Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Study Protocol
2.3. Questionnaires
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Women (N = 47) | Men (N = 55) | p-Value |
---|---|---|---|
Age (years) | 36.6 ± 10.7 | 39.3 ± 14.1 | 0.287 |
Body mass index (Kg/m2) | 23.2 ± 6.5 | 23.9 ± 6.6 | 0.909 |
Diagnosis time (months) | 5 (3–12) | 6 (3–12) | 0.886 |
HD vintage (months) | 3 (2–5) | 3 (1–6) | 0.964 |
Glucose (mg/dL) | 89 (76–110) | 90 (74–106) | 0.965 |
Hemoglobin (mg/dL) | 8.75 ± 1.67 | 10.33 ± 2.10 | <0.001 |
Creatinine (mg/dL) | 8.71 ± 1.87 | 11.87 ± 3.42 | <0.001 |
Blood urea nitrogen (mg/dL) | 51.06 ± 19.08 | 61.83 ± 21.6 | 0.012 |
Uric acid (mg/dL) | 5.94 ± 1.14 | 6.59 ± 1.51 | 0.023 |
Albumin (g/dL) | 4.02 ± 0.25 | 4.12 ± 0.28 | 0.056 |
Potassium (mEq/L) | 4.82 ± 0.62 | 4.70 ± 0.72 | 0.420 |
Sodium (mmol/L) | 136.6 ± 3.2 | 137.8 ± 2.7 | 0.046 |
Calcium (mg/dL) | 8.7 ± 0.8 | 8.7 ± 1.0 | 0.978 |
Phosphorus (mg/dL) | 4.27 ± 1.69 | 5.02 ± 2.09 | 0.059 |
KF etiology | 0.015 | ||
Diabetes mellitus | 4 (8.5%) | 5 (9.1%) | |
Essential hypertension | 2 (4.3%) | 13 (23.6%) | |
Autoimmune disease | 7 (14.9%) | 2 (3.6%) | |
Other | 34 (72.3%) | 35 (63.6%) | |
HD mode | 0.418 | ||
Hemodiafiltration | 21 (44.7%) | 29 (52.7%) | |
Hemodialysis | 26 (55.3%) | 26 (47.3%) | |
Vascular access | 0.437 | ||
Arterio–venous fistula | 21 (46.7%) | 31 (58.5%) | |
Tunneled catheter | 21 (46.7%) | 18 (34.0%) | |
Non-tunneled catheter | 3 (6.7%) | 4 (7.5%) | |
Expecting renal transplant | 21 (45.7%) | 23 (41.8%) | 0.699 |
Arterial hypertension | 31 (70.5%) | 35 (63.6%) | 0.475 |
Diabetes mellitus | 8 (17.0%) | 9 (16.4%) | 0.929 |
Cardiac disease | 7(14.9%) | 9 (16.4%) | 0.839 |
Autoimmune disease | 6 (13.0%) | 1 (1.8%) | 0.027 |
Previous surgery | 1 (2.2%) | 1 (1.9%) | 0.909 |
Food of drug allergies | 12 (25.5%) | 6 (10.9%) | 0.009 |
Hepatitis B vaccine | 10 (21.3%) | 11 (20.0%) | 0.874 |
Full vaccination scheme | 8 (17.0%) | 12 (21.8%) | 0.543 |
Previous hospitalization | 13 (27.7%) | 9 (16.4%) | 0.167 |
Blood transfusion | 17 (36.2%) | 16 (29.1%) | 0.446 |
Smoking | 1 (2.1%) | 6 (10.9%) | 0.080 |
Alcohol use | 2 (4.3%) | 7 (12.7%) | 0.133 |
Variables | Women | Men | p-Value |
---|---|---|---|
(N = 47) | (N = 55) | ||
Monthly income (pesos) | 4000 (2000–5000) | 3200 (2000–5000) | 0.878 |
Commute time to clinic (hours) | 1.00 (0.75–0.62) | 1.00 (0.66–0.74) | 0.742 |
Commute expenses (pesos) | 100 (53–238) | 100 (58–150) | 0.222 |
Education | 0.986 | ||
Illiterate | 1 (2.1%) | 1 (1.8%) | |
Primary/secondary school | 25 (53.2%) | 30 (54.5%) | |
High school/College | 21 (44.7%) | 24 (43.6%) | |
Marital status | 0.399 | ||
