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Abstract
Introduction: Individuals with chronic kidney disease may experience reduced quality of life associated with treatment costs.
Objective: To evaluate health-related quality of life and its relationship with financial toxicity in individuals with chronic kidney disease undergoing hemodialysis treatment.
Material and Methods: An observational, cross-sectional study involving 214 individuals was carried out, with data collected from February to May 2022 at four specialized dialysis clinics in the southern region of Brazil. Sociodemographic and clinical questionnaires, the Comprehensive Score for Financial Toxicity, and the Kidney Disease Quality of Life - Short Form were utilized. Descriptive analysis with absolute and relative frequencies was conducted for sociodemographic and clinical variables, and Pearson correlation was used for financial toxicity and health-related quality of life scores.
Results: Four items of the Kidney Disease Quality of Life-Short Form questionnaire had an average score below 50, indicating poor quality of life: “General health” (10.75), “Limitations in physical functioning” (29.93), “Burden of kidney disease” (37.76), and “Work status” (39.49), with physical (34.49) and mental (49.19) composite scores. The relationship between financial toxicity and health-related quality of life revealed that a worse financial toxicity score was associated with a greater number of impaired dimensions. There was a significant correlation between financial toxicity, the mental health dimension, and the effects of kidney disease.
Conclusion: Participants experienced compromised health-related quality of life, with a positive correlation with financial toxicity.
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Copyright (c) 2024 Emanuele Cristina de Sousa-Silva, Maria de Fátima Mantovani, Claudia Geovana da Silva-Pires, Robson Giovani Paes, Luciana Puchalski Kalinke, Luciana de Alcantara Nogueira
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References
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- Scholes-Robertson N, Blazek K, Tong A, Gutman T, Craig JC, Essue BM, Howard K, Wong G, Howell M. Financial toxicity experienced by rural Australian families with chronic kidney disease. Nephrology (Carlton). 2023;28(8):456-66. DOI: https://doi.org/10.1111/nep.14192
- Menon, ACNC. Análise de qualidade de vida de pacientes com insuficiência renal crônica em tratamento hemodialítico no sistema único de saúde na região de saúde de Dourados – MS [dissertação na internet]. Dourados (MS): Universidade Federal da Grande Dourados; 2016 [citado 12 Jan 2024];[aprox. 1 p.] Disponível em: https://files.ufgd.edu.br/arquivos/arquivos/78/MESTRADO-DOUTORADO-CIENCIAS-SAUDE/Disserta%C3%A7%C3%A3o(1).pdf
- Khera R, Valero-Elizondo J, Nasir K. Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions. Disponível em: https://www.ahajournals.org/doi/10.1161/JAHA.120.017793
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- Chan RJ, Gordon L, Zafar SY, Miaskowski C. Financial toxicity and symptom burden: what is the big deal?. Support Care Cancer [Internet]. 2018 [citado 20 Fev 2024];26. Disponível em: https://doi.org/10.1007/s00520-018-4092-6 DOI: https://doi.org/10.1007/s00520-018-4092-6
- Casilla-Lennon MM, Choi SK, Deal AM, Bensen JT, Narang G, Filippou P et al. Financial Toxicity among Patients with Bladder Cancer: Reasons for Delay in Care and Effect on Quality of Life. J. Urol [Internet]. 2018 [citado 20 Fev 2024] 199(5). Disponível em: https://doi.org/10.1016/j.juro.2017.10.049 DOI: https://doi.org/10.1016/j.juro.2017.10.049
