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BACKGROUND: Kidney transplantation is currently the best choice for renal replacement therapy, due to its effect in reducing mortality and improving the quality of life (QoL) of patients with end-stage renal disease. This study aimed to identify factors affecting QoL after kidney transplantation. METHODS: We conducted a cross sectional study by recruiting patients who had kidney transplantation at Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from 2018 - 2020. QoL was assessed using the 36-item Short Form Health Survey (SF-36) questionnaire. We evaluated age, sex, body mass index, hemoglobin level, estimated glomerular filtration rate, duration of dialysis before transplantation, history of diabetes, depression, and performance status as factors associated with QoL score. RESULTS: We involved 107 subjects in our study. Depression, hemoglobin level, ECOG performance status, and duration of dialysis were factors affecting the physical component score (R2=0.21). Depression and hemoglobin level were factors affecting the mental component score (R2=0.34 ). Depression, hemoglobin level, and ECOG performance status were factors contributed to the total QoL score (R2=0.41). CONCLUSION: Factors that contributed to QoL status were depression, ECOG performance status, and hemoglobin levels. This study supported the need for assessment of QoL on regular basis, psychological aspects including depression, as well as other factors that can affect QoL such as performance status and hemoglobin level in patients before and after kidney transplantations.
RESUMO
BACKGROUND: Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality of life in these patients. OBJECTIVES: This study was designed to evaluate the effect of a mind-body interactive qigong intervention on the physical and mental aspects of quality of life, considering bio-physiological and mental covariates in subacute stroke inpatients. METHODS: A randomized controlled trial with repeated measures design was used. A total of 68 participants were recruited from the medical and rehabilitation wards at a teaching hospital in northern Taiwan and then randomly assigned either to the Chan-Chuang qigong group, which received standard care plus a 10-day mind-body interactive exercise program, or to the control group, which received standard care only. Data were collected using the National Institutes of Health Stroke Scale, Hospital Anxiety and Depression Scale, Short Form-12, stroke-related neurologic deficit, muscular strength, heart rate variability and fatigue at three time points: pre-intervention, halfway through the intervention (day 5) and on the final day of the intervention (day 10). RESULTS: The results of the mixed-effect model analysis showed that the qigong group had a significantly higher quality of life score at day 10 (p<0.05) than the control group. Among the covariates, neurologic deficit (p=0.04), muscle strength (p=0.04), low frequency to high frequency ratio (p=0.02) and anxiety (p=0.04) were significantly associated with changes in quality of life. Conversely, heart rate, heart rate variability (standard deviation of normal-to-normal intervals, low frequency and high frequency), fatigue and depression were not significantly associated with change in quality of life (p >0.05). CONCLUSIONS: This study supports the potential benefits of a 10-day mind-body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inpatients.