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People assess their quality of life (QoL) using internal standards, values, and priorities. With health changes, QoL responses shift to reflect current realities. This qualitative study investigated the life experience and QoL assessments of people living with dialysis (PWDs).
Thirty-one interviews with 20 PWDs over the age of 70 (mean time on dialysis 34 months) and 11 family members investigated experience with disease and dialysis, related life challenges, medical decision-making, and future planning. Interviews were recorded, transcribed, and analyzed for themes and hypotheses using qualitative methods and description.
When beginning dialysis, PWDs’ reported that life on dialysis was worth living and recalibrated their QoL assessments incorporating this standard into their daily lives. Three themes emerged as the disease progressed and dialysis became more difficult: PWDs first reported thriving on dialysis and then surviving with the support of dialysis, and when QoL was reported as poor, PWDs were reconsidering whether dialysis was still worth the life it was providing. Each of these steps involved changes in health circumstances, and PWDs explained their QoL assessments at each step using differing values and priorities. These steps in reconceptualization and reprioritization demonstrated PWDs’ Response Shift and eventually led to another (recalibrated) standard: Life with dialysis was no longer worth living.
Quality-of-life assessment is an on-going process for older dialysis patients. Clinicians should be alert for changes in subjective QoL statements as dialysis and underlying diseases progress. Response Shift explains these changes in assessment.
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Arnold, R. M., & Zeidel, M. L. (2007). Dialysis in frail elders: A role for palliative care. New England Journal of Medicine,361(16), 1597–1598. CrossRef
Russ, A. J., & Kaufman, S. R. (2012). Discernment rather than decision-making among elderly dialysis patients. Sem Dial,25(1), 31–32. CrossRef
U. S. Renal Data System. (2011). USRDS 2011 annual data report: Atlas of chronic kidney disease and end-stage renal disease in the United States. Bethesda, MD: National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases.
Lazarus, R. S. (1999). Stress and emotion: A new synthesis. New York, New York: Springer.
Al-Arabi, S. (2006). Quality of life: Subjective descriptions of challenges to patients with end stage renal disease. Nephrology Nursing Journal,33(3), 285–292. PubMed
Kaplan Denour, A. (1981). Prediction of adjustment to chronic hemodialysis. In N. B. Levy (Ed.), Psychonephrology I. psychological factors in hemodialysis and transplantation (pp. 117–132). New York: Plenum. CrossRef
Kutner, N. G., & Jassal, S. V. (2002). Quality of life and rehabilitation of elderly dialysis patients. Sem Dial,15(2), 107–112. CrossRef
Ferrans, C. E., & Powers, M. J. (1993). Quality of life of hemodialysis patients. American Nephrology Nursing Association Journal,20(5), 575–581.
Kimmel, P. L., Peterson, R. A., Weihs, K. L., Simmens, S. J., Boyle, D. H., Cruz, I., et al. (1995). Aspects of quality of life in hemodialysis patients. Journal of the American Society of Nephrology,6(5), 1418–1426. PubMed
Kimmel, P. L. (2000). Just whose quality of life is it anyway? Controversies and consistencies in measurements of quality of life. Kidney International,57(Suppl 74), S113–S120. CrossRef
Hays, R. D., Kallich, J. D., Mapes, D. L., et al. (1997). Kidney disease quality of life short form (KDQOL-SF), Version 1.3: A manual for use and scoring. Santa Monica, CA: Rand.
US Congress Office of Technology Assessment. (1989). Life –sustaining technologies and the elderly: Excerpts of congressional OTA study. Nephrology News Issues,3(10), 22. 31-34.
Rapkin, B. D., & Schwartz, C. E. (2004). Toward a theoretical model of quality-of-life appraisal: Implications of findings from studies of response shift. Health and Quality of Life Outcomes,2(14), 1–12.
Schwartz, C. E., & Rapkin, B. D. (2004). Reconsidering the psychometrics of quality of life assessment in light of response shift an appraisal. Health and Quality of Life Outcomes,2(16), 1–11.
Boucekine, M., Loundou, A., Baumstarck, K., Minaya-Flores, P., Pelletier, J., Ghattas, B., et al. (2013). Using the random forest method to detect a response shift in the quality of life of multiple sclerosis patients: A cohort study. BMC Medical Research Methodology, 13(20): http://www.biomedcentral.com/1471-2288/13/20.
Neuman, H. B., Fuzesi, S., & Temple, L. K. (2012). Rectal caner patients’ quality of life with a temporary stoma: Shifting perspectives. Diseases of the Colon and Rectum,55(11), 117–1124. CrossRef
Rapkin, B. (2000). Personal goals and response shifts: Understanding the impact of illness and events on the quality of life of people living with AIDS. In C. E. Schwartz & M. A. G. Sprangers (Eds.), Adaptation to changing health: Response shift in quality of life research (pp. 53–71). Washington DC: American Psychological Association. CrossRef
O’Boyle, C.A., Browne, J., Hickey, A., McGee, H.M., Joyce, C.R. (1995). Schedule for the evaluation of individual quality of life (SEIQoL): A direct weighting procedure for quality of life domains (SEIQoL- DW). Administration Manual, Dublin, Department of Psychology, Royal College of Sur.
Creswell, J. W. (1998). Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks: Sage Publications.
Frankland, J., & Bloor, M. (1999). Some issues arising in the systematic analysis of focus group materials. In R. S. Barbour & J. Kitzinger (Eds.), Developing focus group research: Politics, theory and practice (pp. 144–155). London: Sage. CrossRef
- Shifting responses in quality of life: People living with dialysis
Barbara A. Elliott
Charles E. Gessert
Pamela M. Larson
Thomas E. Russ
- Springer International Publishing