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