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Fernandes MIDCD, Tinôco JDDS, Fernandes RM, Silva JBD, Almeida ATD, Frazão CMFDQ, Lopes MVDO, Lira ALBDC. Predictors of excess fluid volume in hemodialysis patients: an observational study. Rev Bras Enferm 2024; 77:e20220816. [PMID: 38716904 PMCID: PMC11067934 DOI: 10.1590/0034-7167-2022-0816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 11/25/2023] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES to assess risk factors for excess fluid volume in hemodialysis patients. METHODS a retrospective case-control study was conducted. A total of 392 patients (196 cases and 196 controls) from two hemodialysis centers were included. Sociodemographic data and 23 risk factors for excess fluid volume were assessed using a data collection form. Data were analyzed using a multivariate logistic regression model. RESULTS the insufficient knowledge (OR=2.06), excessive fluid intake (OR=2.33), inadequate fluid removal during hemodialysis (OR=2.62) and excessive sodium intake (OR=1.91) risk factors may increase the chance of occurrence of excess fluid volume in hemodialysis patients by approximately two times. Education level (OR=0.95) and age (OR=0.97) are protective factors for excessive fluid volume. CONCLUSIONS knowing these risk factors may help nurses with accurate and rapid diagnostic inference of the risk of excessive fluid volume.
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Yeom HE, Lee J, Kim YJ. Validation of the Korean Version of the Health Care Climate Questionnaire among Cancer Survivors. Healthcare (Basel) 2024; 12:323. [PMID: 38338208 PMCID: PMC10855044 DOI: 10.3390/healthcare12030323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Healthcare professionals should support autonomy in their patients in order for them to maintain the motivation to cope actively with their conditions. The Health Care Climate Questionnaire (HCCQ) is useful for assessing patients' perceptions of the autonomy support provided to them. We aimed to validate the psychometric properties of the Korean version of the HCCQ (HCCQ-K) among Korean cancer survivors. This study evaluated the factor structure, concurrent validity, and internal consistency. Data from 367 cancer survivors were analyzed using confirmatory factor analysis (CFA), Pearson's correlations, and Cronbach's α values. The CFA validated that the single-factor structure of the HCCQ-K had an excellent fit that was consistent with that of the original English version. Concurrent validity was confirmed by moderate correlations between the HCCQ-K and both psychological well-being and self-management. Reliability was verified by satisfactory internal consistency, with a Cronbach's α value of 0.91 and strong item-total and inter-item correlations. The HCCQ-K is therefore a valid and reliable tool for assessing autonomy support provided by healthcare professionals to Korean cancer survivors. The HCCQ-K may help healthcare professionals understand their patients' needs for autonomy support and develop strategies to motivate active coping behaviors.
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Affiliation(s)
- Hyun-E Yeom
- Department of Nursing, Chungnam National University, Munhwaro 266, Junggu, Daejeon 35015, Republic of Korea;
| | - Jungmin Lee
- Korea Research Institute for Vocational Education & Training, Social Policy Building, Sejong National Research Complex, 370 Sicheong-daero, Sejong-si 30147, Republic of Korea
| | - Young-Joo Kim
- Department of Economics, Hongik University, Seoul 04066, Republic of Korea
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Barreiro RG, Lopes MVDO, Cavalcante LDP. Middle-Range Theory for the Nursing Diagnosis of Low Self-Efficacy in Health. Rev Bras Enferm 2021; 73:e20190370. [PMID: 32638935 DOI: 10.1590/0034-7167-2019-0370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/01/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES theoretical validation of the concept of low self-efficacy in health as a nursing diagnosis construct. METHODS construction of a middle-range theory for validating diagnoses, comprised of five stages: definition of the approach for building the theory; definition of the main concepts; creation of a pictorial diagram; formulation of proposals; establishment of causal relationships and evidence for clinical practice. The main concepts were identified through a literature review and the studies were taken from the LILACS, SCOPUS, CINAHL and PubMed/MEDLINE databases. The final sample was comprised of 92 articles. RESULTS eighteen etiological factors and 16 clinical indicators were identified; characterized as antecedents and manifestations for inferring a diagnosis of low self-efficacy in health. CONCLUSIONS the related concepts of the new nursing diagnosis of low self-efficacy in health, to be applied in clinical nursing practice, were identified and defined.
