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Taşkin Duman H, Karadakovan A. The effect of video training on symptom burden, comfort level, and quality of life in hemodialysis patients: Clustered randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2024; 126:108314. [PMID: 38761675 DOI: 10.1016/j.pec.2024.108314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE Use of video in patient education is becoming widespread due to its low cost, time management, ease of application, and permanent learning. The study aimed to investigate the effect of video training on the symptom burden, comfort level, and quality of life of patients undergoing hemodialysis treatment. METHODS In this clustered randomized controlled trial, the patients were randomly assigned to groups by lottery method according to hemodialysis treatment days and sessions. Individuals in the intervention group(n = 26) were screened one episode of the training video in each session for three episodes per week for 12 weeks. Individuals in the control group(n = 22) received only conventional hemodialysis without video training. RESULTS At the third and fourth measurement times, in intervention group, mean scores of symptom burden decreased compared to baseline (respectively:40,12 ± 21,63; 22,31 ± 14,08;21,54 ± 16,78), mean scores of comfort level increased (respectively:102,42 ± 13,45; 111,42 ± 8,00;115,04 ± 9,73)(p < 0.05), while there was no significant difference in control group(p > 0.05). This study observed a statistically significant difference between quality of life scale scores individuals in intervention group(p < 0,05). CONCLUSION It was concluded that video training delivered to patients undergoing hemodialysis treatment decreased symptom burden of patients and increased their comfort level, and quality of life. PRACTICE IMPLICATIONS Video training can be utilized in the educational program of hemodialysis patients.
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Affiliation(s)
- Halise Taşkin Duman
- Muğla Sıtkı Koçman University Fethiye Faculty of Health Sciences, Nursing Department, Muğla, Turkey.
| | - Ayfer Karadakovan
- Ege University Faculty of Nursing, Nursing Department, İzmir, Turkey
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Ouirdani M, Boutib A, Azizi A, Chergaoui S, Saad EM, Hilali A, Marfak A, Youlyouz-Marfak I. Impact of Nutrition Education on Various Health-Related Components of Hemodialysis Patients: A Systematic Review. Healthcare (Basel) 2024; 12:1197. [PMID: 38921311 PMCID: PMC11203892 DOI: 10.3390/healthcare12121197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
This study aimed to identify the impact of nutrition education on various health-related components of hemodialysis patients. A systematic review was conducted according to the PRISMA guidelines. Relevant literature published between 2013 and 2023 was identified across two databases (PubMed and Science Direct). The protocol was registered in PROSPERO (CRD42023460681). Two independent reviewers retrieved the data, and 41 studies were selected. Nine components related to the impact of nutrition education in hemodialysis patients were identified. Each component was clarified by mentioning each study and its results. This study enabled us to characterize the various components of the impact of nutritional education in hemodialysis patients, namely biological markers, quality of life, cost of care, adherence to dietary recommendations, knowledge, malnutrition inflammation, dietary intake, weight change, and behavior change. This systematic review enables healthcare providers to assess the impact of nutritional education on hemodialysis patients. Also, it gives professionals an exact idea of the impact of nutrition education on hemodialysis patients, with knowledge of new methods using behavior change theories and innovative technological tools.
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Affiliation(s)
- Marouane Ouirdani
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco; (A.B.); (A.A.); (S.C.); (E.M.S.); (A.H.); (I.Y.-M.)
| | - Amal Boutib
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco; (A.B.); (A.A.); (S.C.); (E.M.S.); (A.H.); (I.Y.-M.)
| | - Asmaa Azizi
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco; (A.B.); (A.A.); (S.C.); (E.M.S.); (A.H.); (I.Y.-M.)
| | - Samia Chergaoui
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco; (A.B.); (A.A.); (S.C.); (E.M.S.); (A.H.); (I.Y.-M.)
| | - El Madani Saad
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco; (A.B.); (A.A.); (S.C.); (E.M.S.); (A.H.); (I.Y.-M.)
| | - Abderraouf Hilali
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco; (A.B.); (A.A.); (S.C.); (E.M.S.); (A.H.); (I.Y.-M.)
| | - Abdelghafour Marfak
- National School of Public Health, Ministry of Health and Social Protection, Rabat 6329, Morocco;
- Pole of Health, Euro-Mediterranean University of Fez (UEMF), Fez 51, Morocco
| | - Ibtissam Youlyouz-Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco; (A.B.); (A.A.); (S.C.); (E.M.S.); (A.H.); (I.Y.-M.)
