Social Support: An Important Factor for Treatment Adherence and Health-related Quality of Life of Patients with End-stage Renal Disease

ABSTRACT

End-stage Renal Disease (ESRD) or chronic kidney disease constitutes a serious public health problem in the United States. The purpose of this study is to examine the causal relationship of perceived social support with treatment adherence and health-related quality of life (HRQOL) of ESRD patients. The study utilized a non-experimental research design and Structural Equation Modeling (SEM) to analyze the data collected from a sample of 413 ESRD patients. The findings of the study supported a statistically significant relationship between perceived social support and HRQOL as well as between perceived social support and treatment adherence. Formulating appropriately targeted interventions to improve social support may help in enhancing the HRQOL and treatment adherence, where both those factors were empirically supported to be related to mortality and hospitalizations in ESRD patients. This study helps to enhance the body of knowledge relating to HRQOL of ESRD patients, and provided foundation for interventions in improving treatment adherence and the HRQOL. Future research may focus on the complexities associated with the HRQOL and treatment adherence in ESRD patients, with emphasis on demographic characteristics and its relationship with social support.     

Use of the International Prostate Symptom Score (IPSS) in Chinese male patients with benign prostatic hyperplasia

Purpose: To test the psychometric properties of the International Prostate Symptom Score (Hong Kong Chinese version 2) (IPSS) in Chinese male patients with benign prostatic hyperplasia (BPH) under secondary care.

Methods: A prospective longitudinal study was done by interviewing subjects at baseline, at 2 week after baseline for assessing test–retest reliability and at 26 week after baseline for assessing responsiveness. All subjects were interviewed to complete a structured questionnaire including IPSS, Short Form-12 Health Survey version 2 (SF-12v2) and Depression Anxiety Stress Scale (DASS).

Results: The IPSS HRQOL score had weak correlations with SF-12v2 summary and DASS domain scores. For reliability analysis, Cronbach’s alpha coefficient was 0.90 for the seven symptom-related items. The intraclass correlation coefficients of the IPSS total symptom score and HRQOL score were 0.90 and 0.86, respectively. For sensitivity, statistically significant differences were detected between the subjects with BPH and those without for IPSS total symptom score (effect size?=?0.68) but not the IPSS HRQOL score. The areas under ROC curves for the IPSS total symptom and HRQOL scores were 0.67 and 0.60, respectively.

Conclusions: The IPSS was valid, reliable instrument in Chinese patients with BPH. The IPSS total symptom score, but not the HRQOL score, is sensitive in differentiating subgroups.