Concordance with Evidence-based Acute Coronary Syndrome Care Metrics and Predictors of Cardiovascular Outcomes: Data from an Indian Tertiary-care Setting

Introduction: Chronic Kidney Disease (CKD) is associated with physical, psychological, social, and functional problems. While Maintenance Haemodialysis (MHD) is therapeutically beneficial, patients continue to face multiple challenges. Together, the disease and its treatment contribute to a significant decline in quality of life. Self-efficacy and psychological wellness are two key factors influencing the quality of life of patients undergoing longterm treatment. Understanding these relationships is particularly important among female patients in culturally sensitive settings. Aim: The present study aimed to assess the quality of life, selfefficacy, and psychological wellness among women undergoing Haemodialysis (HD), and to determine the correlation between these variables. Materials and Methods: A cross-sectional study was conducted among 100 female participants undergoing MHD at two selected dialysis units in Northern Kerala, India: the Government Medical College, Kannur, and the CH dialysis centre, a nearby charitable facility from 24 March 2024 to 15 May 2024, enrolled using the consecutive sampling technique. The Kidney Disease Quality of Life-36 (KDQOL-36) was used to assess quality of life, the Strategies Used by People to Promote Health (SUPPH) scale to measure self-efficacy, and Ryff’s Psychological Well-Being (PWB) scale to evaluate psychological wellness. Data were analysed using descriptive statistics and Spearman’s rank correlation coefficient. Results: Among the quality-of-life subdomains, the burden of kidney disease had the lowest median score {18.75 (12.50-25.00)}, followed by the Physical Component Summary (PCS) {30.57 (24.91-35.29)}. Relatively higher median scores were obtained for self-efficacy {84.00 (77.00-93.75)} and psychological wellness {74.00 (70.00-78.75)}. A positive correlation was found between self-efficacy and quality of life (ρ=0.358, p<0.001), while self-efficacy showed a weak correlation with psychological wellness (ρ=0.226, p=0.024). No significant correlation was observed between quality of life and psychological wellness (ρ=0.009, p=0.932). Conclusion: The above findings indicate that when patients feel more confident and capable, their quality of life tends to improve. However, self-efficacy may not be a standalone predictor of quality of life, which is likely influenced by a complex interplay of multiple factors. Tailored interventions that enhance confidence in managing the disease, while also addressing physical and psychological challenges, could positively influence quality of life.