Dialysis Patient’s Satisfaction with their Dialysis Therapy Presented By: Mohammed Al-Issa Scientific Program of the Saudi Society of Nephrology 28.04.2008

Objectives of the Study To assess the degree of satisfaction among dialysis patients in their dialytic therapy. To assess the independent impact on satisfaction score of certain factors

Background Patient’s quality of life and satisfaction assessment and improvement are taking increasing importance in health care delivery There is evidence that better QOL and patient satisfaction might be associated with better medical outcome

Methods Demographic data & Charlson Comorbidity Index and Kt/V were collected. Using 1 to 10 scale, the patients were asked to rate Overall satisfaction with the dialysis therapy Overall impact of dialysis therapy on their lives. The effect of dialysis on 15 domains known to impact the QOL They were also asked to list 3 positive and 3 negative effects of dialysis

Methods Inclusion Criteria The patient must be: Over 16 years of age Must have been on dialysis for at least 6 months. Medically stable without acute medical problems for a minimum of 3 months before the study. Be able to understand and answer the questionnaire.

Demographic Data 267 patients were included from 3 dialysis centers Mean age was 51.7 years (+/-15.4) 63 % were males 58 % were on dialysis for > 3 years 54 % had < 4 years of education and only 4 % entered university Mean Charlson Comorbidity Index was 3.2 (+/-2) The mean Kt/V was 1.3 (+/-0.44)

Dialysis Satisfaction Score

Dialysis effect on life generally

Dialysis effect on Stress level

Dialysis effect on Performing Prayers

Dialysis effect on sexual life

Dialysis Effect on Exercise Ability

Negative Aspects of Dialysis

Positive Aspects of Dialysis

Charlson Chronic Illness Index

Comparing scores by Gender )only scores with statistically significant differences are shown(

Comparing scores by Duration on dialysis (only scores with statistically significant differences are shown)

Comparing scores by years on education (only scores with statistically significant differences are shown)

Comparing scores by Center (only scores with statistically significant differences are shown)

Comparing Scores in Riyadh, Dammam & USA Mean age (yr) USA (n=84) Riyadh (n=166 ) Dammam (n= 99) Mean age (yr) 69.6 52.2 51 Global satisfaction 8.02 9 6.5 Global impact of therapy 7.25 6.2 4.6 Family life 6.83 7.6 3.8 Independence 6.18 6.1 Religion/spirituality 7.02 9.7 5.7 Energy level 5.15 2.6 Living situation 6.7 4.5 Stress level 5.91 3.5 2.1 Overall health 6.57 Social life 5.76 7.4 4.2 Mood 5.88 4.9 2.8 Exercise ability 4.85 2.4 2 Recreation 5.12 3 Appetite 5.98 5.6 5.3 Body image Finances 4.96 5.1 Sex life 4.01 3.1 2.3 Overall Mean 5.96 5.62 3.82 p=0.33 0.0001

Comparing Scores in Riyadh, Dammam & USA

Conclusions Main negative effects of dialysis reported were fatigue and dizziness Main positive effect of dialysis reported were improved health Males experienced worse effect on family life, social life, energy & appetite than females. Longer period on dialysis was associated with worse dialysis effect on finances, energy and living arrangement Lower level of education was associated with worse dialysis effect on stress, overall health, sexual life, hobbies and exercise ability. Patients in Dammam had worse scores than patients in Riyadh in 14/15 domains. This was not related to differences in gender, education or period on dialysis. The reasons might be due to : Higher Kt/V in Riyadh patients Lower CCI in Riyadh patients. Riyadh patients are more survey question compliant

Conclusions The mean scores by Riyadh and USA patients were not statistically significant (p=0.33) but was when compared to Dammam patients (p=0.0001) Riyadhs’ patients scored higher than USA patients in these areas: Global satisfaction Family life Social life Spirituality Finances

Thank You Any Questions??