biological, Psychological and Behavioural causes. These findings provide evidence towards the validity and reliability of the IPQ-R as a suitable measure of illness perceptions in the context of ESRD.     

Fluid noncompliance and symptomatology in end-stage renal disease: cognitive and emotional variables

Fluid noncompliance in patients with end-stage renal disease (ESRD) is a widespread problem with severe consequences for health. In addition, ESRD patients report considerable stress in relation to their illness and dialysis treatment. The present study examined the role of cognitive and emotional variables in fluid noncompliance, symptomatology, and stress. Fifty hemodialysis patients were assessed (a) on the cognitive variables of locus of control, self-evaluations of their past compliance, and self-efficacy to resist fluid intake and (b) on the emotional variables of depression, anger, and anxiety. Results showed that cognitive variables accounted for fluid noncompliance and predicted future adherence. Patients high in negative emotions complied equally as well as patients low in negative emotions but were found to report substantially more symptomatology and distress associated with their treatment. The implications of these findings for treatment of ESRD patients and future research are discussed.     

Body image across the adult life span: stability and change

By far, the majority of studies investigating body image in adults have drawn samples from college populations within a very narrow age range. The purpose of the present paper is to review empirical research on the body image of adults older than the typical college student. There are marked changes in appearance across the adult life span, especially for women, which lead to the expectation of concomitant changes in body image. In fact, the review found that body dissatisfaction was remarkably stable across the adult life span for women, at least until they are quite elderly. In contrast, the importance of body shape, weight and appearance decreased as women aged, underscoring an important distinction between evaluation and importance of the body. However, there are many large gaps and limitations in the current literature that will need to be addressed before a more complete understanding of the development of body image across the adult life span is achieved.     

Illness perceptions in dialysis patients and their association with quality of life

The present study explored illness perceptions of end stage renal disease (ESRD) patients on both haemodialysis (HD) and peritoneal dialysis (PD) treatment, and their associations with quality of life. Leventhal's self-regulation model (SRM) was used as a theoretical framework. Illness perceptions and quality of life were assessed with the IPQ-R and the SF-36 in 91 HD and 42 PD patients participating in the NECOSAD-study. Compared to HD patients, PD patients experienced more personal control and had a better understanding of the illness. Illness perceptions explained from 17 to 51% of the variance in quality of life scores. Perception of more symptoms, more consequences and lower personal control were associated with lower well-being. The concept of illness perceptions is useful in understanding the impact of ESRD and of dialysis treatment on quality of life. Interventions aimed at providing more knowledge about ESRD and dialysis, and provision of skills to coping with the illness and its consequences may improve quality of life in dialysis patients.     

Psychological impact of illness intrusiveness in epilepsy - comparison of treatments

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these is the concept of illness intrusiveness, the disruption of lifestyles and activities attributable to constraints imposed by chronic disease and its treatment. This study tested the illness intrusiveness theoretical framework in epilepsy and compared the impact of pharmacological and surgical treatments on illness intrusiveness and QOL. Cross-sectional data compared three epilepsy groups (N = 145): (a) 40 patients admitted for presurgical evaluation to an Epilepsy Monitoring Unit; (b) 52 patients treated pharmacologically; and (c) 53 post-surgical patients. Illness intrusiveness differed significantly across epilepsy patients with the differences primarily related to seizure control. Illness intrusiveness varied inversely with seizure control (p < .05). Seizure freedom, whether achieved by surgical or pharmacological treatments, was associated with maximal reduction of illness intrusiveness. Increased illness intrusiveness correlated significantly with decreased QOL and increased depressive symptoms. Perceived control over diverse life domains correlated positively with QOL and psychosocial outcomes. Path analysis supported the validity of the illness intrusiveness theoretical framework in epilepsy. Illness intrusiveness is an important determinant of the psychosocial impact of epilepsy and its treatment. Effective pharmacological or surgical treatment may reduce illness intrusiveness in epilepsy. Findings also offer encouragement that QOL in epilepsy, as in other chronic conditions, may be enhanced by multidisciplinary bio-psychosocial efforts. Health care providers should consider multifaceted interventions to reduce illness intrusiveness and, thereby, improve QOL.     

Perceived quality of life in Taiwan and Hong Kong: an intra-culture comparison

Cross-society comparisons have become increasingly important to the study of the perceived quality of life. A major critique of these studies, however, is the lack of attention to intra-culture variation. This paper examines how subjective quality of life differs, at both societal and individual levels, between Taiwan and Hong Kong, two Chinese societies that share their cultural heritage but vary in their social and political systems. We draw upon data from synchronic surveys conducted in November 2000 in Taiwan (n=1222) and Hong Kong (n=1044). Ordinal regression analyses confirm that, for both societies, reported satisfaction at the societal level contributes to the variance in individuals quality of life. Moreover, the perceived fairness with regard to personal effort within the opportunity structure provided by the society also significantly affects an individuals quality of life. Different factors accounting for quality of life variation in Taiwan and in Hong Kong are discussed. This paper suggests that for the intra-cultural, cross-society comparisons on quality of life, inclusion of various societal level indicators is not only important, but the subjective perception of the fairness that society also contributes a significant effect.     

