ASSESSING LIFE POST-TRANSPLANT: A COMPARATIVE STUDY OF SF-36 AND WHOQOL-BREF QUALITY OF LIFE SCORES IN RENAL TRANSPLANT RECIPIENTS IN A TERTIARY CARE CENTRE FROM SOUTH INDIA

Introduction:

Renal transplantation aims to significantly improve the quality of life(QoL) and life expectancy of patients with end-stage renal disease(ESRD) while minimizing associated side effects. Apart from the traditional indicators of health like morbidity and mortality, QoL (aptly described as missing measurement in health) is equally important in measuring the impact of the disease. Despite the importance of QoL assessment, there is no consensus on a gold-standard instrument for its measurement. This study evaluates changes in QoL in ESRD patients following kidney transplantation using two different instruments: 36-item short form health survey(SF-36) and the World Health Organization Quality of Life-BREF(WHOQOL-BREF) questionnaires.

Methods:

A cross-sectional, observational study was conducted at the Department of Nephrology, in a tertiary care centre, Telangana. The study included 89 kidney transplant recipients aged 18 years or older with graft survival of over three months, stable graft function, and regular follow-up, all of whom provided informed consent. Quality of Life (QoL) was assessed using the SF-36 and WHOQOL-BREF questionnaires. The SF-36 evaluates health-related QoL across eight domains, while WHOQOL-BREF covers physical health, psychological health, social relationships, and environmental factors.

Both instruments were administered to all participants to gather post-transplantation QoL data. Statistical analysis was performed using SPSS software (version X.X). Pearson correlation analysis was used to explore the relationship between the two instruments' outcomes. Bland-Altman plots were created to assess the agreement between SF-36 and WHOQOL-BREF scores, providing a comparative visualization of the data.

Results:

The study included 89 patients, of whom 33% were female and 67% male, with a mean age of 42 years(range 22-62). The cohort was divided into two groups: 54(61%) underwent live-related renal transplantation(Group 1), and 35(39%) received a deceased donor renal transplantation(Group 2). The mean scores across eight domains of the SF-36 and 4 domains of WHOQOL-BREF are shown in tables 1 and 2 respectively. QoL improved in all domains post-transplantation, with no significant differences observed between the live-related and deceased donor groups. Physical and social functioning scored highest, while role physical and role emotional scored lowest in their respective assessments. 

Conclusions:

This study confirms both the SF-36 and WHOQOL-BREF are reliable and valid instruments for assessing QoL in kidney transplant patients. However, the selection of an instrument should be guided by the specific aspects of QoL that researchers wish to evaluate. The weak correlation observed between the two instruments may stem from the differing focuses of the questionnaires, with SF-36 emphasizing capability and disability, and WHOQOL-BREF focusing on individual perceptions of QoL.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.