- Hays R, Kallich J, Mapes D, Coons S, Amin A, Carter WB et al. Kidney disease quality of life short form (KDQOL-SFTM), version 1.3. manual for use and scoring. Santa Monica [Internet]. 1997 [citado 20 Fev 2024]; Disponível em: https://www.rand.org/pubs/papers/P7994.html
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- Vinhal LB, Lopes LG, Morais ER. Avaliação da qualidade de vida em doentes renais crônicos hospitalizados. Visão Acadêmica [Internet]. 2022 [citado 20 Fev 2024];23(3). Disponível em: https://revistas.ufpr.br/academica/article/view/86806 DOI: https://doi.org/10.5380/acd.v23i3.86806
- Silva OM da, Kuns C M, Bissoloti A, Ascari RA. Perfil clínico e sociodemográfico dos pacientes em tratamento de hemodiálise no oeste catarinense. Saúde (Santa Maria) [Internet]. 2018 [citado 20 Fev 2024];44(1). Disponível em: https://doi.org/10.5902/2236583416918 DOI: https://doi.org/10.5902/2236583416918
- Silva MC, Oliva EFS, Rickli C, Braga LS. Characterization of the epidemiological profile of patients with chronic kidney disease, served in a dialytic treatment unit in Campo Mourão-PR. Res., Soc. Dev. [Internet]. 2022 [citado 12 Jan 2024];11(4) Disponível em: https://doi.org/10.33448/rsd-v11i4.27966 DOI: https://doi.org/10.33448/rsd-v11i4.27966
- Neves PDM de M, Sesso de CC, Thomé FS, Lugon JR, Nascimento MM. Braz J Nephrol [Internet]. 2021 [citado 20 Fev 2024];43 (2):217–27. Disponível em: https://doi.org/10.1590/2175-8239-JBN-2020-0 DOI: https://doi.org/10.1590/2175-8239-jbn-2020-0161
- Nerbass FB, Lima HN, Thomé, FS, Neto OMV, Lugon JR, Sesso R. Censo Brasileiro de Diálise 2020. Braz. J. Nephrol. [Internet]. 2022 [citado 20 Fev 2024];44(3). Disponível em: https://www.scielo.br/j/jbn/a/3Jts9Jdpcy5vc5MFjdMwV3g/?format=pdf&lang=pt DOI: https://doi.org/10.1590/2175-8239-jbn-2021-0198
- García PRS, Souza EF de, Oliveira PJM. de. Avaliação da Qualidade de Vida de Pacientes com Doença Renal Crônica em Hemodiálise no Norte de Mato Grosso. ScientificElectronic Archives [Internet]. 2022 [citado 20 Fev 2024];15(8). Disponível em: https://sea.ufr.edu.br/SEA/article/view/1567 DOI: https://doi.org/10.36560/15820221567
- Butyn G, de Carvalho GM, de Castro CJS, da Silva GR, Arcaro G, Martins CM, Mikowski JRD. Avaliação da qualidade de vida do paciente com doença renal crônica em terapia renal substitutiva. Braz. J. Hea. Rev [Internet]. 2021 [citado 20 Fev 2024];4(1):2785-98. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/24556 DOI: https://doi.org/10.34119/bjhrv4n1-223
- Farias MPO, Souza MA de. Qualidade de vida em pacientes dialíticos. Res Soc Dev [Internet]. 2022 [citado 20 Fev 2024];11(13). Disponível em: https://rsdjournal.org/index.php/rsd/article/view/35929 DOI: https://doi.org/10.33448/rsd-v11i13.35929
- Baldin J, Souza AA, Simões M, Walsh IAP, Accioly, MF. Qualidade de vida, aspectos clínicos e sociodemográficos de indivíduos com doença renal crônica em hemodiálise. REFACS [Internet]. 2021 [citado 20 Fev 2024];9(2). Disponível em: https://www.redalyc.org/articulo.oa?id=497969633009 DOI: https://doi.org/10.18554/refacs.v9i2.4532
- Ver Hoeve ES, Ali-Akbarian L, Preço SN, Lothfi NM, Hamann HÁ. A.Patient-reported financial toxicity, quality of life, and health behaviors in insured US cancer survivors. Support Care Cancer [Internet]. 2021 [citado 20 Fev 2024];29(1). Disponível em: https://dx.doi.org/10.1007/s00520-020-05468-z DOI: https://doi.org/10.1007/s00520-020-05468-z
- Murphy PB, Severance S, Savage S, Obeng-Gyasi S, Timsina LR, Zarzaur BL. Financial toxicity is associated with worse physical and emotional long-term outcomes after traumatic injury. J Trauma Acute Care Surg [Internet]. 2019 [citado 20 Fev 2024];87(5). Disponível em: https://pubmed.ncbi.nlm.nih.gov/31233442/. DOI: https://doi.org/10.1097/TA.0000000000002409
References
Brasil. Ministério da Saúde. Biblioteca Virtual em Saúde. Dia mundial do Rim [Internet]. 2020 [citado 20 Fev 2024]. Disponível em: http://bvsms.saude.gov.br/ultimas-noticias/3138-12-3-dia-mundial-do-rim