Married or common-law | 27 (57.4%) | 27 (49.1%) | |
Single, widow(er), divorced | 20 (42.6%) | 28 (50.9%) | |
Work status | 0.341 | ||
Unemployed | 18 (40.0%) | 14 (26.4%) | |
Remunerated work | 22 (48.9%) | 33 (62.3%) | |
Non-remunerated work | 5 (11.1%) | 6 (11.3%) | |
Family structure | 0.888 | ||
Alone | 1 (2.1%) | 2 (3.6%) | |
Nuclear | 38 (80.9%) | 43 (78.2%) | |
Extensive | 8 (17.0%) | 10 (18.2%) | |
Role in the family | 0.193 | ||
Father/mother | 22 (47.8%) | 18 (33.3%) | |
Son/daughter | 14 (30.4%) | 23 (42.6%) | |
Husband/wife | 9 (19.6%) | 6 (11.1%) | |
Brother/sister | 1 (2.2%) | 4 (7.4%) | |
Other | 0 (0.0%) | 2 (3.7%) | |
House ownership | 0.281 | ||
Own | 23 (48.9%) | 35 (63.6%) | |
Borrowed | 10 (21.3%) | 10 (18.2%) | |
Other | 14 (29.8%) | 10 (18.2%) | |
Health insurance system | 0.660 | ||
IMSS | 32 (69.6%) | 37 (67.3%) | |
ISSSTE | 1 (2.2%) | 2 (3.6%) | |
Seguro popular | 5 (10.9%) | 3 (5.5%) | |
None/other | 8 (17.4%) | 13 (23.6%) | |
Private health insurance | 12 (25.5%) | 14 (25.5%) | 0.993 |
Variables | Women (N = 47) | Men (N = 55) | p-Value |
---|---|---|---|
Self-care | 77.1 ± 10.8 | 77.5 ± 9.9 | 0.871 |
HD symptoms | |||
Intensity (points) | 35.2 ± 21.8 | 22.2 ± 16.5 | 0.001 |
Prevalence (%) | 12.7 ± 6.5 | 8.9 ± 5.1 | 0.001 |
QoL | |||
Total score | 68.8 ± 13.6 | 73.4 ± 11.1 | 0.064 |
Symptoms | 83.3 (75.0–89.5) | 89.5 (79.1–93.7) | 0.002 |
Disease effect | 68.7 (62.5–81.2) | 78.1 (68.7–90.6) | 0.074 |
Renal disease load | 50 (25–69) | 50 (31–75) | 0.688 |
Work status | 50 (50–100) | 50 (0–100) | 0.721 |
Cognitive function | 86.6 (66.6–100.0) | 86.6 (73.3–100.0) | 0.499 |
Social interaction quality | 86.6 (66.6–100.0) | 86.6 (66.6–93.3) | 0.560 |
Sexual function | 93.7 (56.2–100.0) | 100.0 (65.6–100.0) | 0.640 |
Sleep | 56.6 (50–63.3) | 60.0 (53.3–63.3) | 0.114 |
Social support | 83.3 (66.6–100.0) | 83.3 (66.6–100.0) | 0.543 |
Positive interaction with health staff | 75.0 (62.5–100.0) | 87.5 (75.0–100.0) | 0.105 |
Patient’s satisfaction | 83.3 (50.0–100.0) | 83.3 (66.6–100.0) | 0.608 |
Physical functioning | 70 (40–80) | 75 (60–90) | 0.033 |
Physical role | 50 (25–100) | 75 (25–100) | 0.446 |
Pain | 68 (55–90) | 88 (68–100) | 0.039 |
Overall health | 50 (45–65) | 65 (50–75) | 0.041 |
Emotional status | 80 (64–92) | 84 (76–96) | 0.063 |
Emotional role | 100 (67–100) | 100 (100–100) | 0.307 |
Social function | 75 (63–100) | 88 (63–100) | 0.497 |
Fatigue/energy | 60 (40–80) | 70 (55–80) | 0.044 |
Self-Care | HD Symptoms Prevalence | HD Symptoms Intensity | ||||
---|---|---|---|---|---|---|
Variables | Women (N = 47) | Men (N = 55) | Women (N = 47) | Men (N = 55) | Women (N = 47) | Men (N = 55) |
