Improving Quality of Life Measurement in Older Dialysis Patients

改善老年透析患者的生活质量测量

• 批准号: 8956917
• 负责人: Rasheeda K Hall
• 金额: $ 11.93万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8956917
• 关键词: Address; Adult; Affect; Age; Age-Years; Albumins; Caregivers; Caring; Cessation of life; Clinical; Clinical Research; Comorbidity; Data; Development; Dialysis patients; Dialysis procedure; Disease; Elderly; End stage renal failure; Ensure; Floor; Frail Elderly; Frail Older Adults; Future; Goals; Health; Health Services; Health Status; Hemoglobin; Hospitalization; Intervention; Interview; Kidney Diseases; Knowledge; Laboratories; Length; Measurement; Measures; Medicare; Methodology; Methods; Modality; Outcome; Outcome Measure; Patient Care; Patient Outcomes Assessments; Patient-Centered Care; Patients; Perceived quality of life; Performance; Physical environment; Population; Property; Provider; Psychometrics; Quality of life; Quality-of-Life Assessment; Reporting; Research; Social support; Sorting - Cell Movement; Spirituality; Structure; Testing; Treatment Effectiveness; Validity and Reliability; Work; clinical decision-making; clinical practice; cohort; cost effectiveness; end of life; experience; frailty; functional decline; functional disability; health related quality of life; high risk; improved; instrument; novel; older patient; patient oriented; preference; public health relevance; response; service intervention; shared decision making; treatment strategy

 DESCRIPTION (provided by applicant): Adults over 75 years of age comprise the fastest growing group receiving dialysis. Unfortunately, many of these patients experience significant functional impairment and declines in quality of life (QOL) after starting dialysis. Because QOL informs treatment decisions (e.g., shared decision-making about dialysis modality, dialysis discontinuation, or length of therapy) and treatment effectiveness (i.e., research that measures the effect of a treatment on QOL), accurate QOL measurement is essential. The Kidney Disease Quality of Life (KDQOL-36) instrument is widely used in clinical practice and research, but it has not been validated in older patients treated with dialysis, in whom floor effects may be problematic. Also, it is not known if the KDQOL-36 adequately measures QOL domains of highest importance to older adults (e.g., spirituality, physical environment, and end of life domains). My long-term goal is to develop a patient-centered approach to improving quality of life for older dialysis patients. As a first step towards this goal, the objectives of this applicaion are to improve the measurement of QOL in older dialysis patients. The aims of this application are to: 1) determine the reliability and validity of the KDQOL-36 in older patients, and 2) determine additional QOL domains not included in the KDQOL-36 that older patients receiving dialysis view as highly important. In the first aim, the KDQOL-36's psychometric properties will be evaluated using data from a large cohort of older patients receiving dialysis. In the second aim, patient perspectives on QOL will be obtained through semi-structured interviews of local older patients receiving dialysis and their caregivers. Upon completion of these aims, I will have preliminary data to develop a novel, valid, and comprehensive instrument (or set of instruments) that incorporates the values and preferences of this population to measure QOL. Improving the measurement of QOL among older dialysis patients is critical for future intervention and cost-effectiveness studies.

 描述（由申请人提供）：75 岁以上的成年人是接受透析的增长最快的群体，不幸的是，许多患者在开始透析后会出现明显的功能障碍和生活质量 (QOL) 下降，因为 QOL 会影响治疗决策。例如，关于透析方式、透析终止或治疗时长的共同决策）和治疗有效性（即衡量治疗对生活质量影响的研究），准确的 QOL 测量至关重要 肾脏疾病生活质量 (KDQOL-36) 仪器在临床实践和研究中广泛使用，但尚未在接受透析治疗的老年患者中得到验证，这些患者可能会出现地板效应。 此外，尚不清楚 KDQOL-36 是否充分衡量了对老年人最重要的 QOL 领域（例如精神、身体环境和临终领域）。改善老年透析患者生活质量的方法 作为实现这一目标的第一步，该应用程序的目标是改善老年透析患者的 QOL 测量。该应用程序的目的是： 1) 确定2) 确定 KDQOL-36 在老年患者中的可靠性和有效性，以及 2) 确定接受透析的老年患者认为非常重要的 KDQOL-36 中未包含的其他 QOL 领域。在第一个目标中，将评估 KDQOL-36 的心理测量特性。在第二个目标中，将通过对接受透析的当地老年患者及其护理人员进行半结构化访谈来获得患者对生活质量的看法。为了实现这些目标，我将获得初步数据来开发一种新颖、有效且全面的工具（或一套工具），该工具结合了该人群的价值观和偏好来衡量生活质量，改善老年透析患者生活质量的测量至关重要。用于未来的干预和成本效益研究。