Tannor EK, Archeret E, Kapembwa K, Schalkwyk SCV, Davids R. Quality of life in patients on chronic dialysis in South Africa: a comparative mixed methods study. BMC nephrology [Internet]. 2017 [citado 20 Fev 2024];18(4). Disponível em: https://dx.doi.org/10.1186/s12882-016-0425-1 DOI: https://doi.org/10.1186/s12882-016-0425-1
Modi GK, Yadav AK, Ghosh A, et al. Nonmedical Factors and Health-Related Quality of Life in CKD in India. Clin J Am Soc Nephrol [Internet]. 2020 [citado 20 Fev 2024];15(2):191-9. Disponível em: https://doi.org/10.2215/CJN.06510619. DOI: https://doi.org/10.2215/CJN.06510619
Lima JPS, Lima LSA, Silva DCB, Ramalho ACA, Santos JCF, Silva DAV. Quality of life of people with chronic kidney disease in a Brazilian capital. Res Soc Dev [Internet]. 2021 [citado 12 Jan 2024];10(7)e9210716406. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/16406 DOI: https://doi.org/10.33448/rsd-v10i7.16406
Scholes-Robertson N, Blazek K, Tong A, Gutman T, Craig JC, Essue BM, Howard K, Wong G, Howell M. Financial toxicity experienced by rural Australian families with chronic kidney disease. Nephrology (Carlton). 2023;28(8):456-66. DOI: https://doi.org/10.1111/nep.14192
Menon, ACNC. Análise de qualidade de vida de pacientes com insuficiência renal crônica em tratamento hemodialítico no sistema único de saúde na região de saúde de Dourados – MS [dissertação na internet]. Dourados (MS): Universidade Federal da Grande Dourados; 2016 [citado 12 Jan 2024];[aprox. 1 p.] Disponível em: https://files.ufgd.edu.br/arquivos/arquivos/78/MESTRADO-DOUTORADO-CIENCIAS-SAUDE/Disserta%C3%A7%C3%A3o(1).pdf
Khera R, Valero-Elizondo J, Nasir K. Financial Toxicity in Atherosclerotic Cardiovascular Disease in the United States: Current State and Future Directions. Disponível em: https://www.ahajournals.org/doi/10.1161/JAHA.120.017793
Zafar SY. Financial toxicity of cancer care: It’s time to intervene. J Natl Cancer Inst [Internet] 2016 [citado 20 Fev 2024];108(5). Disponível em: https://pubmed.ncbi.nlm.nih.gov/26657334/. DOI: https://doi.org/10.1093/jnci/djv370
Lathan CS, Cronin A, Tucker-Seeley R, Zafar SY, Ayanian JZ, Schrag D. Association of financial strain with symptom burden and quality of life for patients with lung or colorectal cancer. J Clin Oncol [Internet] 2016 [citado 20 Fev 2024];34(15). Disponível em: https://pubmed.ncbi.nlm.nih.gov/26926678/. DOI: https://doi.org/10.1200/JCO.2015.63.2232
Smith GL, Lopez-Olivo MA, Advani PG, Ning MS, Geng Y, Giordano SH et al. Financial Burdens of Cancer Treatment: A Systematic Review of Risk Factors and Outcomes. J Natl Compr Canc Netw [Internet]. 2019 [citado 20 Fev 2024];17(10). Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370695/. DOI: https://doi.org/10.6004/jnccn.2019.7305
Chan RJ, Gordon L, Zafar SY, Miaskowski C. Financial toxicity and symptom burden: what is the big deal?. Support Care Cancer [Internet]. 2018 [citado 20 Fev 2024];26. Disponível em: https://doi.org/10.1007/s00520-018-4092-6 DOI: https://doi.org/10.1007/s00520-018-4092-6
Casilla-Lennon MM, Choi SK, Deal AM, Bensen JT, Narang G, Filippou P et al. Financial Toxicity among Patients with Bladder Cancer: Reasons for Delay in Care and Effect on Quality of Life. J. Urol [Internet]. 2018 [citado 20 Fev 2024] 199(5). Disponível em: https://doi.org/10.1016/j.juro.2017.10.049 DOI: https://doi.org/10.1016/j.juro.2017.10.049
Hays R, Kallich J, Mapes D, Coons S, Amin A, Carter WB et al. Kidney disease quality of life short form (KDQOL-SFTM), version 1.3. manual for use and scoring. Santa Monica [Internet]. 1997 [citado 20 Fev 2024]; Disponível em: https://www.rand.org/pubs/papers/P7994.html
