In 1994 the Kidney Disease Quality of Life Working Group developed the KDQOL in an attempt to understand the relationship between functional status and well-being in end stage renal disease patients and the impact on outcomes measures.
According to the Center for Medicare and Medicaid Services (CMS) ESRD Conditions for Coverage (CfC) the interdisciplinary team (IDT) must provide necessary monitoring and social work interventions based on assessment results. These including counseling services and referrals for other social services, to assist the patient in achieving and sustaining an appropriate psychosocial status as measured by a standard mental and physical assessment tool chosen by the social worker. The tool must be used at regular intervals, or more frequently on an as-needed basis.
While this regulation allows the social worker to choose a “standardized mental and physical assessment tool,” the tool selected by the National Quality Forum and the CMS CPMs for adult patients is the KDQOL-36 assessment survey. In the future, patients taking this assessment survey annually will need to be reported electronically to CMS. Facilities may choose to use the KDQOL-36 from the implementation date of these regulations in order to have more comparable data when the KDQOL-36 is mandated.
“At regular intervals” means that the assessment survey is administered to the patient by the time of the first reassessment (i.e., within 4 months of initiating treatment), and repeated at least annually. Examples of an “as needed basis” would include repeat use of the survey with the patient who has a significant life changing event (e.g., loss of spouse, loss of job, recent move to a nursing home) or a change in health status.
The social worker must have a system for routine use of the assessment survey, evaluation of the results, and incorporation of the survey results into the development and updating of the psychosocial portion of the Plan of Care (POC).
- Instruments: You may access the instruments, including the KDQOL-SF 36, on the Kidney Disease Quality of Life Working Group site. Downloads are free but registration is required.
- Scoring: Also available for download are scoring programs including manuals, spreadsheet templates and samples. Arbor Research Collaborative for Health created a KDQOL table of average scores in May of 2008 using DOPPS3 initial prevalent cross-section data (approximately from 2006).
- Professional Exchange: A Web chat site, hosted by QualityMetric Inc. and International Quality of Life Assessment (IQOLA) Project, has been established to facilitate discussion among professionals regarding the use of SF tools in clinical trials.
- KDQOL COMPLETE™- Life Options has created – KDQOL-36 ONLINE – an online version of the short form designed as a learning tool for professionals.
- ESRD & Emotional Health: Taking a Closer Look at Dialysis & Depression
Reprinted from the Renal Rehabilitation Report
- Managing Mental Illness in the Dialysis Treatment Environment: A team approach
Megan Prescott, MSW, Nephrology News & Issues, December 2006
Data can be easily scored and variables can be quantified along any number of variables. For more examples link to the following:
- Quality of Life in Patients with Chronic Renal Failure Kamyar Kalantar-Zadeh, MD, MPH, Assistant Professor of Medicine and Pediatrics,David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, California, USA 3rd Congress of Nephrology in Internet, October 2003
- Statistical Summary of Quality of Life for Dialysis Patients Questionnaire Study Findings Promoting Excellence ESRD Workgroup