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Rafiee M, Khandan M. An Investigation of the Effectiveness of Distance Learning on Nutrition Quality of Hemodialysis Patients during the COVID-19 Pandemic: A Single-Blind Randomized Clinical Trial. J Caring Sci 2024; 13:36-43. [PMID: 38659437 PMCID: PMC11036171 DOI: 10.34172/jcs.2024.33055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/04/2023] [Indexed: 04/26/2024] Open
Abstract
Introduction The COVID-19 pandemic has limited hemodialysis patient's attendance in healthcare centers and receiving diet education. This study was conducted to investigate the effectiveness of distance learning on the nutrition quality of hemodialysis patients during the COVID-19 pandemic. Methods In the single-blind randomized clinical trial, 60 patients undergoing hemodialysis were randomly divided into control (n=30) and experimental (n=30) groups. Before and after the intervention, Dialysis Malnutrition Score (DMS), Malnutrition-Inflammation Score (MIS) (primary outcome), albumin, the total iron-binding capacity of the blood (TIBC), and body mass index (BMI) (Secondary outcome) were investigated. The experimental group received educational content through social networks for three months, whereas the control group received routine care and training. Results There was no significant difference between the two groups in terms of the mean of DMS, MIS, albumin, and TIBC before the intervention. Pre-test BMI had a confounding effect; therefore, an analysis of covariance was performed to eliminate that effect. This analysis showed significant differences in the post-test mean DMS, MIS, TIBC, and BMI between the two groups. In the control group, significant differences were observed in MIS and BMI toward deterioration. The results also indicated a significant relationship between education level and age with TIBC and between marital status and albumin index. Conclusion Distance learning can be considered by healthcare managers and police makers as a suitable alternative to the classic face-to-face learning method to enhance hemodialysis patients' nutrition quality during the COVID-19 pandemic.
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Affiliation(s)
- Mahdieh Rafiee
- Department of Nursing, School of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Maryam Khandan
- Department of Nursing, School of Nursing and Midwifery, Kerman Branch, Islamic Azad University, Kerman, Iran
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Curtis F, Burton JO, Butt A, Dhaliwal HK, Graham-Brown MM, Lightfoot CJ, Rawat R, Smith AC, Wilkinson TJ, March DS. Lifestyle interventions delivered by eHealth in chronic kidney disease: A scoping review. PLoS One 2024; 19:e0297107. [PMID: 38266006 PMCID: PMC10807786 DOI: 10.1371/journal.pone.0297107] [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: 09/11/2023] [Accepted: 12/22/2023] [Indexed: 01/26/2024] Open
Abstract
A method of overcoming barriers associated with implementing lifestyle interventions in CKD may be through the use of eHealth technologies. The aim of this review was to provide an up-to-date overview of the literature on this topic. Four bibliographical databases, two trial registers, and one database for conference proceedings were searched from inception to August 2023. Studies were eligible if they reported a lifestyle intervention using eHealth technologies. A narrative synthesis of the findings from the included studies structured around the type of eHealth intervention was presented. Where a sufficient number of studies overlapped in terms of the type of intervention and outcome measure these were brought together in a direction of effect plot. There were 54 included articles, of which 23 were randomised controlled trials (RCTs). The main component of the intervention for the included studies was mobile applications (n = 23), with the majority being in the dialysis population (n = 22). The majority of eHealth interventions were reported to be feasible and acceptable to participants. However, there was limited evidence that they were efficacious in improving clinical outcomes with the exception of blood pressure, intradialytic weight gain, potassium, and sodium. Although eHealth interventions appear acceptable and feasible to participants, there is insufficient evidence to make recommendations for specific interventions to be implemented into clinical care. Properly powered RCTs which not only demonstrate efficacy, but also address barriers to implementation are needed to enhance widespread adoption.
