Quality of life in caregivers compared with dialysis recipients: The Co-ACTIVE sub-study of the ACTIVE dialysis trial

Nicholas A Gray; Li Zuo; Daqing Hong; Brendan Smyth; Min Jun; Janak De Zoysa; Kha Vo; Kirsten Howard; Jing Wang; Chunlai Lu; Zhangsuo Liu; Alan Cass; Vlado Perkovic; Meg Jardine

doi:10.1111/nep.13530

Quality of life in caregivers compared with dialysis recipients: The Co-ACTIVE sub-study of the ACTIVE dialysis trial

Nephrology (Carlton). 2019 Oct;24(10):1056-1063. doi: 10.1111/nep.13530. Epub 2019 Apr 29.

Authors

Nicholas A Gray^{1

2}, Li Zuo³, Daqing Hong^{4

5

6}, Brendan Smyth^{4

7}, Min Jun⁴, Janak De Zoysa^{8

9}, Kha Vo^{4

10}, Kirsten Howard¹¹, Jing Wang¹², Chunlai Lu¹³, Zhangsuo Liu¹⁴, Alan Cass¹⁵, Vlado Perkovic⁴, Meg Jardine^{4

16}

Affiliations

¹ Department of Nephrology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia.
² The University of Queensland, Sunshine Coast Clinical School, Birtinya, Queensland, Australia.
³ Department of Nephrology, Peking University People's Hospital, Beijing, China.
⁴ The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
⁵ Renal Department, Sichuan Provincial People's Hospital, Chengdu, China.
⁶ University of Electronic Science and Technology of China Medical School, Chengdu, China.
⁷ Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
⁸ Renal Service, North Shore Hospital, Waitemata DHB, Auckland, New Zealand.
⁹ Department of Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.
¹⁰ Bureau of Health Information, NSW Health, Sydney, New South Wales, Australia.
¹¹ Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
¹² Department of Nephrology, First Affiliated Hospital of Dalain Medical University, Dalain, China.
¹³ Department of Nephrology, Shanghai 85th Hospital, Shanghai, China.
¹⁴ Department of Nephrology, First Affiliated Hospital of Zhengzhou University, China.
¹⁵ Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
¹⁶ Department of Renal Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.

PMID: 30723975
DOI: 10.1111/nep.13530

Abstract

Aim: To compare quality of life (QOL) of caregivers of dialysis patients with the cared for patients and population norms.

Methods: The ACTIVE Dialysis study randomized participants to extended (median 24 h/week) or standard (median 12 h/week) haemodialysis hours for 12 months. A subgroup of participants and their nominated caregivers completed QOL questionnaires including the EuroQOL-5 Dimension-3 Level (EQ5D-3 L), short form-36 (SF-36, also allowing estimation of the SF-6D), as well as a bespoke questionnaire and the personal wellbeing index (PWI). Caregiver QOL was compared with dialysis patient QOL and predictors of caregiver QOL were determined using multivariable regression.

Results: There were 54 patients and caregiver pairs, predominantly from China. Caregivers mean (SD) age was 53.4 (11.3) years, 60% were female, 71% cared for their spouse/partner, and 36% were educated to university level. Caregivers had better physical but similar mental QOL compared with dialysis patients (mean SF-36 physical component summary: 46.9 ± 8.7 vs 40.4 ± 10.2, P < 0.001; mental component summary: 47.8 ± 9.7 vs 49.6 ± 12.0, P = 0.84). Health utility measured with EQ5D-3 L was not significantly different between caregivers and dialysis patients (mean 0.869 ± 0.185 vs 0.798 ± 0.227, P = 0.083). Caregiver PWI was 43.7 ± 15.5, significantly lower than the Chinese population norm (68.2 ± 14.2, P < 0.001). Higher physical and mental QOL among caregivers was predicted by university education but not age, gender or daily hours caring.

Conclusion: Caregivers have higher physical and equivalent mental QOL to dialysis patients but poorer personal well-being than the Chinese population. University education predicts better QOL and may be a surrogate for socioeconomic or other factors. (NCT00649298).

Keywords: A clinical trial of intensive dialysis; caregiver; extended dialysis; haemodialysis; quality of life.

Publication types

Randomized Controlled Trial

MeSH terms

Caregivers* / psychology
Caregivers* / statistics & numerical data
China / epidemiology
Consumer Behavior
Female
Humans
Karnofsky Performance Status
Male
Middle Aged
Patient Acceptance of Health Care / statistics & numerical data
Quality of Life*
Renal Dialysis* / methods
Renal Dialysis* / psychology
Renal Dialysis* / statistics & numerical data
Renal Insufficiency, Chronic* / epidemiology
Renal Insufficiency, Chronic* / psychology
Renal Insufficiency, Chronic* / therapy
Sickness Impact Profile
Socioeconomic Factors

Associated data

ClinicalTrials.gov/NCT00649298