Duration of Hemodialysis and its Impact on Quality of Life

end-stage renal illness is hemodialysis. In managing patients with hemodialysis-dependent chronic kidney disease, quality of life is crucial. Objective: To determine duration of hemodialysis and its impact on Quality of Life. Methods: A descriptive, correlational research design was used to investigate the quality-of-life patients with hemodialysis. Purposive sampling technique was used in selection of the participants. This study was conducted at the Nishtar Hospital's Renal Dialysis Unit, a teaching hospital a�liated with Nishtar Medical University, Multan. The sample consisted of 50 patients (Male-32, Female-18) on Hemodialysis. World Health Organization Quality of Life BREF (WHOQOL, BREF) Urdu version was administered to assess the quality of life due to hemodialysis treatment. Results: Results showed that out of 50 subjects, majority of patients 32 (64%) were Male, 17 (34%) were about 31-40 years age group, 11(22%) were on hemodialysis treatment from 5 years. In quality of life, 38.2% patient's physical domain more affected in 2 years of hemodialysis, 31.4% were affected in psychological domain in less than 03 months, 23.4% affected in social domain after 5 years of dialysis and 39% environmental domain disturbed in 4 years of dialysis. Conclusions: It was concluded that Hemodialysis strong effect on quality of life of the patients and its duration and prolonged hemodialysis also impact on patients' social relationships, psychological domain, physical health and environment domain.


I N T R O D U C T I O N
One of the main treatments for people with end-stage renal illness is hemodialysis.In managing patients with hemodialysis-dependent chronic kidney disease, quality of life is crucial.Objective: To determine duration of hemodialysis and its impact on Quality of Life.Methods: A descriptive, correlational research design was used to investigate the quality-of-life patients with hemodialysis.Purposive sampling technique was used in selection of the participants.This study was conducted at the Nishtar Hospital's Renal Dialysis Unit, a teaching hospital a liated with Nishtar Medical University, Multan.The sample consisted of 50 patients (Male-32, Female-18) on Hemodialysis.World Health Organization Quality of Life BREF (WHOQOL, BREF) Urdu version was administered to assess the quality of life due to hemodialysis treatment.Results: Results showed that out of 50 subjects, majority of patients 32 (64%) were Male, 17 (34%) were about 31-40 years age group, 11(22%) were on hemodialysis treatment from 5 years.In quality of life, 38.2% patient's physical domain more affected in 2 years of hemodialysis, 31.4% were affected in psychological domain in less than 03 months, 23.4% affected in social domain after 5 years of dialysis and 39% environmental domain disturbed in 4 years of dialysis.Conclusions: It was concluded that Hemodialysis strong effect on quality of life of the patients and its duration and prolonged hemodialysis also impact on patients' social relationships, psychological domain, physical health and environment domain.negative effect on life of patient occur in those with stage kidney disease.Some studies looked at quality of life of the patients qualitatively from the family carers' viewpoint, who are the patients' closest friends and relatives [7].The disease progression is closely monitored by the family carers, who also note changes in the disease, issues with it, and side effects from hemodialysis [8].
Hemodialysis patients nd it extremely challenging to costly treatment while simultaneously maintaining a better quality of living.When people with end-stage renal disease already had a very low quality of life, hemodialysis made it even worse.Patients on hemodialysis must also deal with various health-related problems like cardiac illness, gastrointestinal conditions, etc., which also lower their quality of life [9].People delay getting dialysis until other serious health problems or severe diseases arise because they are unaware of their condition [10].Dialysis patients frequently experience depression, which is linked to poor quality of life.End-stage renal illness has developed more prevalent in Pakistan, notably over the past 20 years.Patients in Pakistan must receive lifetime care because of their extreme poverty [11].Studies showed dialysis patients' quality of life is also negatively impacted by the length of their treatments and this association was found to be statistically signi cant [12].When comparing patients with dialysis durations of 1-3 years to those with hemodialysis durations of less than a year, quality of life is often higher in starting years.When patients rst begin receiving dialysis, they might initially believe that their kidneys would recover and dialysis will end.However, as time goes on and they continue receiving dialysis, their fears grow and negatively affect their quality of life [13].

M E T H O D S
illness, those in a coma, and women who were pregnant.
Informed consent was written and obtained from the patients before all the demographic data, which included socio-demographic information including gender, age, location, marital status, level of education, occupation, and length of hemodialysis therapy, was gathered on a Performa that had been pre-designed.Additionally, con dentiality was assured.

