Clinical, sociodemographic, and psychological correlates of health-related quality of life in chronic hemodialysis patients.

BACKGROUND: Physical comorbidities and depression are associated with poor health-related quality of life (HRQoL) in patients undergoing chronic hemodialysis, but little is known about the impact of psychological determinants such as coping strategies in this association. This study examined the relation between psychosocial factors, particularly health-related locus of control (HLOC) and quality of life (QoL) in chronic hemodialisys patients.

METHODS: Three hundred hemodialysis patients underwent assessment of QoL (SF-36), depression (Beck Depression Inventory score), anxiety (State-Trait Anxiety Inventory), and HLOC profile (Multidimensional Health Locus of Control scale). Comorbidities and sociodemographic factors were assessed.

RESULTS: All QoL scores were low. Depression and comorbidities were negatively correlated with physical QoL components and depression, anxiety, and comorbidities were negatively correlated with mental components. However, internal locus of control (LOC) and external LOC (influence of "powerful others") were positively correlated with mental QoL components. Multiple regression analysis showed internal LOC significantly and positively associated with mental QoL components, especially mental health score (P < 0.01).

CONCLUSIONS: Altered QoL of patients undergoing chronic hemodialysis is associated with physical and psychiatric comorbidities, in particular depression and anxiety. However, internal and external LOC seem to have differential impact on QoL. Increasing awareness and empowerment of the internal and external components of the LOC could help patients improving QoL.