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Burnier M, Fouque D. The unsolved challenge of implementing sustained reductions of sodium intake in patients with chronic kidney disease. Nephrol Dial Transplant 2020; 36:gfaa268. [PMID: 33367776 DOI: 10.1093/ndt/gfaa268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Michel Burnier
- Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland
- Hypertension Research Foundation, St-Légier, Switzerland
| | - Denis Fouque
- Department of Nephrology, Nutrition and Dialysis, University of Lyon, Hospital Lyon-SUD, Pierre-Bénite, France
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Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, Fouque D, Friedman AN, Ghaddar S, Goldstein-Fuchs DJ, Kaysen GA, Kopple JD, Teta D, Yee-Moon Wang A, Cuppari L. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis 2020; 76:S1-S107. [PMID: 32829751 DOI: 10.1053/j.ajkd.2020.05.006] [Citation(s) in RCA: 795] [Impact Index Per Article: 198.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/29/2020] [Indexed: 12/14/2022]
Abstract
The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for nutrition in kidney diseases since 1999. Since the publication of the first KDOQI nutrition guideline, there has been a great accumulation of new evidence regarding the management of nutritional aspects of kidney disease and sophistication in the guidelines process. The 2020 update to the KDOQI Clinical Practice Guideline for Nutrition in CKD was developed as a joint effort with the Academy of Nutrition and Dietetics (Academy). It provides comprehensive up-to-date information on the understanding and care of patients with chronic kidney disease (CKD), especially in terms of their metabolic and nutritional milieu for the practicing clinician and allied health care workers. The guideline was expanded to include not only patients with end-stage kidney disease or advanced CKD, but also patients with stages 1-5 CKD who are not receiving dialysis and patients with a functional kidney transplant. The updated guideline statements focus on 6 primary areas: nutritional assessment, medical nutrition therapy (MNT), dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes. The guidelines primarily cover dietary management rather than all possible nutritional interventions. The evidence data and guideline statements were evaluated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.
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Spies HC, van den Berg VL, Nel M. Knowledge, attitude and practices of patients receiving maintenance haemodialysis in Bloemfontein, South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2020. [DOI: 10.1080/16070658.2020.1751415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- HC Spies
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
| | - VL van den Berg
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
| | - M Nel
- Department of Biostatistics, University of the Free State, Bloemfontein, South Africa
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Humalda JK, Klaassen G, de Vries H, Meuleman Y, Verschuur LC, Straathof EJM, Laverman GD, Bos WJW, van der Boog PJM, Vermeulen KM, Blanson Henkemans OA, Otten W, de Borst MH, van Dijk S, Navis GJ. A Self-management Approach for Dietary Sodium Restriction in Patients With CKD: A Randomized Controlled Trial. Am J Kidney Dis 2020; 75:847-856. [PMID: 31955921 DOI: 10.1053/j.ajkd.2019.10.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023]
Abstract
RATIONALE & OBJECTIVE Patients with chronic kidney disease (CKD) are particularly sensitive to dietary sodium. We evaluated a self-management approach for dietary sodium restriction in patients with CKD. STUDY DESIGN Randomized controlled trial. SETTING & PARTICIPANTS Nephrology outpatient clinics in 4 Dutch hospitals. 99 adults with CKD stages 1 to 4 or a functioning (estimated glomerular filtration rate≥25mL/min/1.73m2) kidney transplant, hypertension, and sodium intake>130mmol/d. INTERVENTION Routine care was compared with routine care plus a web-based self-management intervention including individual e-coaching and group meetings implemented over a 3-month intervention period, followed by e-coaching over a 6-month maintenance period. OUTCOMES Primary outcomes were sodium excretion after the 3-month intervention and after the 6-month maintenance period. Secondary outcomes were blood pressure, proteinuria, costs, quality of life, self-management skills, and barriers and facilitators for implementation. RESULTS Baseline estimated glomerular filtration rate was 55.0±22.0mL/min/1.73m2. During the intervention period, sodium excretion decreased in the intervention group from 188±8 (SE) to 148±8mmol/d (P<0.001), but did not change significantly in the control group. At 3 months, mean sodium excretion was 24.8 (95% CI, 0.1-49.6) mmol/d lower in the intervention group (P=0.049). At 3 months, systolic blood pressure (SBP) decreased in the intervention group from 140±3 to 132±3mm Hg (P<0.001), but was unchanged in the control group. Mean difference in SBP across groups was-4.7 (95% CI, -10.7 to 1.3) mm Hg (P=0.1). During the maintenance phase, sodium excretion increased in the intervention group, but remained lower than at baseline at 160±8mmol/d (P=0.01), while it decreased in the control group from 174±9 at the end of the intervention period to 154±9mmol/d (P=0.001). Consequently, no difference in sodium excretion between groups was observed after the maintenance phase. There was no difference in SBP between groups after the maintenance phase. LIMITATIONS Limited power, postrandomization loss to follow-up, Hawthorne effect, lack of dietary data, short-term follow-up. CONCLUSIONS A coaching intervention reduced sodium intake at 3 months. Efficacy during the maintenance phase was diminished, possibly due to inadvertent adoption of the intervention by the control group. FUNDING Grant funding from the Netherlands Organization for Health Research and Development and the Dutch Kidney Foundation. TRIAL REGISTRATION Registered at ClinicalTrials.gov with study number NCT02132013.