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Affiliation(s)
- Ffion Curtis
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, United Kingdom
| | - James O. Burton
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Ayesha Butt
- Leicester Diabetes Centre, University of Leicester, Leicester, United Kingdom
| | | | - Matthew M.P. Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Courtney J. Lightfoot
- Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Rishika Rawat
- Leicester Medical School, University of Leicester, Leicester, United Kingdom
| | - Alice C. Smith
- Department of Population Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Thomas J. Wilkinson
- Leicester Diabetes Centre, University of Leicester, Leicester, United Kingdom
| | - Daniel S. March
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Visiedo L, López F, Rivas-Ruiz F, Tortajada B, Giménez Martínez R, Abilés J. Effect of a personalized nutritional intervention program on nutritional status, quality of life and mortality in hemodialysis patients. NUTR HOSP 2023; 40:1229-1235. [PMID: 37705451 DOI: 10.20960/nh.04756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Introduction Objective: dietary advice provided through a nutritional intervention program (NIP) is recommended by renal clinic guidelines to prevent or treat malnutrition, that could improve quality of life (QoL) and survival in hemodialysis (HD) patients. This study set out to evaluate the effect of a personalized NIP on the nutritional status and its impact on QoL and mortality in dialyzed patients. Material and methods: this was a 12-month intervention study with regular follow-up in which nutritional parameters were measured at baseline and after 6 and 12 months. QoL was assessed by the Kidney Disease Quality of Life version 1.2 (KDQOL-SF) at baseline and at the end of the study. All dialyzed patients received individualized consultations with a trained dietitian. The content of the nutritional education program included a personalized meal plan and educational materials addressing nutrition to manage fluids, electrolytes, and vitamin D. Results: a total of 75 patients were included. After the NIP, visceral proteins, phosphorous, potassium and vitamin D levels had improved significantly (p < 0.001). The percentage of well-nourished patients increased by 30 % (p < 0.001). At the end of the study, the well-nourished patients had significantly improved scores on the general summary areas of the KDQOL-SF, reduced worry concerning fluid and dietary restrictions (p < 0.001), and the survival rate was 12 months longer (p < 0.01). Conclusion: the results of this study suggest that personalized NIP contributed to improved nutritional status, QoL and survival in HD patients.
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Affiliation(s)
- Lucía Visiedo
- Pharmacy and Nutrition Unit. Hospital Universitario Costa del Sol
| | | | | | - Begoña Tortajada
- Pharmacy and Nutrition Unit. Hospital Universitario Costa del Sol
| | | | - Jimena Abilés
- Pharmacy and Nutrition Unit. Hospital Universitario Costa del Sol
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Barello S, Anderson G, Acampora M, Bosio C, Guida E, Irace V, Guastoni CM, Bertani B, Graffigna G. The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: a systematic review and a meta-analysis. Int Urol Nephrol 2023; 55:897-912. [PMID: 36180655 PMCID: PMC10030538 DOI: 10.1007/s11255-022-03374-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Hemodialysis has become a standard therapy for adults with end-stage renal diseases. Adults undergoing hemodialysis have to cope with unique psychological issues that make their care journey particularly fatiguing. In this systematic review and meta-analysis, we aimed to summarize and evaluate the effects of psychosocial interventions on the reduction of anxiety and depression in adults with HDs. METHODS We included randomized controlled trials and quasi-experimental studies that measure change in depression, anxiety, and quality of life. RESULTS We identify three categories of psychosocial interventions delivered to adults undergoing hemodialysis. Based on our analysis, there was a medium effect of psychosocial intervention on depression (SMD - 0.85, 95%CI - 1.17; - 0.52, I2 = 80%, p < 0.01) and anxiety (SMD - 0.99, 95%CI - 1.65; - 0.33, I2 = 88%, p < 0.01) in adults undergoing hemodialysis. CONCLUSIONS Psychosocial interventions, such as psychological support or relaxation-based therapy, seems all to reduce depression and anxiety in adults undergoing HD. Preliminary evidence suggests that there may be a benefit of psychosocial interventions on the quality of life for adults undergoing HD.
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Affiliation(s)
- Serena Barello
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy.
- Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123, Milan, Italy.
| | - Gloria Anderson
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Marta Acampora
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Caterina Bosio
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elena Guida
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Vincenzo Irace
- Associazione Nazionale Emodializzati Emodialisi e Trapianto-ONLUS, Rome, Italy
| | | | - Barbara Bertani
- Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123, Milan, Italy
- Ordine degli Psicologi della Lombardia, Milan, Italy
| | - Guendalina Graffigna
- EngageMinds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, L.go Gemelli 1, 20123, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, via Milano 24, 26100, Cremona, Italy
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Worboys HM, Cooper NJ, Burton JO, Young HML, Waheed G, Fotheringham J, Gray LJ. Measuring quality of life in trials including patients on haemodialysis: methodological issues surrounding the use of the Kidney Disease Quality of Life Questionnaire. Nephrol Dial Transplant 2022; 37:2538-2554. [PMID: 35689670 PMCID: PMC9681926 DOI: 10.1093/ndt/gfac170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Haemodialysis (HD) treatment causes a significant decrease in quality of life (QoL). When enrolled in a clinical trial, some patients are lost prior to follow-up because they die or they receive a kidney transplant. It is unclear how these patients are dealt with in the analysis of QoL data. There are questions surrounding the consistency of how QoL measures are used, reported and analysed. METHODS A systematic search of electronic databases for trials measuring QoL in HD patients using any variation of the Kidney Disease Quality of Life (KDQoL) Questionnaire was conducted. The review was conducted in Covidence version 2. Quantitative analysis was conducted in Stata version 16. RESULTS We included 61 trials in the review, of which 82% reported dropouts. The methods to account for missing data due to dropouts include imputation (7%) and complete case analysis (72%). Few trials (7%) conducted a sensitivity analysis to assess the impact of missing data on the study results. Single imputation techniques were used, but are only valid under strong assumptions regarding the type and pattern of missingness. There was inconsistency in the reporting of the KDQoL, with many articles (70%) amending the validated questionnaires or reporting only statistically significant results. CONCLUSIONS Missing data are not dealt with according to the missing data mechanism, which may lead to biased results. Inconsistency in the use of patient-reported outcome measures raises questions about the validity of these trials. Methodological issues in nephrology trials could be a contributing factor to why there are limited effective interventions to improve QoL in this patient group. PROSPERO REGISTRATION CRD42020223869.