Total score | 0.415 * | 0.293 * | −0.539 * | −0.512 * | −0.580 * | −0.513 * |
Symptoms | 0.167 | 0.040 | −0.660 * | −0.631 * | −0.757 * | −0.610 * |
Disease effect | 0.380 * | 0.137 | −0.391 * | −0.403 * | −0.350 * | −0.409 * |
Renal disease load | 0.463 * | 0.228 | −0.320 * | −0.294 * | −0.317 * | −0.331 * |
Work status | 0.030 | 0.037 | −0.175 | −0.171 | −0.261 | −0.120 |
Cognitive function | 0.328 * | 0.002 | −0.396 * | −0.573 * | −0.485 * | −0.556 * |
Social interaction quality | 0.151 | 0.216 | −0.416 * | −0.455 * | −0.497 * | −0.453 * |
Sexual function | 0.297 | 0.091 | −0.112 | −0.165 | −0.240 | −0.237 |
Sleep | 0.155 | 0.375 * | −0.334 * | −0.363 * | −0.446 * | −0.390 * |
Social support | 0.295 * | 0.158 | −0.261 | −0.173 | −0.246 | −0.114 |
Positive interaction with health staff | 0.284 | 0.132 | 0.133 | −0.082 | 0.159 | −0.011 |
Patient’s satisfaction | 0.340 * | 0.021 | 0.062 | 0.003 | 0.113 | −0.001 |
Physical functioning | 0.297 * | 0.270 * | −0.249 | −0.233 | −0.196 | −0.204 |
Physical role | 0.163 | 0.158 | −0.349 * | −0.104 | −0.347 * | −0.119 |
Pain | 0.081 | 0.095 | −0.546 * | −0.479 * | −0.564 * | −0.485 * |
Overall health | 0.273 | 0.069 | −0.295 * | −0.132 | −0.333 * | −0.157 |
Emotional status | 0.297 * | 0.189 | −0.603 * | −0.468 * | −0.669 * | −0.469 * |
Emotional role | 0.048 | 0.158 | −0.351 * | −0.268 * | −0.438 * | −0.298 * |
Social function | 0.210 | 0.181 | −0.493 * | −0.377 * | −0.488 * | −0.392 * |
Fatigue/energy | 0.300 * | 0.272 * | −0.552 * | −0.450 * | −0.575 * | −0.419 * |
Variables | All Patients (N = 102) | Women (N = 47) | Men (N = 55) |
---|---|---|---|
Age (years) | 0.058 | 0.009 | 0.093 |
Body mass index (Kg/m2) | −0.190 | −0.113 | −0.259 |
Diagnosis time (months) | 0.051 | 0.104 | −0.023 |
HD vintage (months) | −0.078 | −0.086 | −0.105 |
Hemoglobin (mg/dL) | −0.049 | 0.014 | −0.061 |
Glucose (mg/dL) | −0.185 | −0.257 | −0.136 |
Creatinine (mg/dL) | −0.056 | −0.227 | 0.032 |
Blood urea nitrogen (mg/dL) | −0.001 | −0.115 | 0.123 |
Uric acid (mg/dL) | −0.121 | −0.179 | −0.062 |
Albumin (g/dL) | 0.170 | 0.146 | 0.194 |
Potassium (mEq/L) | 0.028 | −0.139 | 0.163 |
Sodium (mmol/L) | 0.043 | 0.119 | 0.024 |
Calcium (mg/dL) | −0.093 | −0.072 | −0.122 |
Phosphorous (mg/dL) | −0.081 | −0.070 | −0.108 |
Monthly income | −0.009 | 0.017 | −0.044 |
Commute time to clinic (hours) | 0.213 * | 0.206 | 0.220 |
Commute expenses (pesos) | 0.094 | 0.167 | 0.027 |
Prevalence HD symptoms | −0.050 | −0.175 | 0.019 |
Intensity HD symptoms | −0.018 | −0.081 | 0.003 |
Variable | Women | Men |
---|---|---|
(N = 47) | (N = 55) | |
Diabetes Mellitus | ||
