Falls, Frailty and Quality of Life Among Individuals on a Regular Haemodialysis Programme: Implications for Rehabilitation Nursing

TL;DR

This study explores how falls, frailty, and quality of life are connected in people undergoing hemodialysis, highlighting the need for rehabilitation nursing.

Contribution

The study identifies a significant link between frailty and falls, and highlights implications for rehabilitation nursing in hemodialysis patients.

Findings

32.2% of participants reported falls in the year before the study.

Frailty was found in 40.3% of participants and was significantly associated with falls.

Lower quality of life scores were observed in participants who experienced falls.

Abstract

Background: Chronic kidney disease and haemodialysis treatment are associated with physiological and functional alterations that compromise postural stability, favouring frailty and the risk of falls. These conditions directly affect the quality of life and autonomy of people undergoing haemodialysis, constituting an important challenge for rehabilitation nursing. In this sense, the aim of this study was to analyse the relationship between falls, frailty and quality of life in people with chronic kidney disease on a regular haemodialysis programme, identifying implications for rehabilitation nursing care. Methods: This was a quantitative, observational and cross-sectional study conducted with 62 participants from a haemodialysis unit in northern Portugal. The Tilburg Frailty Indicator and the Kidney Disease Quality of Life Instrument (KDQOL-SF™ 1.3) were applied. Statistical analysis used parametric and non-parametric tests, considering a significance level of p < 0.05. Results: The prevalence of falls in the year preceding the data collection was 32.2%, and the prevalence of frailty was 40.3%. A significant association was found between frailty and falls (p = 0.038) and between sex and falls (p = 0.002). The dimensions Symptoms/problems and Effects of kidney disease on daily life showed lower scores among participants with falls (p < 0.001). Conclusions: Frailty and poorer illness perception were associated with the occurrence of falls and with lower quality of life. Comprehensive assessment and the implementation of rehabilitation programmes led by specialist nurses in rehabilitation nursing are essential to promote functionality, safety and autonomy in people undergoing haemodialysis.