A health-related quality of life model for patients undergoing haemodialysis

Aims and objectives: This study aimed to construct and verify a model that explains and predicts the health-related quality of life in patients undergoing haemodialysis. Background: Individual and disease-related characteristics, social support, physical and emotional symptoms, patient role adherence and perceived health status may be interrelated and might affect the health-related quality of life of patients undergoing haemodialysis directly or indirectly. Design: A correlational, cross-sectional research design was used. Methods: Participants were 202 patients undergoing haemodialysis at one of the seven nephrology clinics specified in this study. A structured questionnaire was used to collect data from September–November 2017. The collected data were analysed using spss version 25.0^® and amos 23.0. This study adhered to the STROBE guideline. Results: The hypothetical model with 13 of the 15 analysed paths showed a good fit to the empirical data: χ² = 85.67 (p <.001), normed χ² = 2.14, GFI = 0.94, CFI = 0.97, NFI = 0.94, TLI = 0.94, RMSEA = 0.08, and RMSR = 0.04. Symptoms (fatigue, quality of sleep, and depression), environmental (social support) and individual (age) characteristics and general health perception had a direct effect on health-related quality of life. Additionally, individual and environment characteristics affected health-related quality of life through biological functions, symptoms, functional status and general health perception. These variables explained 78.6% of the variation in health-related quality of life. Conclusions: To improve health-related quality of life in patients undergoing haemodialysis, systematic and integrated intervention programmes need to be developed and applied considering a variety of factors related to health-related quality of life. Relevance to clinical practice: Individual and environment characteristics, biological functions, symptoms, functional status and general health perception should be systematically monitored to improve the health-related quality of life of patients on haemodialysis. It is also necessary to develop detailed interventions that consider all these factors.