Abstract
Introduction. The decline in quality of life among geriatric patients undergoing hemodialysis has a negative impact on treatment adherence, physical functioning, dietary patterns, and mortality. This study was conducted to assess the quality of life of geriatric hemodialysis patients and its association with comorbidities, functional status, frailty, sarcopenia, nutritional status, depression, hemoglobin levels, hemodialysis vintage, vascular access, and hemodialysis adequacy.
Methods. This study employed a cross-sectional design with primary data collection. Consecutive sampling was used to recruit participants. The study was conducted at the hemodialysis units of Cipto Mangunkusumo National General Hospital (RSCM), Persahabatan National General Hospital (RSP), and Fatmawati National General Hospital (RSF) from June 2024 to August 2024. The inclusion criteria were patients aged ≥60 years undergoing maintenance hemodialysis. Exclusion criteria were unstable clinical condition, cognitive or mental impairment, and refusal to participate. Quality of life was assessed using the EQ-5D-5L instrument. Data on medical history and laboratory findings were obtained from hospital medical records. Bivariate analysis was performed using the Mann–Whitney U test for comorbidities, sarcopenia, depression, hemoglobin level, vascular access, and dialysis adequacy; the Kruskal–Wallis test for frailty, functional status, and nutritional status; and Spearman’s correlation for hemodialysis vintage. Multivariate analysis was conducted using linear regression to identify factors associated with reduced quality of life.
Results. A total of 124 subjects (mean age 67 years) were included in this study. The mean EQ-5D-5L index score was 0.76 (IQR 0.63–1.00), while the mean VAS score was 70. The majority of subjects (75%) reported no difficulties in self-care or daily activities. Functional status (p < 0.0001) and depression (p < 0.002) were significantly associated with the quality of life in geriatric patients undergoing hemodialysis, with an adjusted R² value of 0.642.
Conclusions. Geriatric patients undergoing HD at RSCM, RSP, and RSF had an average EQ-5D-5L index score of 0.76 (out of 1.000), and 75% of the patients reported no issues with self-care and daily activities. Functional status and depression have been proven to play a significant role in determining their quality of life.
Bahasa Abstract
Pendahuluan. Penurunan kualitas hidup pada pasien geriatri yang menjalani hemodialisis (HD) berdampak negatif pada kepatuhan berobat, kemampuan fisik, pola makan, dan mortalitas. Penelitian ini dilakukan untuk mengetahui gambaran kualitas hidup pasien geriatri yang menjalani HD serta hubungannya dengan komorbiditas, status fungsional, frailty, sarkopenia, status nutrisi, depresi, kadar hemoglobin, lama (vintage) HD, akses vaskular, dan adekuasi HD.
Metode. Desain penelitian ini adalah potong lintang dengan menggunakan data primer. Pengambilan sampel menggunakan metode consecutive sampling. Penelitian dilaksanakan di Unit HD RSUPN Dr. Cipto Mangunkusumo (RSCM), RSUP Persahabatan (RSP), dan RSUP Fatmawati (RSF) dalam periode Juni 2024 – Agustus 2024 pada pasien berusia 60 tahun ke atas yang menjalani hemodialisis. Pasien dengan kondisi tidak stabil, gangguan kognitif dan mental, dan pasien yang menolak mengikuti penelitian dieksklusi dari penelitian. Kualitas hidup diukur menggunakan instrumen EQ-5D-5L. Data riwayat penyakit dan hasil pemeriksaan laboratorium diperoleh dari rekam medis rumah sakit. Analisis bivariat dilakukan menggunakan uji Mann-Whitney untuk variabel komorbiditas, sarkopenia, depresi, kadar hemoglobin, akses vaskular, dan adekuasi HD; uji Kruskal-Wallis untuk variabel frailty, status fungsional, dan status nutrisi; serta uji korelasi Spearman untuk variabel lama HD. Analisis multivariat menggunakan regresi linier dilakukan untuk mengidentifikasi faktor yang berhubungan dengan penurunan kualitas hidup.
Hasil. Sebanyak 124 subjek (rerata usia 67 tahun) diikutsertakan dalam studi ini. Rerata skor indeks EQ-5D-5L tercatat sebesar 0,76 (RIK 0,63–1,00), sementara rerata skor visual analog scale (VAS) adalah 70. Sebanyak 75% subjek tidak mengalami kesulitan dalam perawatan diri maupun aktivitas sehari-hari. Status fungsional (p < 0,001) dan depresi (p < 0,002) merupakan faktor yang berhubungan signifikan dengan kualitas hidup pasien geriatri yang menjalani hemodialisis, dengan nilai adjusted R² sebesar 0,642.
Kesimpulan. Pasien geriatri yang menjalani HD di RSCM, RSP, dan RSF memiliki rerata skor indeks EQ-5D-5L 0,76 (dari 1,000) dan 75% pasien tidak memiliki masalah pada perawatan diri dan aktivitas sehari-hari. Status fungsional dan depresi terbukti berperan penting dalam menentukan kualitas hidup mereka.
Kata Kunci: geriatri, hemodialisis, kualitas hidup, penyakit ginjal tahap akhir
Recommended Citation
Mohammad, Nurhidayat; Soejono, Czeresna Heriawan; Lydia, Aida; Rinaldi, Ikhwan; Syafiq, Muhammad; and Wardoyo, Elizabeth Yasmine
(2025)
"Faktor-Faktor yang Berhubungan dengan Kualitas Hidup Pasien Geriatri yang Menjalani Hemodialisis,"
Jurnal Penyakit Dalam Indonesia: Vol. 12:
Iss.
4, Article 1.
DOI: 10.7454/jpdi.v12i4.1733
Available at:
https://scholarhub.ui.ac.id/jpdi/vol12/iss4/1
Included in
Geriatrics Commons, Internal Medicine Commons, Nephrology Commons
