Measuring the health status burden in hemodialysis patients using the SF-36® health survey
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The SF-36, a generic measure of 8 domains of health-related quality of life (HRQOL), has been widely used to examine HRQOL of end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). The current study synthesizes existing literature to examine which SF-36 domains capture the largest burden in this patient population.
A literature search of published studies that presented descriptive statistics for baseline SF-36 scale scores from HD patients was conducted. Disease burden was estimated by comparing HD patients’ SF-36 scores to those from either a control group or a general population normative sample taken from the same country. For each study, Cohen d effect sizes for between-sample differences were calculated for each scale.
Twenty-six articles that matched set criteria were identified. Estimation of differences between HD patients and comparison groups showed that the SF-36 physical functioning scale yielded the largest weighted mean effect size across studies (d = 1.46), followed by the general health (d = 1.29) and role physical (d = 1.21) scales.
Among the eight domains of the SF-36, physical functioning, general health, and role physical scales best captured disease burden for HD patients. The disease burden negatively impacts physical HRQOL more strongly than mental HRQOL.
KeywordsRenal dialysis Quality of life Cost of illness Meta-analysis Questionnaires
Bodily pain scale
End-stage renal disease
General health scale
Health-related quality of life
Kidney disease quality of life instrument
Mental component summary score
Mental health scale
Physical component summary score
Physical functioning scale
Role emotional scale
Role physical scale
Social functioning scale
Short form 36 health survey
The current research was supported by Novo Nordisk A/S. The writing of this manuscript was supported by funding from Novo Nordisk A/S. Authors from Novo Nordisk A/S own stock and/or hold stock options in the company. Non-Novo Nordisk A/S authors do not own or hold stock options in the company.
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