Using the Revised Wilson and Cleary Model to Explore Factors Affecting Quality of Life in Persons on Hemodialysis

Abstract

The purpose of this study was to describe the quality of life in persons with end stage renal disease and examine factors that may affect quality of life. A revised version of Wilson and Cleary's model for health-related quality of life was used to guide the study. Biological factors (serum albumin and serum hemoglobin), symptoms (dialysis symptoms, anxiety, depression, and fatigue), functional status, general health perception, characteristics of the individual (age, gender, race/ethnicity), and characteristics of the environment (time on dialysis, marital status, and socioeconomic status) were examined to determine their potential impact on overall quality of life.

A cross-sectional, correlational non-experimental study was conducted with a convenience sample of 73 persons undergoing hemodialysis at an outpatient dialysis center located within one city in central North Carolina. The majority of the participants was female (55%), African American (76%), not married (67%), and had incomes above the federal poverty level (56%). The mean age was 56 (SD = 15.8) and mean time on hemodialysis was 56 months (SD = 58.3). When all variables were included in the model, 61% of the variability in overall quality of life was explained. However, only the health-related variables of anxiety, depression, general health perception, and albumin significantly (p < .05) contributed to quality of life. Quality of life may be better predicted from psychological factors than physiological factors. Future studies should continue to identify factors that influence quality of life and determine interventions that enhance a person's sense of well-being.