الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 183 |  |  |
| | | from | 183 | | |
Abstract
C
hronic kidney disease is a worldwide health problem, with an estimated 10% to 13% of the world’s population being affected CKD is classified into 5 stages; stage 1 and 2 are considered mild, stage 3 and 4 are considered moderate and stage 5 is referred to as end stage kidney disease (ESKD) (Campbell et al., 2016).
This study was carried out at renal insufficiency outpatient clinics at Ain shams University Hospitals in Cairo governorate. Data were collected from a purposive sample of one hundred twenty two adult patients were included in the current study according to the following criteria: adult male and female patients, age ranged from 21- 50 years old as the most common age in the renal insufficiency outpatient renal insufficiency clinics in Ain shams university hospitals. The aim of this study was to determine quality of life for adult clients with chronic kidney disease.
The following tools were utilized for data collection:
Tool I: Interviewing questionnaire sheet:
It was developed by the investigator based on the recent related literature review and reviewed by professors in community health nursing and consisted of three main parts:
Part (1): Socio-demographic characteristics for Adult client with chronic kidney disease)(Q1 – Q9): this part covering age, gender, marital status, educational level, place of residence, employment status, income, the family bread winner, and no. of family.
Part (2): Adult client knowledge about (Q 10 - Q22):
A. the chronic kidney disease regarding component of urinary system, meaning, signs and symptoms, complications, ways of improvement, importance of kidney treatment and side effect of medication.
B. Adult client knowledge about the hemodialysis as meaning of hemodialysis, importance of hemodialysis, precaution before dialysis, complications of hemodialysis, fistula location, and the way to care with fistula.
Part (3): Adult client compliance (Q23 – Q37) with therapeutic regimen regarding nutritional pattern, therapeutic regimen, and save the fistula Tool II: Adult client medical record (Q 38 – Q 43):
Tool II: Adult client medical record (Q 38 – Q 43):
This tool covering client comorbidities: diabetes mellitus, hypertension, heart disease, and arthritis.
Tool III: Kidney disease quality of life the short form (KD QoL -SFtm) version 1.3 (Q 44- Q64). It was developed and validated by Abd El Hafeez, et al., (2012) and adopted by the investigator to measure quality of life the short form included Overall burden of diseases on the physical side (11 questions), psychological (mental side ) (3 questions), emotional, and spiritual (3 questions), and social interaction (5 questions).
The main findings of the present study were:
The finding of the current study revealed that mean age of the study sample were 23.4 ± 15.2 years, 63.1% of them was male and married (66.4%), 44.2% have technical education, 50.8% of them lives in rural area. As regard to employment status there were 60.7% of them working and has enough income 68.9%.
More than one third of the adult clients’ (34.4%) defined hemodialysis correctly & importance of hemodialysis respectively, also, 36.1% of them had correct knowledge about the precaution before hemodialysis and35.2% of them correctly answer the complications of hemodialysis. The majority of the clients’ (92.3%) have fistula mentioned vein-arterial in arm is the location of fistula and (82.0%) don’t know the way to care with fistula.
More than one third of the client with chronic kidney disease had satisfactory knowledge and compliance level about their disease.
Regarding clients’ compliance therapeutic for the patient, showed that 76.9 % of the clients have fistula committed to the precaution to save fistula, 47.5% of the clients committed to therapeutic regimen, followed by 22.1% of them have committed to nutritional pattern.
More than half (52.5%) of the client with chronic kidney disease had poor QoL level, more than one third (38.5%) of them had average QoL and the minority (9.0%) of them had good QoL.
Near to half (52.5%) of clients’ had poor QOL aged between 40- 49 years, 53.1% of them was male, 68.2% of them was married, 56.2% of them had technical education level, 45.3% of them was worked, and 82.8% of them had 4- 6 person in their family with statistically significance differences.
The minority (9.0%) of the client had satisfactory knowledge had good QoL with no statistically significance difference between and one fifth (20.9%) of them had satisfactory compliance had good QoL with statistically significance difference.
Near to two third (65.1%) of the client had satisfactory knowledge, also had satisfactory compliance with statistically significance difference between of them in which P – value 0.000**
Conclusion: More than one third of the client with chronic kidney disease had satisfactory knowledge and compliance level about their disease, more than one third of the client take fluids as prescribed and eat as the previous habits and near to half of them water and tea are the most intake fluids, more than half 52.5% of them had poor QoL level, more than one third 38.5% of them had average QoL and the minority 9.0%of them had good QoL.
Recommendations
Based on results of the present study the following can be recommended:
Ongoing education for the hemodialysis clients, and Provide patients with sufficient written and visual knowledge about kidney disease, importance of hemodialysis, care of fistula, therapeutic regimen, and follow-up.
Health education program to improve clients self-care compliance regarding medication, side effect of treatment, care of vascular access, diet and fluid restriction, important exercise, prevention and management of complication.
It is important to keep in mind that a variety of factors that have an impact on quality of life need to be considered and that there are likely unique points to consider in each country.
ESRD care expands and the number of CKD patients’ increases, the focus will need to shift from simply prolonging life to providing a better quality of life.
Ongoing education for the hemodialysis clients, and their care givers, it should initiated during the pre-dialysis stage and continued after maintenance dialysis using a multitude of audiovisual materials that suite the needs for each patient and achieve a satisfactory level of adherence.
Provide patients with health education about quality of life during the session of hemodialysis to help in decreasing symptoms (and activities of daily living for the patient to meet their needs).
Further researches:
• There is a need for more studies to assess the quality of life of patients with CRD.
• Replication of the study on a larger probability sample in different geographical areas in Egypt to figure out the main aspects of these problems.