Predictors of Quality of Life of Elderly End-Stage Renal Disease Patients: An Application of Roy's Model
Review TypeNone: Degree-based Submission
Repository Posting Date2020-01-21T17:43:21Z
Author(s)Hay, Celia G.
Author DetailsDr. Celia G. Hay, RN, PhD
Lead Author Sigma AffliationEpsilon Alpha
Level of EvidenceOther
Research ApproachAdvanced Analytics
CINAHL HeadingsHemodialysis; Kidney Failure, Chronic; Quality of Life; Hemodialysis--In Old Age; Kidney Failure, Chronic--In Old Age; Quality of Life--In Old Age
There is increasing recognition that what matters most to chronically ill patients is how well they are able to function and how they evaluate the quality of day-to-life. Understanding the impact of chronic illness and associated treatment on functioning and well-being in the physical and psychosocial dimensions of older people's lives is essential. In 2004, over half of all new patients starting dialysis were 65 years of age or older (USRDS, 2004). The physical and psychosocial impact of end-stage renal disease may lead older hemodialysis patients to withdraw from treatment and die from uremia, rather than live with seriously diminished QOL. The purpose of this study was to test a theoretical path model of the effects of age, income, gender, education, time on dialysis, functional health status, spirituality, powerlessness, and depression on the perceived of quality of life of the elderly end-stage renal disease patients. Roy's Adaptation Model was used as a theoretical framework to guide the identification of the factors that predict the quality of life of elderly ESRD patients. The study sample consisted of 79 in-center hemodialysis patients over the age of 65. Five self-report instruments and researcher-developed demographic and medical data questionnaires were used. The instruments included the Inventory of Functional Status-Dialysis (IFS-D), Religious Coping Scale (R-COPES), Life Satisfaction Index-Z (LSI-Z), Center for Epidemiological Studies-Depression (CES-D), and Health-related Powerlessness Scale (HRPS). The final path model showed that the role function mode (total functioning), self-concept mode (depression and spiritual coping) all had significant and direct effects on quality of life. The interdependence mode (powerlessness) had a significant direct effect to quality of life and a significant indirect effect through the role function mode. Together these variables explained 68% of the variance in the quality of life of older hemodialysis patients. The role function mode (total functioning) had the strongest influence on quality of life so that the greater the level of functioning the better the quality of life. Lower levels of depression and powerlessness and the use of spiritual coping along with higher levels of total functioning positively influenced the quality of life and formed a trimmed path model in this study. These findings provide an initial direction for further theory refinement and suggest that there should be a focus on the development of nursing interventions that include physical and psychosocial variables with elderly dialysis patients in order to improve their quality of life.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3166438; ProQuest document ID: 304999693. The author still retains copyright.
Degree GrantorGeorgia State University
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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