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Affiliation(s)
- Hannah M Worboys
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Nicola J Cooper
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - James O Burton
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Hannah M L Young
- Leicester Diabetes Centre, University of Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Ghazala Waheed
- Leicester Clinical Trials Unit, University of Leicester, Leicester, UK
| | - James Fotheringham
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
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Sugizaki CSA, Rodrigues HCN, Ivo JFM, Freitas ATVS, Stringhini MLF, Paiva SAR, Minicucci MF, Peixoto MRG, Costa NA. The relationship between grip strength with health-related quality of life and mortality in hemodialysis patients. NUTRIRE : REVISTA DE SOCIEDADE BRASILEIRA DE ALIMENTACAO E NUTRICAO = JOURNAL OF THE BRAZILIAN SOCIETY OF FOOD AND NUTRITION 2022; 47:21. [PMID: 38625334 PMCID: PMC9422936 DOI: 10.1186/s41110-022-00171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/13/2022] [Indexed: 12/02/2022]
Abstract
Purpose Hemodialysis (HD) is a therapeutic modality that enables the highest survival for individuals with chronic kidney disease (CKD). In contrast, HD contributes to the pro-inflammatory state and may negatively affect the muscle strength and quality of life (QoL) of these individuals. To date, few studies have evaluated the association between decrease in strength and QoL in HD patients. Thus, our objective was to assess whether diminished muscle strength is associated with worse health related QoL and mortality. Methods We included patients aged ≥ 18 years on HD. Clinical and demographic data were collected from patients' medical records. Clinical data, nutritional status (laboratory, anthropometry, bioimpedance analysis) and health-related QoL (World Health Organization's quality of life questionnaire, WHOQOL-Bref) were analyzed at baseline. Mortality was recorded for 32 months. Results Among the 105 patients evaluated, the median age was 52 (43-64) years, and males were predominant (n = 73; 70%). The general median of QoL was 66.8 ± 11.9. Approximately 30% of patients were considered to have a worse QoL and 12,4% to have low muscle strength. This was not associated with QoL and mortality. HD vintage greater then to 5 years was associated with higher dissatisfaction in the perception of the environmental domain and overall QoL. Conclusion Our data suggest that low muscle strength was not associated with health-related QoL using the WHOQOL-Bref instrument and mortality.
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Affiliation(s)
- Clara S. A. Sugizaki
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Hellen C. N. Rodrigues
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Jéssica F. M. Ivo
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Ana T. V. S. Freitas
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Maria L. F. Stringhini
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Sérgio A. R. Paiva
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, São Paulo Brazil
| | - Marcos F. Minicucci
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, São Paulo Brazil
| | - Maria R. G. Peixoto
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Nara A. Costa
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
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UZDİL Z, TÜRKER PF, TERZİ M. Effects of nutrition education given to persons with multiple sclerosis and their families on diet quality and anthropometric and biochemical measurements. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e220153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
ABSTRACT Objective: In this study, it was aimed to investigate the effects of nutrition education given to persons with multiple sclerosis and their families on anthropometric and biochemical measurements and diet quality. Methods: Data from 51 persons with multiple sclerosis were analysed in this intervention study. The study was conducted with 3 groups. The education group consisted of only persons with multiple sclerosis, the family education group consisted of persons with multiple sclerosis and a family member living with them, and the control group consisted of persons with multiple sclerosis who had not received an education. Anthropometric and biochemical measurements and dietary quality assessments were made before (T1) and immediately after education (T2) and also 3 months after education (follow-up, T3). Results: The distribution of family education group diet quality scores showed a significant increase from “poor” to “needs improvement” at T3 compared to T1. The upper middle arm circumference measurements of the female control group were decreased at T2 and T3 [from 29.0 (23-34) cm to 28.0 (22-31) cm and to 27.5 (22-31) cm]. Women in family education group, levels of serum haemoglobin and haematocrit were higher than in control group at T2 and T3. Also, men in family education group, levels of alanine aminotransferase were lower than those in education group at follow up. Levels of total cholesterol and low-density lipoprotein cholesterol in education group were higher than those control group at T1, T2, and T3. Conclusion: This study indicates that nutrition education affects some biochemical and anthropometric measurements in persons with multiple sclerosis. Diet quality improved when receiving education together with families.
