RESUMEN
BACKGROUND: The burden of symptoms and other concerns in chronic kidney disease (CKD) is known to be high, adversely affecting the quality of life of the growing number of those with this condition in developing countries. In this paper, we describe the protocol of a longitudinal observational study among people living with CKD. The study is developed to assess the bio-psychosocial factors associated with palliative care symptoms and concerns, and pattern of health services usage among Nigerians with stages 3-5 CKD. The overall objective is to establish the evidence-base for advocacy and policy formulation, treatment guidelines, care and services, and future clinical trial studies. METHODS: This is a multi-center study to investigate the longitudinal course of symptoms and other concerns among patients with stages 3-5 CKD in Nigeria. Interviewer administered and self-report measures at baseline (T0) and 3-month (T1) address socio-demographic characteristics, clinical-illness related information, palliative care-related symptoms and other concerns, pattern of formal or informal service usage, and bio psychosocial measures including estimated glomerular filtration rate (eGFR), anxiety, depression, quality of life, functioning, social support and spiritual wellbeing. DISCUSSION: This study represents the first longitudinal investigation of palliative care symptoms and concerns among people with CKD in Nigeria. It includes early stages of CKD in compliance with best practices, and a comprehensive range of bio-psychosocial outcomes to understand how these factors are associated with symptoms. This study will provide evidence for how best to integrate palliative care into management of CKD to improve care and quality of life of people with CKD. The study team welcomes collaborations with both national and international researchers.
Asunto(s)
Fallo Renal Crónico/psicología , Calidad de Vida , Estudios de Cohortes , Femenino , Humanos , Estudios Longitudinales , Masculino , Nigeria , Cuidados Paliativos , Proyectos de InvestigaciónRESUMEN
The aim of this study is to find out the prevalence, types and correlates of anxiety disorders among people living with HIV/AIDS (PLWHA) attending a sub-Saharan Africa HIV clinic. Three hundred HIV positive adults were subjected to semi-structured clinical interview using the Schedule for Clinical Assessment in Neuropsychiatry to diagnose anxiety disorders in them. Additionally, a socio-demographic/clinical profile questionnaire designed for the study was administered to the study participants. The prevalence of anxiety disorders among PLWHA in this study was 21.7 %, and anxiety disorder unspecified (6.2 %), mixed anxiety-depressive disorder (5.3 %) and social phobia (4 %) among others were the subtypes of anxiety disorders elicited among the participants. Lack of family support [correlation coefficient (r) = 0.212, P < 0.001], unemployment (r = 0.168, P = 0.004) and being unmarried (r = 0.182, P = 0.002) were much more likely to be found among participants with anxiety disorders; while younger age group (r = -0.126, P = 0.039) and negative previous mental illness (r = -0.894, P = 0.021) seem protective against anxiety disorders in this study. Our findings suggest a high burden of anxiety disorders among PLWHA and up to five-folds when compared to the general population. Thus, integration of proactive mental health screening as well as treatment services with inclusion of targeted intervention for anxiety disorders among PLWHA is recommended.