Occupation
Table 2 shows duration of Hemodialysis.Out of 50 patients 11(22%) were on hemodialysis treatment from 5 years.

D I S C U S S I O N
64% unemployed.various other researchers also reported.These researches suggested, 68.4% married, 57.4% were from rural area [19], 41.1% from rural area [13], 50.3% married [5], 10% [18], 28.8% were uneducated [18].Present study also revealed, quality of life effect patients with hemodialysis.In this study, results showed strong relationship between hemodialysis poor quality of life especially with duration of illness, such as 22% of the patients were on dialysis from ve years, 18% from two years and 14% patients on hemodialysis from one year.Other researches result's sowed, 8% less than 3 years, 28% 3 to 5 years [11], from one to 12 years, with a median of ve years [2] and 165 patients were on hemodialysis for less than 36 months while 81 had a longer duration of dialysis [13].Hemodialysis patients run the risk of having a low quality of life.The ndings of the present study indicated that the majority of patients had a very low quality of life.In this study, quality of life effected in hemodialysis patients, also as duration increased.In quality-of-life results, 38.2% patient's physical domain more affected in 2 years of hemodialysis, 31.4% were affected in psychological domain in less than 03 months, 23.4% affected in social domain after 5 years of dialysis and 39% environmental domain disturbed in 4 years of dialysis.In other researches, one study found that 13% respondents were satis ed with their Quality of Life, compared to 43% subjects who were dissatis ed.The remaining 44% participants gave neither low nor good ratings [18].In one more study, 34.5% had a good quality of life.The results for patients on dialysis for less than three years and more than three years were for overall average quality of life [13].Lower ratings for symptoms and physical role constraints were seen in patients who had hemodialysis for more than three years, however higher scores for disease burden, illness in uence on life, physical pain, and mental health were seen as hemodialysis duration rose [20].One study result showed the psychological domain 17.27%, physical domain 21.44%, environmental domain 10.4% and social domains 23.49% [11].As duration of dialysis increase, the reduction in quality of life.Due to several physical, psychological, environmental and social people with chronic kidney disease on hemodialysis have a di cult time maintaining or returning to their jobs.This reality helps create a vicious cycle of tension, worry, despair, and the feeling that they are a burden to their families.Social support from partners, families, friends, coworkers, or the community is strongly correlated with a higher quality of life [19].This was different from the past research that indicated that hemodialysis patients had a lower quality of life.This variation or difference may be the result of several population, environmental, nancial, cultural and nutritional factors and poor health facilities.
Stress in daily life frequently manifests as tension, anxiety, concern, and mental strain.Patients undergoing hemodialysis for renal failure must deal with a variety of potential hardships and lifestyle modi cations [15].Rest and dietary restrictions may be all that a patient needs in the early stages of renal failure and dialysis, but when the disease progresses or becomes chronic, the patient may not be physically able to resume work or be employed, due to ongoing inpatient or outpatient treatment [16].His/her employment may be eliminated or his/her hours reduced during this time, which will have an impact on the entire family, especially if the patient is the primary provider of income.Most of the hemodialysis patients in our study had a better quality of life [17].In our research, 64% were Males & 36% were females presenting with hemodialysis.This was in concordance with another research in which 57.2% were male & 28.1% were female patients [5], other researchers reported female and male ratio respectively 59%-41% [18], 53% male and 47% female [2].In this study, majority patients 34% were presented with hemodialysis at 31-40 years & 26% were from 41-50 years age group.This is in accordance with observation of other studies in which 12% from 40-49 years, 30.1% from 50-59 years of age [19], 36% were from 35-60 years [18].In this study, 52% belonged to rural area, 74% married, 42% uneducated & Tables 3 shows 04 Domains of quality of life in Hemodialysis patients with duration of hemodialysis.In which 38.2% patient's physical domain more affected in 2 years of hemodialysis, 31.4% were affected in psychological domain in less than 03 months, 23.4% affected in social domain after 5 years of dialysis and 39% environmental domain disturbed in 4 years of dialysis.

Table 1 :
Demographic Details (N=50) from January 1 to January 31 , 2023.The study included all hemodialysis patients who were willing to take part, regardless of age, gender, or the etiology of their renal failure.The study excluded patients with chronic liver R E S U L T S

Table 2 :
Duration of Hemodialysis

Table 3 :
Quality of Life Domains of Patients on HemodialysisHemodialysis and its Impact on Quality of Life PJHS VOL. 4 Issue.10 October 2023 Copyright © 2023.PJHS, Published by Crosslinks International Publishers