Priming across modalities and priming across category levels: extending the domain of preserved function in amnesia

Amnesia is considered to reflect the effects of damage to a specific brain system required for elaboration, consolidation, and conscious recollection. The study of amnesia is therefore a useful approach for establishing dissociations of function and for understanding the normal organization of memory functions. Amnesic patients and two control groups were tested in two studies of priming. In the first experiment, as measured by a word completion test, all groups exhibited significant priming effects that were greater within a modality than across modalities. The amnesic patients exhibited normal priming effects both within and across modalities, despite severe impairment in recall. In the second experiment, all groups exhibited significant and equivalent priming of category exemplars when category labels were presented and subjects were asked to produce the first exemplars that came to mind. The results extend the domain in which preserved priming effects can be observed in amnesia and they suggest that features of priming observed in normal subjects describe a capacity that is independent of the brain system damaged in amnesia.     

Regret and quality of life across the adult life span: the influence of disengagement and available future goals

Two studies examined the associations between life regrets and indicators of quality of life across the adult life span. Given that opportunities to undo regrets decline with age, regret intensity was expected to be inversely associated with subjective well-being and health among older adults. In addition, the research explored protective factors that have the potential to reduce older adults' regret intensity. It was suggested that being disengaged from undoing the consequences of regrets and having many future goals available may reduce older adults' intensity of regret and thereby contribute to a better quality of life. Across both studies, the findings demonstrate that older adults perceived reduced opportunities to undo the consequences of their regrets and that regret intensity predicted a reduced quality of life only among older adults. Furthermore, the findings support the adaptive value of disengagement and available future goals for managing life regrets in older adults.     

Explanatory style across the life span: evidence for stability over 52 years

Analyzed explanatory style across the life span. 30 Ss whose average age was 72 responded to questions about their current life and provided diaries or letters written in their youth, an average of 52 years earlier. A blind content analysis of explanatory style derived from these 2 sources revealed that explanatory style for negative events was stable throughout adult life (r = .54, p less than .002). In contrast, there appeared to be no stability of explanatory style for positive events between the same 2 time periods. These results suggest that explanatory style for negative events may persist across the life span and may constitute an enduring risk factor for depression, low achievement, and physical illness.     

Illness perception and quality of life of HIV-positive persons: mediation effects of tenacious and flexible goal pursuit

Medical advances contribute to raise life expectancy of people living with HIV/AIDS (PLHIV). However, they still face challenges related to the disease, thus, quality of life (QOL) became a priority on the field. The self-regulatory model (SRM) guided this study. Illness perceptions (IP) are the beliefs, cognitions, representations of a disease, impacting PLHIV coping strategies and QOL. Tenacious goal pursuit (TGP) is the pursuit of goals with determination, flexible goal adjustment (FGA) is doing it with flexibility, disengaging if necessary, they can both be considered as coping strategies. This study aims to measure the impact of HIV Perception in the QOL of PLHIV mediated by the TGP and FGA. Data was collected from 196 PLHIV with the WHOQOL-HIV Bref, the Brief-IPQ and the FGA and TGP scales. Structural equation model provided a good fit consistent with the theoretical SRM. IP, TGP and FGA had direct effects on the QOL of PLHIV. IP had also an indirect effect (partially mediated by TGP/FGA), suggesting that TGP/FGA reduce the impact of a threatening IP in the QOL. Goal oriented interventions should focus in the HIV perception of PLHIV to ameliorate their QOL.     

Type of hemodialysis and preference for behavioral involvement: interactive effects on adherence in end-stage renal disease

Examined the effects of hemodialysis type (i.e., staff controlled, in center vs. patient controlled, home) and patient preference for behavioral involvement on adherence and emotional adjustment in a sample of 53 patients with end-stage renal disease. Consistent with person x treatment interaction models, higher levels of preference for behavioral involvement were associated with better dietary adherence (i.e., lower serum potassium) for patients receiving dialysis at home but worse dietary adherence for patients receiving treatment in a dialysis center. A similar though weaker patient x treatment type matching pattern was observed for fluid-intake adherence (i.e., interdialytic weight gain). No effects were observed for patients' self-reported depression levels. Possible mechanisms for the interactional effect on adherence are discussed.     

