Abstract

HURTADO, Paola Andrea; ARANGO, Javier  and  GONZALEZ, María Teresa. Effects of ludic-education activities in the quality of life of patients on hemodialysis. Acta Med Colomb [online]. 2005, vol.30, n.4, pp.261-267. ISSN 0120-2448.

Objective: observe the effect of the ludic education during hemo- dialysis and the perception of the patients with terminal chronic renal disease in terms of their quality of life. Design and Methods: experimental study carried out at the renal unit of the Fresenius Medical Care Armenia (Quindío). Test SF36 was applied (instrument of quality of life), see annex 1; to an intervention group (32 patients) and a control group (32 patients) before and after the ludic-education activity in the hemodialysis room. Reference framework: since the first descriptions published by Evans in 1985 where he clearly described the difference in the quality of life of transplanted patients vs. those on dialysis (1), many reports have come out in the literature where they review the quality of life in patients on dialysis. (2,3) Having a clear individual perception of the quality of life of patients on dialysis has benefits, not only for the patient but also for the health provider institutions, in the assessment of the measurements taken in patients' care at times when the resources available for health are limited, as well as the associations with the most important complications that under the present medicine circumstances demand increases in economic resources (4). There are no clinical trials in the present bio-medical literature that assess changes produced in the quality of life of patients with renal disease, stage 5, after daily interventions in the renal units, regardless if they have been scheduled or not, such as patients education. Participants: 64 Patients with terminal chronic renal disease, under treatment with hemo dialysis at the renal unit of the Fresenius Medical Care in Armenia, participated in the research. These patients to be part of the intervention group (with ludic education activity) were elected via the method of heads or tails, and the control group, with which no ludic- education activity was carried out, just the daily activities related to their treatment, such as hemo dialysis sessions, blood pressure measurements, watching TV, listening to music and the company of assistance personnel. Interventions: the SF 36 test was applied; measuring the perception of patients with chronic renal disease, about their quality of life, the intervention group and the control group, before and after the ludic education activity was performed on the intervention group. The following results were observed in the intervention group: 25% of patients did not experience any improvement, 35% did improve in emotional and/or physical aspects and 52% stayed in the same emotional and physical state. In the control group the following results were observed: 28% of the patients did not show any improvement, 9.4% some emotional and/or physical improvement and 52% stayed in the same emotional and/or physical level. The above shows an Absolute Risk Reduction of 25%, Relative Risk, 3.67 with confidence interval of 1.13 to 11.19 with p of 0.034 with the corrected Chates Method and a Necessary to Treat Number of 4, all this in favor of the ludic-education activity as a method for positive changes in the quality of life in the patients on dialysis. Conclusions: · The ludic-education activity has a significant internal impact on the scales that are part of the SF36 Quality of Life Test. · The group under intervention has a higher percentage than the group that had no intervention regarding improvement (35% to a 9.4%) in terms of the general aspects that were evaluated with the SF36 Quality of Life Test. · There is an age group to whom these activities should be oriented, it is between 51 and 60 years of age, taking into account their truthful and productive responses. · For other age groups it is necessary to implement new strategies to work on the emotional and physical aspect, towards improvement of their quality of life and compliance with the treatment. · In general terms, we could say that these activities would have more impact on the total scale of the Quality of Life SF36 test, if with just one activity the changes above mentioned can be achieved.

Keywords : quality of life; ludic education; end-stage renal patient; hemodialysis.

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