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Kurniawan AL, Yang YL, Chin MY, Hsu CY, Paramastri R, Lee HA, Ni PY, Chao J. Association of Nutrition Education and Its Interaction with Lifestyle Factors on Kidney Function Parameters and Cardiovascular Risk Factors among Chronic Kidney Disease Patients in Taiwan. Nutrients 2021; 13:nu13020298. [PMID: 33494197 PMCID: PMC7909784 DOI: 10.3390/nu13020298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
We evaluated the interactive effects of nutrition education (NE) and lifestyle factors on kidney function parameters and cardiovascular risk factors among chronic kidney disease (CKD) patients. This cross-sectional cohort study recruited 2176 CKD stages 3-5 patients aged > 20 years from Integrated Chronic Kidney Disease Care Network, Shuang Ho Hospital, Taiwan between December 2008 and April 2019. The multivariable regression analysis was performed to investigate the interactive effects of NE with lifestyle factors on kidney function parameters and cardiovascular risk factors. Relative excess risk due to interaction (RERI) and attributable proportion (AP) were applied to assess additive interaction. Patients who were smoking or physically inactive but received NE had better estimated glomerular filtration rate (eGFR) (β: 3.83, 95% CI: 1.17-6.49 or β: 3.67, 95% CI: 2.04-5.29) compared to those without NE. Patients with smoking and NE significantly reduced risks for having high glycated hemoglobin A1c (HbA1c) by 47%, high low-density lipoprotein cholesterol (LDL-C) by 38%, and high corrected calcium (C-Ca) by 50% compared to those without NE. Moreover, NE and smoking or inactive physical activity exhibited an excess risk of high C-Ca (RERI: 0.47, 95% CI: 0.09-0.85 for smoking or RERI: 0.46, 95% CI: 0.01-0.90 and AP: 0.51, 95% CI: 0.03-0.99 for physical activity). Our study suggests that CKD patients who were enrolled in the NE program had better kidney function. Thus, NE could be associated with slowing kidney function decline and improving cardiovascular risk factors.
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Affiliation(s)
- Adi-Lukas Kurniawan
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Xinyi District, Taipei 110, Taiwan; (A.-L.K.); (R.P.); (P.-Y.N.)
- Research Center for Healthcare Industry Innovation, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Peitou District, Taipei 112, Taiwan
| | - Ya-Lan Yang
- Diet and Nutrition Department, Shuang Ho Hospital, Taipei Medical University, 291 Jhongjheng Road, Jhonghe District, New Taipei 235, Taiwan;
| | - Mei-Yun Chin
- Diet and Nutrition Department, Shuang Ho Hospital, Taipei Medical University, 291 Jhongjheng Road, Jhonghe District, New Taipei 235, Taiwan;
- Correspondence: (M.-Y.C.); (J.C.); Tel.: +886-2-2249-0088 (ext.8312) (M.-Y.C.); +886-2-2736-1661 (ext. 6548) (J.C.)
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Peitou District, Taipei 112, Taiwan;
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Xinyi District, Taipei 110, Taiwan
| | - Rathi Paramastri
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Xinyi District, Taipei 110, Taiwan; (A.-L.K.); (R.P.); (P.-Y.N.)
| | - Hsiu-An Lee
- Department of Computer Science and Information Engineering, Tamkang University, 151 Yingzhuan Road, Tamsui District, New Taipei 251, Taiwan;
| | - Po-Yuan Ni
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Xinyi District, Taipei 110, Taiwan; (A.-L.K.); (R.P.); (P.-Y.N.)
| | - Jane Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Xinyi District, Taipei 110, Taiwan; (A.-L.K.); (R.P.); (P.-Y.N.)
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Xinyi District, Taipei 110, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Xinyi District, Taipei 110, Taiwan
- Correspondence: (M.-Y.C.); (J.C.); Tel.: +886-2-2249-0088 (ext.8312) (M.-Y.C.); +886-2-2736-1661 (ext. 6548) (J.C.)
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