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Affiliation(s)
- Jelmer K Humalda
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerald Klaassen
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Hanne de Vries
- Department of Nephrology, ZGT Hospital, Almelo/Hengelo, the Netherlands
| | - Yvette Meuleman
- Department of Health, Medical and Neuropsychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Lara C Verschuur
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Elisabeth J M Straathof
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | - Willem Jan W Bos
- Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, the Netherlands; Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Paul J M van der Boog
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Olivier A Blanson Henkemans
- Department of Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Wilma Otten
- Department of Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Martin H de Borst
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Sandra van Dijk
- Department of Health, Medical and Neuropsychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, the Netherlands
| | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Matin H, Nadrian H, Jahangiry L, Sarbakhsh P, Shaghaghi A. Psychometric properties of the Persian Health Care Climate Questionnaire (HCCQ-P): assessment of type 2 diabetes care supportiveness in Iran. Patient Prefer Adherence 2019; 13:783-793. [PMID: 31190760 PMCID: PMC6529674 DOI: 10.2147/ppa.s201400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 04/18/2019] [Indexed: 12/27/2022] Open
Abstract
Background: Health-care systems play a key role in responding to the growing problems of patients with type 2 diabetes by supporting their autonomy in providing routine care. The Health Care Climate Questionnaire (HCCQ) was designed to assess patients' perceived degree of autonomy support within the care practice settings. The main purpose of this study was to translate and evaluate psychometric properties of the Persian version of the HCCQ (HCCQ-P) to be applied among Iranian and other Persian-speaking patients with type 2 diabetes. Method: Translation/back-translation procedures were carried out to prepare a preliminary draft of the HCCQ-P that was subsequently sent for face and content validity appraisal by a group of 15 health education/promotion and nursing specialists. Minor revisions were performed based on the feedback, and the content validity ratio (=0.91) and content validity index (=0.95) were within the acceptable range. The structural validity of the scale was assessed by exploratory and confirmatory factor analysis. Results: The exploratory and confirmatory factor analysis outputs (root mean square error of approximation=0.079, comparative fit index=0.976, Tucker Lewis index=0.967, standardized root mean square residual=0.022) demonstrated the proper performance and fitness statistics of the translated HCCQ in a one-dimensional model similar to the original scale. The internal consistency and reliability scores endorsed the validity of the translated measure (α=0.945, intraclass correlation coefficient=0.999, P=0.000). Conclusion: In this study, the translated HCCQ-P scale showed robust internal validity for its application in the assessment of health-care settings' supportiveness in care provision to Persian-speaking patients with type 2 diabetes. Future cross-cultural and multidisciplinary studies are recommended to investigate the applicability of the scale in different patients/cultural groups and health-care settings.