Duarte OS, Miyazaki MCOS, Ciconelli RM, Sesso R. Tradução e adaptação cultural do instrumento de avaliação de qualidade de vida para pacientes renais crônicos (KDQOL-SF TM). Rev. Assoc. Med. Bras [Internet] 2003 [citado 20 Fev 2024];49 (4). Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302003000400027&lng=en&nrm=iso DOI: https://doi.org/10.1590/S0104-42302003000400027
Vinhal LB, Lopes LG, Morais ER. Avaliação da qualidade de vida em doentes renais crônicos hospitalizados. Visão Acadêmica [Internet]. 2022 [citado 20 Fev 2024];23(3). Disponível em: https://revistas.ufpr.br/academica/article/view/86806 DOI: https://doi.org/10.5380/acd.v23i3.86806
Silva OM da, Kuns C M, Bissoloti A, Ascari RA. Perfil clínico e sociodemográfico dos pacientes em tratamento de hemodiálise no oeste catarinense. Saúde (Santa Maria) [Internet]. 2018 [citado 20 Fev 2024];44(1). Disponível em: https://doi.org/10.5902/2236583416918 DOI: https://doi.org/10.5902/2236583416918
Silva MC, Oliva EFS, Rickli C, Braga LS. Characterization of the epidemiological profile of patients with chronic kidney disease, served in a dialytic treatment unit in Campo Mourão-PR. Res., Soc. Dev. [Internet]. 2022 [citado 12 Jan 2024];11(4) Disponível em: https://doi.org/10.33448/rsd-v11i4.27966 DOI: https://doi.org/10.33448/rsd-v11i4.27966
Neves PDM de M, Sesso de CC, Thomé FS, Lugon JR, Nascimento MM. Braz J Nephrol [Internet]. 2021 [citado 20 Fev 2024];43 (2):217–27. Disponível em: https://doi.org/10.1590/2175-8239-JBN-2020-0 DOI: https://doi.org/10.1590/2175-8239-jbn-2020-0161
Nerbass FB, Lima HN, Thomé, FS, Neto OMV, Lugon JR, Sesso R. Censo Brasileiro de Diálise 2020. Braz. J. Nephrol. [Internet]. 2022 [citado 20 Fev 2024];44(3). Disponível em: https://www.scielo.br/j/jbn/a/3Jts9Jdpcy5vc5MFjdMwV3g/?format=pdf&lang=pt DOI: https://doi.org/10.1590/2175-8239-jbn-2021-0198
García PRS, Souza EF de, Oliveira PJM. de. Avaliação da Qualidade de Vida de Pacientes com Doença Renal Crônica em Hemodiálise no Norte de Mato Grosso. ScientificElectronic Archives [Internet]. 2022 [citado 20 Fev 2024];15(8). Disponível em: https://sea.ufr.edu.br/SEA/article/view/1567 DOI: https://doi.org/10.36560/15820221567
Butyn G, de Carvalho GM, de Castro CJS, da Silva GR, Arcaro G, Martins CM, Mikowski JRD. Avaliação da qualidade de vida do paciente com doença renal crônica em terapia renal substitutiva. Braz. J. Hea. Rev [Internet]. 2021 [citado 20 Fev 2024];4(1):2785-98. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/24556 DOI: https://doi.org/10.34119/bjhrv4n1-223
Farias MPO, Souza MA de. Qualidade de vida em pacientes dialíticos. Res Soc Dev [Internet]. 2022 [citado 20 Fev 2024];11(13). Disponível em: https://rsdjournal.org/index.php/rsd/article/view/35929 DOI: https://doi.org/10.33448/rsd-v11i13.35929
Baldin J, Souza AA, Simões M, Walsh IAP, Accioly, MF. Qualidade de vida, aspectos clínicos e sociodemográficos de indivíduos com doença renal crônica em hemodiálise. REFACS [Internet]. 2021 [citado 20 Fev 2024];9(2). Disponível em: https://www.redalyc.org/articulo.oa?id=497969633009 DOI: https://doi.org/10.18554/refacs.v9i2.4532
Ver Hoeve ES, Ali-Akbarian L, Preço SN, Lothfi NM, Hamann HÁ. A.Patient-reported financial toxicity, quality of life, and health behaviors in insured US cancer survivors. Support Care Cancer [Internet]. 2021 [citado 20 Fev 2024];29(1). Disponível em: https://dx.doi.org/10.1007/s00520-020-05468-z DOI: https://doi.org/10.1007/s00520-020-05468-z
Murphy PB, Severance S, Savage S, Obeng-Gyasi S, Timsina LR, Zarzaur BL. Financial toxicity is associated with worse physical and emotional long-term outcomes after traumatic injury. J Trauma Acute Care Surg [Internet]. 2019 [citado 20 Fev 2024];87(5). Disponível em: https://pubmed.ncbi.nlm.nih.gov/31233442/. DOI: https://doi.org/10.1097/TA.0000000000002409