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Social Life of End Stage Renal Disease Patients
Pakistan Journal of Medical and Biological Sciences
www.pjmbs.com
ORIGINAL
Social Life of End Stage Renal Disease Patients
Zahira Batool, Muhammad Nafees, Rizwan Ashraf*, Umer Hayyat, Sajjad Anwar
Chronic Kidney Disease (CKD) is associated with premature deaths,
low quality of life and high cost medical treatment problems worldwide. When
CKD did not cured, the End Stage Renal Disease (ESRD) emerge which
required to be treated by Renal Replacement Therapy (RRT) that comprises of
kidney transplant, or dialysis. Due to the dependency on the family members,
inability to participate in economic activities and inability to fulfill various social
responsibilities, such patients face many social problems. The objectives of
this study is focused the socio-economic characteristics of the respondents,
impact of ESRD on social life of patients, and to suggest some policy measure
to eliminate the social problems of such patients. The Study design was cross
sectional study. The study was conducted at Dialysis center of Allied Hospital
Faisalabad, Pakistan in the month of December, 2017 and its duration was one
month. A total sample of 105 respondents was recruited through convenient
sampling technique and responses were obtained using a structured interview
schedule. Data was analyzed and interpreted using (SPSS version 22). The
study concluded that patients of ESRD were facing a lot of social problems
due to the inability to participate in paid work, inability to fulfill their social
responsibilities, and dependency on their family members for their dialysis
and routine activities. There is need to address their social problems through
suitable policy initiatives.
Abstract:
Department of Sociology,
Government College University,
Faisalabad
Corresponding Author Email:-
Keywords: ESDR, Social life, patients
INTRODUCTION
Chronic Kidney Disease is a global health
problem that is related with early age deaths,
diminished life quality, and expanded healthcare
expenses. Kidney diseases are responsible for
20,000 deaths each year in Pakistan. If CKD is
not treated, it can cause ESRD that require RRT
in form of kidney transplantation or dialysis. Now
a days, ESRD is considered to be a disease
whom treatment is expensive particularly in less
developed countries due to less resources (1).
The victims of CKD who rely on RRT usually
encounter troubles in participating in different
spheres of life, for example, sports, paid works,
and other leisure and social exercises (2). Also
this disease adds up to failure of these patients
to have a job because of the inordinate utilization
of time amid their day by day visits and their
Pak J Med Biol Sci 2018 - Vol. 2, Issue 1
conceivable hospitalizations (3). So all the social
dimensions of the victims of ESRD are altered
with misery and they are compelled to spend a
restricted life.
MATERIAL AND METHODS
This cross-sectional study was carried out in
the dialysis center located in Allied Hospital,
Faisalabad Punjab, Pakistan in December,
2017. Prior permissions for data collection were
obtained from the Medical superintendent of the
hospital and also from the head of nephrology
department.
METHODOLOGY
A total number of 105 respondents were
recruited in this study to collect responses
using convenient sampling technique. Consent
from all the respondents was also taken before
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Social Life of End Stage Renal Disease Patients
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conducting their interviews. In order to diminish
bias, all the respondents were interviewed by the
same (one) researcher. Data was collected by the
researcher using a structured interview schedule.
The collected data was analyzed by using SPSS
(version 22). Univariate and bivariate statistical
techniques were applied to analyze the data. The
patients with diagnosed ESRD receiving RRT in
the form of Hemodialysis from dialysis center
Allied Hospital, Faisalabad and above the age of
18 years were included in this study. The patients
whom ages were less than 18 years were not
included in the study.
RESULTS AND DISCUSSION
Overall responses from 105 respondents were
collected out of them 62.9% (n = 66) were male
and 37.1% (n = 39) were female. Most of the
respondents 51.43% (n= 54) were belonged to
the age group 47 years to 60 years of age. 24.76%
(n= 26) respondents were above 60 years of age,
20.00 %( n= 21) respondents were between 32 to
46 and the remaining 3.81% (n= 4) were from the
age group 18 to 31. Hypertension and diabetes
are considered to be usual factors responsible
for onset of ESDR. It is therefore, there was less
number of respondents in the less age group.
63.81% (n=67) respondents were living in the
rural areas compared to 36.19 (n= 38) who were
living in the urban areas.
Table No. 1 Feeling anxieties and depression due to ESDR
Total number of
respondents
Gender
Feeling anxieties and depression due to ESDR
Yes
No
Frequency
%age
Frequency
%age
Male
66
37
56.06
29
43.94
Female
39
32
82.05
7
17.95
Responses according to above table shows that
out of 39 female respondents 82.05% (n = 32)
were feeling anxieties and depression due to
the disease compared to 56.06% (n = 37) male
respondents. Almost similar to that of the findings
conducted earlier which concluded that the
women were feeling more anxiety, depression,
less positive thoughts and less social activities as
compared to the males (4). The social life with
regard to marital status according to this study
shows that the bulk of the respondents 82.86% (n
= 87) were married. Out of them, 32.38 percent (n
= 34) were “completely satisfied” with the respect
and affection from their family while 43.81% (n =
46) were satisfied with the same. A previous study
showed same conclusion, that married family
life was strongly contributing in confidence, and
wellness, of these patients (5).
