A Quality of Life Enhancement Model and Its Effects on Clinical Outcomes in End-Stage Renal Disease Patients Not Receiving Renal Replacement Therapy.

Abstract

     This study aimed to develop a quality of life enhancement model for end-stage renal disease (ESRD) patients who are not receiving renal replacement therapy, and to evaluate its effects on clinical outcomes and overall quality of life. A Research and Development approach integrated with participatory action research was applied in three phases: situation analysis, development of an Advance Care Planning (ACP) model, and implementation with evaluation. The sample consisted of 30 ESRD patients and their primary caregivers, purposively selected. Research instruments included demographic questionnaires, a knowledge assessment on treatment options, a quality-of-life assessment tool, an ACP form, and clinical outcome recording sheets. Quantitative data were collected before and after the intervention; qualitative data were obtained through in-depth interviews and focus group discussions. Quantitative data were analyzed using descriptive statistics and paired t-tests, while qualitative data were analyzed using content analysis.

     The results indicated that the developed model—which comprised individualized education, goal-of-care communication, shared decision-making support, and continuous follow-up—enhanced patient knowledge regarding treatment options, clarified end-of-life care goals, and improved overall quality of life. Several clinical indicators, such as blood pressure and symptom burden, also showed improvement after the intervention. Qualitative findings revealed that patients experienced enhanced self-empowerment, reduced treatment-related anxiety, and perceived holistic support from the multidisciplinary team.