Yes | 69.9 ± 17.5 | 77.7 ± 8.1 |
No | 78.7 ± 8.6 a | 77.5 ± 10.4 |
Arterial hypertension | ||
Yes | 75.4 ± 11.8 | 77.4 ± 10.2 |
No | 80.6 ± 7.9 | 77.6 ± 9.7 |
Cardiac disease | ||
Yes | 72 ± 11.7 | 75.9 ± 10.4 |
No | 78 ± 10.62 | 77.8 ± 9.9 |
Allergy | ||
Yes | 78.1 ± 13.8 | 74.3 ± 3.5 |
No | 76.8 ± 9.8 | 77.8 ± 10.4 |
Previous hospitalization | ||
Yes | 76.1 ± 12.0 | 80.7 ± 9.6 |
No | 77.5 ± 10.5 | 76.8 ± 10.0 |
Previous transfusion | ||
Yes | 76.4 ± 11.8 | 80.3 ± 7.8 |
No | 77.5 ± 10.4 | 76.3 ± 10.5 |
Alcohol drinking | ||
Yes | 75 ± 8.2 | 80 ± 7.6 |
No | 77.2 ± 11 | 77.1 ± 10.2 |
Education | ||
Illiterate, primary or secondary | 75.2 ± 13 | 77.1 ± 9.7 |
High school or college | 79.5 ± 6.9 | 77.9 ± 10.4 |
Marital status | ||
Married/common-law partner | 77 ± 10.4 | 78 ± 10.6 |
Single/widow(er)/divorced | 77.3 ± 11.6 | 77 ± 9.4 |
Work status | ||
Remunerated work | 73.1 ± 10.5 | 78.4 ± 10.1 |
Unemployed/Non-remunerated | 75.5 ± 11.0 | 76 ± 10.1 |
House ownership | ||
Own | 76.8 ± 14.1 | 76.1 ± 11.1 |
Borrowed | 79.4 ± 6.8 | 79.4 ± 81.6 |
Other | 76.1 ± 6.5 | 76.1 ± 8 |
Health insurance system | ||
Government agency | 77.4 ± 10.06 | 76.7 ± 10.1 |
None/other | 74.1 ± 14.3 | 79.8 ± 9.2 |
Private health insurance | ||
Yes | 77.2 ± 9.8 | 79.1 ± 10.1 |
No | 77.1 ± 11.3 | 76.93 ± 9.9 |
Hemodialysis mode | ||
Hemodiafiltration | 80.6 ± 6.9 | 78.5 ± 7.8 |
Hemodialysis | 74.3 ± 12.6 b | 76.3 ± 11.9 |
Vascular access | ||
Arterio-venous fistula | 79.4 ± 9.6 | 78.1 ± 7.5 |
Tunneled catheter | 74.7 ± 12.1 | 73.6 ± 12.4 |
Non-tunneled catheter | 81.1 ± 13.0 | 86 ± 10.5 |
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Lerma, C.; Lima-Zapata, L.I.; Amaya-Aguilar, J.A.; Leonardo-Cruz, I.; Lazo-Sánchez, M.; Bermúdez, L.A.; Pérez-Grovas, H.; Lerma, A.; Cadena-Estrada, J.C. Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients. Int. J. Environ. Res. Public Health 2021, 18, 13022. https://doi.org/10.3390/ijerph182413022
Lerma C, Lima-Zapata LI, Amaya-Aguilar JA, Leonardo-Cruz I, Lazo-Sánchez M, Bermúdez LA, Pérez-Grovas H, Lerma A, Cadena-Estrada JC. Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients. International Journal of Environmental Research and Public Health. 2021; 18(24):13022. https://doi.org/10.3390/ijerph182413022
Chicago/Turabian StyleLerma, Claudia, Larissa I. Lima-Zapata, Jorge A. Amaya-Aguilar, Itzel Leonardo-Cruz, Monica Lazo-Sánchez, Luis A. Bermúdez, Héctor Pérez-Grovas, Abel Lerma, and Julio César Cadena-Estrada. 2021. "Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients" International Journal of Environmental Research and Public Health 18, no. 24: 13022. https://doi.org/10.3390/ijerph182413022