Serial position curves in short-term memory: functional equivalence across modalities

Four experiments investigated item and order memory for sequences of seen unfamiliar faces and heard nonwords. Experiments 1 and 3 found bowed serial position curves using the serial reconstruction test of order with faces and nonwords, respectively. Experiments 2 and 4 found limited recency, no primacy, and above chance performance on all items using a two-alternative forced choice (2AFC) test of item recognition, again with faces and nonwords. These results suggest that the different serial position curves typically found using traditional paradigms for exploring visual and verbal short-term memory are due to differences in the methods used rather than modality-specific mechanisms.     

Memory storage and retrieval within and across modalities in children

Twenty-four kindergarten and fourth grade children were asked to locate a display card which had been visually or verbally presented. A probe, which identified the card to be located, was presented verbally and visually equally often. The children's ability to recall the location of an item did not differ as a function of the modality to which the material was presented. Nor was recall significantly affected when the presentation modality differed from the probe modality, suggesting that children as young as 5 can cross these sensory modalities to retrieve material with no loss in accuracy. Serial position curves suggest that the verbal and visual material is not stored in a common intersensory store. The primacy effect is found to be stronger with visually presented material and the recency effect strongest with auditorily presented material. Probe modality did not influence the serial position curves.     

Analyzing distributional properties of interference effects across modalities: chances and challenges

In research investigating Stroop or Simon effects, data are typically analyzed at the level of mean response time (RT), with results showing faster responses for compatible than for incompatible trials. However, this analysis provides only limited information as it glosses over the shape of the RT distributions and how they may differ across tasks and experimental conditions. These limitations have encouraged the analysis of RT distributions using delta plots. In the present review, we aim to bring together research on distributional properties of auditory and visual interference effects. Extending previous reviews on distributional properties of the Simon effect, we additionally review studies reporting distributional analyses of Stroop effects. We show that distributional analyses of sequential effects (i.e., taking into account congruency of the previous trial) capture important similarities and differences of interference effects across tasks (Simon, Stroop) as well as across sensory modalities, despite some challenges associated to this approach.     

The burden of disease in personality disorders: diagnosis-specific quality of life

A generic quality of life measure was used to investigate the burden of disease in a large sample of patients with personality disorders. The 1,708 subjects included in this study were recruited from six different mental health care institutes in the Netherlands. The burden of disease was measured using the EuroQol EQ-5D. Personality disorders were diagnosed using the Structured Interview for DSM-IV Personality (SIDP-IV). The mean EQ-5D index value was 0.56. Primarily the total number of personality disorder diagnoses rather than the specific type determined the quality of life. Notably borderline personality disorder was not associated with the highest burden. The findings indicate that patients with personality disorders experience a high burden of disease, comparable to that of severe somatic illnesses. The results call into question the primary focus in literature on borderline personality disorder. The current study yields a strong argument in favor of reimbursing (effective) treatments for this patient population.     

Managing stress and managing illness: Survival and quality of life in chronic disease

Interest has been steadily building in the impact of stress on psychological and physiological functioning, in particular on immune system responses, furthering the concept of a strong connection between the mind and the body. Implications for prevention of disease onset or treatment of stress-induced illness or immunocompromised conditions have been explored through the implementation of stress management techniques. Cognitive behavioral stress management interventions, biofeedback, relaxation, guided imagery, hypnosis, individual and group psychotherapy, aerobic exercise, and guided self-efficacy treatment are briefly reviewed to identify possible treatment mechanisms that may affect immune function and promote quality of life. The application of behavioral techniques to reduce distress and sharpen coping skills has great promise in reducing the costs associated with chronic disease and in enhancing quality of life among those afflicted.Presented at the APA Presidential Miniconvention, To Your Health: Psychology Through the Life Span, Session VIII, Assuring a Healthy Lifestyle: Psychology Delivers. Chair: Diane J. Willis, Ph.D. The third author received partial funding through the Terry Fox Research Fellowship 5257, National Cancer Institute of Canada.     

Predictive and treatment validity of life satisfaction and the quality of life inventory

The clinical and positive psychology usefulness of quality of life, well-being, and life satisfaction assessments depends on their ability to predict important outcomes and to detect intervention-related change. These issues were explored in the context of a program of instrument validation for the Quality of Life Inventory (QOLI) involving 3,927 clients from various clinical settings. Clinical norms were also generated that supplement existing nationwide norms. The predictive validity of the QOLI and life satisfaction in a university counseling center was supported in terms of its ability to predict academic retention both by itself and in conjunction with cumulative grade point average 1 to 3 years in advance. The QOLI was also found to be sensitive to treatment-related change in two naturalistic clinical settings and samples. The interpretation and intervention utility of measures of quality of life, well-being, and life satisfaction are discussed with respect to clinical and positive psychology research.