Improvement in quality of life of dialysis patients
during six months of exercise
1
2
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1
K. Pugh-Clarke BSc (Hons) RGN , P. Koufaki BSc (Hons) , V. Rowley RGN , T. Mercer PhD , P. Naish MB FRCP
1
North Staffordshire Hospital Trust
Manchester Metropolitan University
2
Introduction
Quality of life (QOL) assessment has rapidly become an integral variable of outcome in clinical research; over 1,000
new articles each year are indexed under “quality of life” (1). Despite the proliferation of instruments and the burgeoning
theoretical literature devoted to QOL evaluation, no unified approach has been derived for its measurement, and little
agreement has been attained on what it means (2). Lack of clarity regarding the definition of QOL has led to several
related concepts, namely functional status, life-satisfaction, well-being, and health status, being used interchangeably
with QOL (3), further contributing to ambiguity.
Compared to the general population, patients with end-stage renal disease (ESRD) experience a poorer QOL (4).
Questionnaire-based QOL measurement in ESRD has demonstrated that QOL is best in renal transplantation and worst
in unit-based haemodialysis. The main determinants of difference are the physical function domains.
QOL in ESRD has traditionally been measured by a number of disease-specific, domain-specific and generic instru-
ments, all exhibiting a fixed design. However, the fixed nature of the aforementioned instruments, is problematic in that
what is measured is predetermined and hence may not represent the free choice of the individual whose QOL is assessed
(5). Questionnaire-based instruments may not reflect individual priorities.
Key words
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–
–
Quality of life
Exercise
Intervention
HE AIMS OF THE PRESENT STUDY were to evaluate
Dialysis
Controls
19
T
the impact on QOL of a six-month exercise training inter-
vention, using a non-questionnaire based instrument, the
Schedule for the Evaluation of individual Quality of Life
Number
Gender
10 HD;
8
CAPD (18)
14 male;
13 male;
6 female
53.9 ± 16.5
(
SEIQoL).
4
female
58.3 ± 15.2
Age (years)
The study
Time on dialysis
The SEIQoL (6) is a patient-centred structured interview tech-
nique in which the subject is asked to: identify five themes that
impinge on subjective QOL; rate each theme on a scale ranging
from ‘as bad as could possibly be’ to ‘as good as could possibly
be’, and finally, rank each theme in order of importance, to gen-
erate a final global score out of 100.
(months)
42.2 ± 44.1
N/A
N/A
Haemoglobin (gdl) 12.0 ± 1.41
Table 1: Patient and normal subject characteristics
age-, gender- and activity-matched normal subjects. The
The exercise intervention was of six months duration, and patients’ and normal subjects’ characteristics are depicted in
comprised three sessions per week of forty minutes of accumu- Table 1.
lated moderate-intensity aerobic cycle ergometer exercise. Hae-
modialysis (HD) patients exercised on the dialysis unit, thirty Results 1: Global SEIQoL score
minutes into dialysis. Continuous ambulatory peritoneal dialy- The results of the study demonstrated that patients’ SEIQoL was
sis (CAPD) patients exercised in a supervised gym, significantly lower than the normal subjects’ before the exercise
Patients’ SEIQoL was measured at the start and at three and intervention (65.5 ± 21.8 versus 77.2 ± 15.3, p < 0.0S inde-
six months of exercise, and compared with that of twenty-two pendent t-test).
Repeated measures ANOVA showed an overall significant
Karen Pugh-Clarke registered as a nurse in 1990.
She completed her BSc (Hons) Nursing Studies/
Applied Biology in 1994.
Karen is presently the Renal Research Nurse/
Anaemia Coordinator for predialysis and a post-
graduate student at Manchester Metropolitan
University.
improvement in SEIQoL over the exercise period (67.3 ± 19.7
at three months, and 80.5 ± 15.2 at six months, p < 0.01).
Post-hoc analysis showed significant differences (p < 0.05)
between nought and six months and three and six months, but
EDTNA|ERCA JOURNAL 2002 XXVIII 1
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Saw'jalow
