Identifying what Aspects of the Post-Kidney Transplant Experience Affect Quality of Life
Notice bibliographique
Résumé
Introduction Although transplantation improves quality of life (QOL) of patients with end stage renal disease, post-transplant QOL scores remain below age- and sex-matched norms. To optimize post-transplant QOL, it is important to identify what matters to kidney transplant recipients as they recover. This will inform future personalized and patient-centered interventions. The majority of the tools available to measure QOL and health-related quality of life (HRQL) in kidney transplant recipients include standardized domains, which may not reflect what matters to patients. In contrast, the Patient Generated Index (PGI) is an individualized measure of QOL where people nominate areas of life affected by their health condition or living situation. The objectives of this study were to 1) identify what aspects of the post-kidney transplant experience are affecting QOL and 2) estimate the strength of the relationship between the PGI and standardized generic measures of health aspects of QOL. Materials and Methods We conducted a cross-sectional study at McGill University Health Centre. QOL was evaluated using three questionnaires (the EuroQol-5D (EQ-5D)TM, Visual Analogue Health States (VAHS) and PGI) and analyzed by descriptive statistics. Areas nominated on the PGI were categorized into a standard nomenclature. The relation between PGI, EQ-5D and VAHS was evaluated using Pearson correlations. Results and Discussion Fifty-one kidney transplant recipients (time post-transplant: < 1 year (n=25; 49%); 1-3 years (n=16; 31%) and >3 years (n=10; 20%)) participated in the study. The total EQ-5D score was 70 ± 17 (Mean ± SD). Participants reported having problems in all five domains and most commonly with mobility (47%) and the least common problem being self-care (6%). On the VAHS, the most common domains achieving scores of ≤ 6 (reflecting a need for intervention) were fatigue and sleep. The overall PGI score was 45.2 ± 27.6 (Mean ± SD). Seventy-one percent of the study participants reported ≥1 area of concern as impacting their QOL, with 30% reporting ≥3 areas. The most commonly nominated areas were physiological complaints (e.g. urine infection, creatinine levels), nutrition, mobility, pain, mood/emotions and fatigue. Pain and mood/emotions were the only dimensions assessed across all three questionnaires. The PGI identified six unique affected areas that were not identified on the EQ-5D or VAHS (i.e., nutrition, physiological, libido, restricted socialization, consequences of surgery and restriction on work). A weak relationship was found between the PGI and VAHS (r=0.16; CI: -0.17-0.46) and PGI and EQ-5D (r=0.34; CI: -0.01-0.6). Conclusions Of the QOL measures, the PGI appears to be the most sensitive for identifying what matters to each individual kidney transplant recipient. Given the breadth of QOL areas affected by kidney transplantation, comprehensive interventions such as self-management may be considered to target these areas of concerns. Fonds de Recherche Santé Québec (FRQS).
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».