Pilot Study on Depression, Food Insecurity, and Health-Related Quality of Life in Jamaican Patients with ESKD

Le résumé fourni par la source

Background: Poor health related quality of life (HRQOL), depression and food insecurity are independent risk factors for adverse outcomes in end stage kidney disease (ESKD). Despite the apparent high attributable morbidity of ESKD, little is known of the impact and burden on people living with ESKD in Jamaica. We sought to determine the HRQOL, prevalence of depression and food insecurity amongst hemodialysis patients at the University Hospital of the West Indies (UHWI) in Kingston, Jamaica. Methods: Adult patients (aged >=18 years) at the UHWI haemodialysis unit were recruited, and interviews were conducted using the following validated instruments: the Kidney Disease Quality of Life Short Form (KDQOL-SF™) Version 1.3, the Beck’s Depression Inventory II (BDI-II) and a modified version of the Centre of Disease Control and Prevention (CDC)’s National Health and Nutrition Examination Survey (NHANES) Food Security questionnaires after obtaining informed consent. Chart review was conducted to obtain demographic, laboratory and clinical data. Summary statistics was used to describe data. Results: 35 participants, 63% (n=22) males with mean age ± SD of 49.2 ± 15.1 years were enrolled. Two-thirds (65.7%) were unemployed and 54.3% had a monthly household income of less than US$320 per month, whilst 71.4% had at least high school education. The mean ± SD dialysis duration was 9.7 ±9.6 years, the majority received dialysis twice weekly (77.1%), and most (85.7%) had an arteriovenous fistula. Mean ± SD haemoglobin was 10.1 ± 2.0g/dL, and 23% required blood transfusion in the last year. Dialysis was inadequate (Urea reduction ratio <0.65) in 28.6%. Mean ± SD phosphorus and albumin levels were 1.5 ± 0.6 mmoles/L and 35.1 ± 7.0 g/dL. Mean ± SD QOL score in the physical domain was lowest 36.6 ± 29.2, and highest in mental functioning and symptoms in ESKD with mean scores of 81.0 ±17.1 and 81.7 ± 11.7 respectively. The prevalence of moderate to severe depression was 17.1% while food insecurity was 42.9%. Conclusion: High rates of food insecurity and low quality of life scores in the physical domain were found in the patients interviewed. Further research is needed to guide policies to improve the health outcomes of Jamaican patients with ESKD on haemodialysis.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.