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Affiliation(s)
- H Matin
- Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - H Nadrian
- Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - L Jahangiry
- Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - P Sarbakhsh
- Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A Shaghaghi
- Health Education & Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence: A ShaghaghiHealth Education & Promotion Department, Tabriz University of Medical Sciences, Golgasht Street, Attar e Neishabouri Street, 5166614711, Tabriz, IranTel +98 914 841 6498Fax +98 413 334 0634Email
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Chironda G, Bhengu B. Barriers to management of Chronic Kidney Disease (CKD) CKD in a renal clinic in KwaZulu-Natal Province, South Africa – A qualitative study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Hu L, St-Jules DE, Popp CJ, Sevick MA. Determinants and the Role of Self-Efficacy in a Sodium-Reduction Trial in Hemodialysis Patients. J Ren Nutr 2018; 29:328-332. [PMID: 30579673 DOI: 10.1053/j.jrn.2018.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/21/2018] [Accepted: 10/12/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study was to assess the impact of baseline dietary self-efficacy on the effect of a dietary intervention to reduce sodium intake in patients undergoing hemodialysis (HD) and to identify determinants of low dietary self-efficacy. METHODS This is a post hoc analysis of the BalanceWise study, a randomized controlled trial that aimed to reduce dietary sodium intake in HD patients recruited from 17 dialysis centers in Pennsylvania. The main outcome measures include dietary self-efficacy and reported dietary sodium density. Analysis of variance with post hoc group-wise comparison was used to examine the effect of baseline dietary self-efficacy on changes in reported sodium density in the intervention and control groups at 8 and 16 weeks. Chi-square test, independent t tests, or Wilcoxon rank-sum tests were used to identify determinants of low dietary self-efficacy. RESULTS The interaction between dietary self-efficacy and the impact of the intervention on changes in reported dietary sodium density approached significance at 8 and 16 weeks (P interaction = 0.051 and 0.06, respectively). Younger age and perceived income inadequacy were significantly associated with low self-efficacy in patients undergoing HD. CONCLUSION The benefits of dietary interventions designed to improve self-efficacy may differ by the baseline self-efficacy status. This may be particularly important for HD patients who are younger and report inadequate income as they had lower dietary self-efficacy.
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Affiliation(s)
- Lu Hu
- New York University School of Medicine, Center for Healthful Behavior Change, New York, New York.
| | - David E St-Jules
- New York University School of Medicine, Center for Healthful Behavior Change, New York, New York
| | - Collin J Popp
- New York University School of Medicine, Center for Healthful Behavior Change, New York, New York
| | - Mary Ann Sevick
- New York University School of Medicine, Center for Healthful Behavior Change, New York, New York
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Cobb M, Pacitti D. The Importance of Sodium Restrictions in Chronic Kidney Disease. J Ren Nutr 2018; 28:e37-e40. [DOI: 10.1053/j.jrn.2018.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/01/2018] [Indexed: 12/12/2022] Open
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Nerbass FB, Calice-Silva V, Pecoits-Filho R. Sodium Intake and Blood Pressure in Patients with Chronic Kidney Disease: A Salty Relationship. Blood Purif 2018; 45:166-172. [PMID: 29478050 DOI: 10.1159/000485154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hypertension affects almost all chronic kidney disease patients and is related to poor outcomes. Sodium intake is closely related to blood pressure (BP) levels in this population and decreasing its intake consistently improves the BP control particularly in short-term controlled trials. However, most patients struggle in following a controlled diet on sodium according to the guidelines recommendation due to several factors and barriers discussed in this article. SUMMARY This review article summarizes the current knowledge related to the associations between sodium consumption, BP, and the risk of cardiovascular disease and chronic kidney disease (CKD); it also provides recommendations of how to achieve sodium intake lowering. Key Messages: Evidences support the benefits in decreasing sodium intake on markers of cardiovascular and renal outcomes in CKD. Trials had shorter follow-up and to maintain long-term sodium intake control is a major challenge. Larger studies with longer follow-up looking at hard endpoints will be important to drive future recommendations.
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Affiliation(s)
- Fabiana B Nerbass
- Department of Internal Medicine, School of Medicine, Pontificia Universidade Católica do Paraná, Curitiba, Brazil.,Division of Nephrology, Pro-Rim Foundation, Joinville, Brazil
| | - Viviane Calice-Silva
- Department of Internal Medicine, School of Medicine, Pontificia Universidade Católica do Paraná, Curitiba, Brazil.,Division of Nephrology, Pro-Rim Foundation, Joinville, Brazil
| | - Roberto Pecoits-Filho
- Department of Internal Medicine, School of Medicine, Pontificia Universidade Católica do Paraná, Curitiba, Brazil
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