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The SF36 as an outcome measure of services for end stage renal failure

By J.P. Wight, L. Edwards, J.E. Brazier, S. Walters, J.N. Payne and C.B. Brown


OBJECTIVE: —To evaluate the use of the short\ud form 36 (SF36) as a measure of health\ud related quality of life of patients with end\ud stage renal failure, document the results,\ud and investigate factors, including mode of\ud treatment, which may influence it.\ud DESIGN: Cross sectional survey of patients\ud with end stage renal failure, with the\ud standard United Kingdom version of the\ud SF36 supplemented by specific questions\ud for end stage renal failure.\ud SETTING: A teaching hospital renal unit.\ud Subjects and methods—660 patients\ud treated at the Sheffield Kidney Institute by\ud haemodialysis, peritoneal dialysis, and\ud transplantation. Internal consistency, percentage\ud of maximal or minimal responses,\ud SF36 scores, effect sizes, correlations\ud between independent predictor variables\ud and individual dimension scores of the\ud SF36. Multiple regression analysis of the\ud SF36 scores for the physical functioning,\ud vitality, and mental health dimensions\ud against treatment, age, risk (comorbidity)\ud score, and other independent variables.\ud RESULTS: A high response rate was\ud achieved. Internal consistency was good.\ud There were no floor or ceiling effects other\ud than for the two “role” dimensions. Overall\ud health related quality of life was poor\ud compared with the general population.\ud Having a functioning transplant was a significant\ud predictor of higher score in the\ud three dimensions (physical functioning,\ud vitality, and mental health) for which\ud multiple regression models were constructed.\ud Age, sex, comorbidity, duration\ud of treatment, level of social and emotional\ud support, household numbers, and hospital\ud dialysis were also (variably) significant\ud predictors.\ud CONCLUSIONS: The SF36 is a practical and\ud consistent questionnaire in this context,\ud and there is evidence to support its\ud construct validity. Overall the health related\ud quality of life of these patients is\ud poor, although transplantation is associated\ud with higher scores independently of\ud the effect of age and comorbidity. Age,\ud comorbidity, and sex are also predictive of\ud the scores attained in the three dimensions\ud studied. Further studies are required\ud to ascertain whether altering those\ud predictor variables which are under the\ud influence of professional carers is associated\ud with changes in health related quality\ud of life, and thus confirm the value of this\ud outcome as a measure of quality of care

Year: 1998
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