Journal of Mazandaran University of Medical Sciences (Oct 2023)
The Relationship between Dialysis Adequacy and Quality of Life: The Mediating Effect of Sleep Quality in Hemodialysis Patients in Medical Education Centers of Mazandaran University of Medical Sciences
Abstract
Background and purpose: Patients undergoing hemodialysis experience many problems, both physically and mentally, which lead to low quality of sleep, and subsequent changes in the quality of their life. In addition, dialysis adequacy plays a pivotal role in the quality of their life. Therefore, the present study was conducted to determine the relationship between dialysis adequacy and quality of life with the mediating effect of sleep quality. Materials and methods: A descriptive, analytical, correlational study was performed on 208 patients undergoing hemodialysis in medical education centers of Mazandaran using head count sampling. The implemented tools included demographic information checklist, WHOQOL quality of life questionnaires, Pittsburgh sleep quality (PSQI), and dialysis adequacy checklist. The data were analyzed using SPSS V22 and performing the statistical tests of t-test (comparing the mean of two groups), analysis of variance (comparing the mean of more than two groups), and Pearson correlation (to check the correlation between two quantitative variables). Multiple linear regression was used to identify factors affecting the score of dependent variables and to control confounding variables. Structural equation analysis was also used to investigate the relationship between dialysis adequacy and quality of life with regard to the mediating effect of sleep quality. Results: The mean and standard deviation of quality of life, sleep quality, and dialysis adequacy were 48.43±17.14, 5.52±3.46, and 1.28±0.30, respectively. Based on the results of correlation coefficient and structural equations, no statistically significant relationship was found between dialysis adequacy and quality of life (P=0.114). There was a significant inverse relationship between dialysis adequacy and the score of sleep quality (a score of less than 5 is desirable) (r=0.15, P=0.034), so that the quality of sleep improved as the dialysis adequacy increased. There was a statistically significant and inverse relationship between sleep quality score and quality of life (r=-0.53, P<0.001) so that improvement in the quality of sleep contributed to the improvement in the quality of life. Conclusion: Sleep quality, as a mediator factor which is influenced by the adequacy of dialysis, affects the overall quality of life and improves the quality of life in dialysis patients.
