Quality of life and spirituality of patients with chronic kidney disease: pre- and post-transplant analysis

Olivera, Letícia Meazzini de; Okuno, Meiry Fernanda Pinto; Barbosa, Dulce Aparecida; Sesso, Ricardo de Castro Cintra; Scherrer Júnior, Gerson; Pessoa, João Luis Erbs; Fonseca, Cassiane Dezoti da; Belasco, Angélica Gonçalves Silva

doi:10.1590/0034-7167-2019-0408

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (suppl 5) • 2020 • https://doi.org/10.1590/0034-7167-2019-0408 copy

Quality of life and spirituality of patients with chronic kidney disease: pre- and post-transplant analysis

Calidad de vida y espiritualidad de los pacientes con insuficiencia renal crónica: análisis pre y posterior al trasplant

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to compare the quality of life (QoL) of patients under dialysis and after kidney transplant; correlate the QoL of transplant patients to sociodemographic, morbid and spirituality/religiosity variables.

Method:

prospective study with a quantitative approach, with a sample of 27 patients who underwent peritoneal dialysis or dialysis undergoing kidney transplant. QoL and spirituality were assessed by the KDQOL-SF and WHOQOL-SRPB tools, being correlated with sociodemographic and economic variables.

Results:

the dimensions of total mental component, kidney disease effects and kidney disease burden showed significant improvement in the post-transplant period, with p <0.0004. There was a significant correlation between four dimensions of spirituality and seven dimensions of QoL; p ranged from 0.04 to 0.006.

Conclusion:

there was a significant improvement in QoL in the post-transplant period. The dimensions of spirituality: wholeness and integration, spiritual connection, wonder and inner peace were positively correlated with seven dimensions of QoL.

Descriptors:
Renal Insufficiency; Chronic; Kidney Transplantation; Quality of Life; Spirituality; Religion

Variables (n)	n (%)
Number of patients	27 (100)
Average age (years)	55.1
Feminine gender	17 (63)
Male gender	10 (37)
White skin color	18 (66.7)
Family income (wages)
from 3 to 7	12 (44.4)
from 1.5 to 3	7 (25.9)
Up tp 1.5	5 (18.6)
from 7 to 14	2 (7.4)
14 and older	1 (3.7)
Schooling
Elementary School	12 (44.4)
High school	10 (37)
Higher education	3 (11.2)
Illiterate	2 (7.4)
Occupation^* * The sum of occupancy items before transplant exceeds 100%, as they are non-excluding items. 1 - Umbanda is a Brazilian religion that blends African religions with Catholicism, Spiritism, and considerable indigenous lore; 2- Candomblé ("dance in honour of the gods") is an African-originated or Afro-Brazilian religion, practiced mainly in Brazil by the "povo de santo" ("people of the saint"). It is a mixture of traditional Yoruba, Fon, and Bantu beliefs which originated from different regions in Africa.
Retired	13 (48.10)
Employee/Self Employed	8 (29.6)
Pension/Paid Sick Leave	5 (18.6)
From home	1 (3.7)
Religion
Catholic	19 (70.4)
Evangelical	6 (22.2)
Spiritist	1 (3.7)
Umbanda¹/Camdomblé ²	1 (3.7)
Marital status
Married /Stable union	15 (55.6)
Not married	9 (33.3)
Separated/Divorced	2 (7.4)
Widower	1 (3.7)

	Dialytic Modality		p value
	Dialysis	Peritoneal Dialysis	p value
Total physical component			0.0479
Pre	47.7(8.6)	49.7(10.8)
Post	44.2(9.2)	44.3(9.9)
Total mental component			<0.0001
Pre	38.4(6.2)	40.6(6.7)
Post	50.4(9.9)	53.1(9.9)
Kidney disease effects			<0.0001
Pre	66.7(19.4)	71.7(21.5)
Post	93.1(1.9)	93(10.6)
Kidney disease burden			0.0004
Pre	37.5(30.6)	55.7(34.2)
Post	74.7(23)	80.7(14.2)

Variables (n)	Sleep	Social Support	Social Aspects	Patient Satisfaction	Work Situation	Vitality
Gender	*	∞	*
Female (17)	70	79	62	NS	NS	NS
Male (10)	84	100	84	NS	NS	NS
Marital status						*
Married (15)	NS	NS	NS	NS	NS	71
Single, separated or widower (12)	NS	NS	NS	NS	NS	56
Skin color				*
White (18)	NS	NS	NS	61	NS	NS
Non-white (9)	NS	NS	NS	76	NS	NS
Occupation					°
Employed (4)	NS	NS	NS	NS	75	NS
Self Employed (4)	NS	NS	NS	NS	100	NS
Retired/From home (14)	NS	NS	NS	NS	39	NS
Paid Sick Leave (5)	NS	NS	NS	NS	10	NS

Variables (n)	QSI	CF	SP	V	PA	WELL	TPC
Religion	α
Others (8)	94	NS	NS	NS	NS	NS	NS
Catholic (19)	79	NS	NS	NS	NS	NS	NS
Pray once a day or more				α	*
Yes (21)	NS	NS	NS	69	78	NS	NS
No (6)	NS	NS	NS	48	57	NS	NS
Acute rejection		*			*	**	*
Yes (4)	NS	55	NS	NS	50	48	35
No (23)	NS	84	NS	NS	77	81	46
Infection episode					*		**
Yes (15)	NS	NS	NS	NS	65	NS	40
No (12)	NS	NS	NS	NS	83	NS	49
Pre-transplant guidance			*	β	*		β
Yes (23)	NS	NS	87	69	78	NS	46
No (4)	NS	NS	75	39	47	NS	31

	Spiritual Connection		Admiration		Wholeness and Integration		Inner Peace
	R	p	R	p	R	p	R	p
Kidney disease effects	-0.08	NS	0.15	NS	0.42	0.0296	0.20	NS
Overload imposed by kidney disease	0.36	NS	0.42	0.0286	0.36	NS	0.33	NS
Function	0.21	NS	0.24	NS	0.38	0.0480	0.44	0.0221
Cognitive	0.34	NS	0.08	NS	0.51	0.0064	0.26	NS
Capacity	0.31	NS	0.20	NS	0.37	NS	0.41	0.0346
functional	-0.003	NS	0.08	NS	0.38	NS	0.49	0.0099
Patient Satisfaction	0.42	0.0281	0.14	NS	0.29	NS	0.35	NS

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[1] Corresponding author: Letícia Meazzini de Olivera E-mail: leticia.oliveira@unifesp.br