PURPOSE Patient priorities for quality of life change with age. We conducted a qualitative study to identify quality of life themes of importance to older adults receiving dialysis and the extent to which these are represented in existing quality of life instruments. METHODS We conducted semi-structured interviews with 12 adults aged ≥ 75 years receiving hemodialysis to elicit participant perspectives on what matters most to them in life. We used framework analysis methodology to process interview transcripts (coding, charting, and mapping), identify major themes, and compare these themes by participant frailty status. We examined for representation of our study's subthemes in the Kidney Disease Quality of Life (KDQOL-36) and the World Health Organization Quality of Life for Older Adults (WHOQOL-OLD) instruments. RESULTS Among the 12 participants, average age was 81 (4.2) years, 7 African-American, 6 women, and 6 met frailty criteria. We identified two major quality of life themes: (1) having physical well-being (subthemes: being able to do things independently, having symptom control, maintaining physical health, and being alive) and (2) having social support (subthemes: having practical social support, emotional social support, and socialization). Perspectives on the subthemes often varied by frailty status. For example, being alive meant surviving from day-to-day for frail participants, but included a desire for new life experiences for non-frail participants. The majority of the subthemes did not correspond with domains in the KDQOL-36 and WHOQOL-OLD instruments. CONCLUSION Novel instruments are likely needed to elicit the dominant themes of having physical well-being and having social support identified by older adults receiving dialysis.

中文翻译：

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接受血液透析的老年人的生活质量：一项定性研究。


目的 患者对生活质量的优先考虑随着年龄的增长而变化。我们进行了一项定性研究，以确定对接受透析的老年人来说重要的生活质量主题，以及这些主题在现有生活质量工具中的体现程度。方法 我们对 12 名 75 岁以上接受血液透析的成年人进行了半结构化访谈，以了解参与者对生活中最重要的事情的看法。我们使用框架分析方法来处理采访记录（编码、图表和映射），确定主要主题，并根据参与者的虚弱状态来比较这些主题。我们检查了肾脏疾病生活质量 (KDQOL-36) 和世界卫生组织老年人生活质量 (WHOQOL-OLD) 工具中我们研究的子主题的代表性。结果 12 名参与者中，平均年龄为 81 (4.2) 岁，其中 7 名非裔美国人，6 名女性，6 名符合虚弱标准。我们确定了两个主要的生活质量主题：(1) 拥有身体健康（子主题：能够独立做事、控制症状、保持身体健康和活着）和 (2) 拥有社会支持（子主题：拥有实际社会支持、情感社会支持和社会化）。对次主题的看法往往因虚弱状况而异。例如，对于虚弱的参与者来说，活着意味着日常生活中的生存，但对于非虚弱的参与者来说，还包括对新生活体验的渴望。大多数子主题与 KDQOL-36 和 WHOQOL-OLD 工具中的领域不对应。结论 可能需要新的工具来引出接受透析的老年人所确定的身体健康和社会支持的主导主题。