Table No. 2 Effect of ESDR on economic activities
Not at all
To some Extent
To a greater extent
Frequency
%age
Frequency
%age
Frequency
%age
5
4.76
7
6.67
93
88.57
The table above reveals that while answering the
question about the effect of ESRD on economic
activities 88.57% (n = 93) responded that after
onset of ESRD, their economic activities “to a
greater extent” were affected compared to only
4.76% (n=5) whom such activities were “not at
Pak J Med Biol Sci 2018 - Vol. 2, Issue 1
all” affected and 6.67% (n= 7) to whom economic
activities were affected “to some extent”. A
study by (6) also confirmed that treatment of
ESRD through dialysis disturbs the economic,
professional, and the social status of such
patients.
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Social Life of End Stage Renal Disease Patients
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In response to the question regarding assistance
needed for routine activities 11.43% (n= 12)
respondents responded that they required it “to
a greater extent”, 46.67% (n= 49) required it “to
some extent” whereas 41.90% (n= 44) were “not
at all” required the same.
Table No. 3 Need of someone’s assistance to go to the dialysis center
Not at all
To some Extent
To a greater extent
Frequency
%age
Frequency
%age
Frequency
%age
4
3.81
10
9.52
91
86.67
Although for routine activities, most of the
respondents do not need or to some extent need
the assistance of someone, however in order to
go to the dialysis center for the dialysis (which
is usually required two to three times a week)
the respondents almost always need assistance
of someone. Data in table no. 3 reveals that
86.67% (n= 91) respondents responded that
they always need assistance of someone to go to
the dialysis center compared to only 9.52% (n=
10) and 3.81% (n= 4) who needed it “few and
far between” and “not at all” respectively. So the
patient almost always required to be assisted or
cared by someone.
Dialysis facilities are not available in every
hospital in Pakistan, only few hospitals offer this
service. So the patients need to travel towards the
dialysis center regardless of how much distant it
is from their residential area. However, the more
distance of dialysis center from residential area of
the patient causes more traveling costs as well as
time consumption. Also due to low or no source
of income, many of the patients do not have their
own vehicles. So they had to travel in the public
transport to go to the dialysis center.
Table No. 4 Distance of dialysis center from the residents of the respondents
Residential distance from dialysis center
Frequency
Up to 25 Km
19
26 to 50 Km
37
More than 50 Km
49
Table No. 4 show that 18.10 Percent (n=19)
respondents were required to travel up to 25 km for
their dialysis, 35.24 Percent (n=37) respondents
from 26 to 50km and 46.67 Percent (n=49) were
required to travel for more than 50 km for the same
purpose. Further data regarding mode of traveling
shows that 84.76 Percent (n=89) respondents
were using public transport, 6.67 Percent (n=7)
respondents used private conveyance and only
8.57 Percent (n=9) respondents were using
their own vehicle to approach the dialysis center.
Traveling especially in public transport is a hard
task for any patient but the patients are strained
to travel twice or thrice a week for their dialysis
along with their caregivers. Such traveling is not
only irritating the patients but also create financial
burden on the patients. Also dependency/ need
Pak J Med Biol Sci 2018 - Vol. 2, Issue 1
Percentage-
of assistance along with the financial problems
arose due inability to involve in the paid work
lessen the confidence level, self-prestige, and
social status of the patients.
CONCLUSION
Study reveals that majority of respondents
due to ESRD had less capacity to participate
in different spheres of life and it was creating
various troubles in their social life. Previous study
also concluded that 39.4 % respondents reported
that due to ESRD they were less able to do work.
This decline in ability to work leads to stress, and
anxiety. Unemployment that was resulted due to
ESDR also causes economic problems, loss of
confidence, psychological and physical problems
in the patients. At this stage of unemployment,
financial crises affect different dimensions of their
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Social Life of End Stage Renal Disease Patients
life and worsen their already emerged social
problems. Dependency on the family members
for the daily routine activities and to receive
dialysis therapy worsens their social life. Dialysis
facilities are available in few hospitals, so the
patients and their caregivers are forced to travel
towards the dialysis centers on regular basis and
most of them used to travel in public transport.
So the social life of the patients of ESRD was
consists of dependency on caregivers, economic
problems due to inability to participate in such
activities, travelling problems due to distant
dialysis centers. So there is dire need to address
the problems of such patients through initiate
special financial and social support at grass root
level. Also there is need to initiate more dialysis
centers to overcome the traveling problems of the
patients.
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