Quality of life, pain and anxiety in patients with nephrostomy tubes

this is a longitudinal descriptive study performed on a sample of n=150 patients. To evaluate the quality of life, the EuroQol-5D questionnaire was used; anxiety was quantified by the Beck Anxiety Inventory; to study pain, a visual analogue scale was employed.

Results:

statistically significant differences were found in the quality of life, with its worsening (r = 0.51; p <0.01) when evaluated at the first tube replacement. Patients presented mild to moderate anxiety before the procedure, which was reduced at the first tube replacement, although this difference was not significant (r = 0.028, p = 0.393). Finally, the degree of pain was also significantly reduced (r = 0.13, p<0.01) after six weeks. As for gender, women presented the worst values in the three variables studied (worse quality of life and greater anxiety and pain).

Conclusions:

nephrostomy tubes have a negative impact on the patient’s quality of life. During the time they live with these tubes, patients have mild to moderate pain and anxiety.

Descriptors:
Percutaneous Nephrostomy; Ostomy; Quality of Life; Anxiety; Pain; Education Nursing

	Total (n=150)		Men (n=102)		Women (n=48)
	Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean	St. Dev^* * St. Dev = Standard Deviation;
Age (years old)	61.6	14.16	62.62	13.8	59.67	14.86
	N	%	N	%	N	%
Working status
Employed	4	2.6	1	1.0	3	6.3
Medical leave	58	38.4	36	35.3	22	45.8
Unemployed	11	7.3	7	6.9	4	8.3

Marital status
Single	19	12.6	15	14.7	4	8.3
Married	102	67.5	69	67.6	33	68.8
Separated	7	4.6	4	3.9	3	6.3
Widower	22	14.6	14	13.7	8	16.7
Family unit^† † Family unit = number of members in the household, including the patient him/herself;
1	16	10.6	11	10.8	5	10.4
2	66	43.7	48	47.1	18	37.5
3	39	25.8	29	28.4	10	20.8
4	23	15.2	13	12.7	10	20.8
5	6	4.0	1	1.0	5	10.4
Education
No studies	27	17.9	15	14.7	12	25.0
First degree	56	37.1	42	41.2	14	29.2
High school	43	28.5	31	30.4	12	25.0
University degree	24	15.9	14	13.7	10	20.8
Leisure activities
No leisure	29	19.2	18	17.5	11	22.9
< twice/week	32	21.2	24	23.5	8	16.7
2 - 5 times/week	39	25.8	26	25.5	13	27.1
> 5 times/week	50	33.1	34	33.3	16	33.3
Take psychopharmaceuticals^‡ ‡ Psychopharmaceuticals = take any drugs which affect psychological behavior (anxiety medication and/or antidepressants)
Yes	43	30.0	32	31.4	13	27.1
No	105	70.0	70	68.6	35	72.9

	Pre-procedure		Post-procedure		P value^† † P value;	d^‡ ‡ d = Cohen's D;	r^§ § r = Effect size
	Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean	St. Dev.^* * St. Dev = Standard Deviation;	P value^† † P value;	d^‡ ‡ d = Cohen's D;	r^§ § r = Effect size
Total (n=150)	7.51	2.104	5.07	1.936	P<0.01	1.20	0.51
Men (n=102)	7.73	1.936	5.24	1.878	P<0.01	1.30	0.54
Women (n=48)	7.06	2.301	4.73	2.029	P<0.01	1.03	0.45

	Pre-procedure		Post-procedure		P value^† † P value;	d^‡ ‡ d = Cohen's D;	r^§ § r = Effect size
	Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean	St. Dev^* * St. Dev = Standard Deviation;	P value^† † P value;	d^‡ ‡ d = Cohen's D;	r^§ § r = Effect size
Total (n=150)	9.62	7.150	9.19	7.700	0.393	0.050	0.028
Men (n=102)	8.84	7.139	8.79	7.854	0.929	0.006	0.003
Women (n=48)	11.27	6.961	10.02	7.373	0.245	0.174	0.080

	Pre-procedure		Post-procedure		Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean
	Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean	St. Dev^* * St. Dev = Standard Deviation;	Mean
Total (n=150)	1.83	2.648	1.23	1.781	0.008	0.26	0.13
Men (n=102)	1.61	2.599	1.23	1.898	0.147	0.167	0.08
Women (n=48)	2.31	2.714	1.25	1.523	0.012	0.48	0.23

	Pre-procedure		Post-procedure		Mean difference pre/post^† † Mean difference pre/post = difference between mean values pre and post implantation of the tube (negative values indicate worse quality of life post-implantation);	P value^‡ ‡ P value;	d^§ § d = Cohen's D;	r^\|\| \|\| r = Size effect
	Mean	St. Dev.^* * St. Dev = Standard Deviation;	Mean	St. Dev.^* * St. Dev = Standard Deviation;		P value^‡ ‡ P value;	d^§ § d = Cohen's D;	r^\|\| \|\| r = Size effect
Mobility	1.11	0.339	1.28	0.493	-0.167	0.00	0.40	0.19
Personal care	1.09	0.355	1.68	0.616	-0.591	0.00	1.19	0.51
Daily activities	1.17	0.440	1.93	0.614	-0.760	0.00	1.42	0.57
Pain/ discomfort	1.43	0.628	1.43	0.584	0	1.00	0	0
Anxiety /depression	1.25	0.533	1.85	0.653	-0.593	0.00	1.00	0.44

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Luis Manuel Fernández Cacho. E-mail: podumonte@hotmail.com / luis.fernandez@scsalud.es