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Jaelani TR, Ibrahim K, Jonny J, Pratiwi SH, Haroen H, Nursiswati N, Ramadhani BP. Peritoneal Dialysis Patient Training Program to Enhance independence and Prevent Complications: A Scoping Review. Int J Nephrol Renovasc Dis 2023; 16:207-222. [PMID: 37720493 PMCID: PMC10505035 DOI: 10.2147/ijnrd.s414447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/04/2023] [Indexed: 09/19/2023] Open
Abstract
Background Peritoneal dialysis (PD) training is essential to ensure patient independence and prevent life-threatening complications, such as peritonitis. The International Society for Peritoneal Dialysis (ISPD) recommends that every PD unit worldwide implement local PD training programs with the goal of improving self-care capabilities. This scoping review aims to give an overview of recent literature and recommendations on PD training programs aiming to improve the quality of care and outcomes for PD patients. Methods The literature search was conducted using the PC (Population, Concept) approach. The population of interest in this study is PD patients, and the study concept is the PD training program. Several databases were used to conduct the literature search, including PubMed, Science Direct, and CINAHL. The search process began from July 2022 until January 2023. The inclusion criteria for the search included research articles and recommendations. Results The search yielded 22 articles recommending training programs lasting from 5-8 days, with 1-3-hour sessions and a nurse-to-patient ratio of 1:1. A cumulative training time of 15 hours or more is recommended to enhance patient independence and reduce peritonitis rates. Home-based or in-unit PD training, conducted by experienced nurses using adult learning strategies, has shown significant value in improving self-care and preventing peritonitis. Evaluating training outcomes should encompass knowledge, skills, and attitudes, and the impact on peritonitis rates. Training programs should be flexible and consider physiological and psychosocial barriers to achieving the best results. Conclusion There are a variety of strategies for dialysis training concerning duration, session length, patient-to-trainer ratio, timing, methods, location, compliance, and the need for retraining. More evidence is needed to assess the impact of PD patient training programs on self-care capabilities and peritonitis incidence. Future studies should investigate the effects of training programs on compliance, self-efficacy, and patient and nurse perspectives.
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Affiliation(s)
| | - Kusman Ibrahim
- Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia
| | - Jonny Jonny
- Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia
| | | | - Hartiah Haroen
- Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia
| | | | - Bunga Pinandhita Ramadhani
- Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia
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Jeloka TK, Abraham G, Bhalla AK, Balasubramaniam J, Dutta A, Gokulnath, Gupta A, Jha V, Khanna U, Mahajan S, Nayak KS, Prasad KN, Prasad N, Rathi M, Raju S, Rohit A, Sahay M, Sampathkumar K, Sivakumar V, Varughese S. Continuous Ambulatory Peritoneal Dialysis Peritonitis Guidelines - Consensus Statement of Peritoneal Dialysis Society of India - 2020. Indian J Nephrol 2021; 31:425-434. [PMID: 34880551 PMCID: PMC8597799 DOI: 10.4103/ijn.ijn_73_19] [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: 04/07/2019] [Revised: 05/08/2019] [Accepted: 06/30/2019] [Indexed: 11/25/2022] Open
Abstract
Continuous ambulatory peritoneal dialysis (CAPD) related peritonitis is a major cause of technique failure, morbidity, and mortality in patients on CAPD. Its prevention and management is key to success of CAPD program. Due to variability in practice, microbiological trends and sensitivity towards antibiotics, there is a need for customized guidelines for management of CAPD related peritonitis (CAPDRP) in India. With this need, Peritoneal Dialysis Society of India (PDSI) organized a structured meeting to discuss various aspects of management of CAPDRP and formulated a consensus agreement which will help in management of patients with CAPDRP.
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Affiliation(s)
- Tarun K Jeloka
- Department of Nephrology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
| | - Georgi Abraham
- Department of Nephrology, Madras Medical Mission, Chennai, Tamil Nadu, India
| | - A K Bhalla
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - J Balasubramaniam
- Department of Nephrology, Kidney Care Centre, Tirunelveli, Tamil Nadu, India
| | - A Dutta
- Department of Nephrology, Fortis Hospital and Kidney Institute, Kolkata, West Bengal, India
| | - Gokulnath
- Department of Nephrology, Apollo Hospital, Bengaluru, Karnataka, India
| | - Amit Gupta
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India
| | - V Jha
- The George Institute for Global Health, New Delhi, India
| | - Umesh Khanna
- Department of Nephrology, Lancelot Kidney and GI Centre, Mumbai, Maharashtra, India
| | - Sandeep Mahajan
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - K S Nayak
- Department of Nephrology, Virinchi Hospitals, Hyderabad, Telangana, India
| | - K N Prasad
- Department of Microbiology, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India
| | - Narayan Prasad
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute, Lucknow, Uttar Pradesh, India
| | - Manish Rathi
- Department of Nephrology, Post Graduate Institute, Chandigarh, India
| | - Sreebhushan Raju
- Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Anusha Rohit
- Department of Microbiology, Madras Medical Mission, Chennai, Tamil Nadu, India
| | - Manisha Sahay
- Department of Nephrology, Osmania Hospital, Hyderabad, Telangana, India
| | - K Sampathkumar
- Department of Nephrology, Meenakshi Mission Hopsital and Research Centre, Madurai, Tamil Nadu, India
| | - V Sivakumar
- Department of Nephrology, SriVenkateshwara Institute of Medical sciences, Tirupati, Andhra Pradesh, India
| | - Santosh Varughese
- Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
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Gadola L, Poggi C, Dominguez P, Poggio MV, Lungo E, Cardozo C. Risk Factors And Prevention of Peritoneal Dialysis-Related Peritonitis. Perit Dial Int 2018; 39:119-125. [PMID: 30257996 DOI: 10.3747/pdi.2017.00287] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/02/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Peritonitis is a major complication and the main cause of peritoneal dialysis (PD) failure. The aim of the present study was to evaluate peritonitis risk factors and its prevention with a new peritoneal educational program (NPEP). METHODS We performed a retrospective analysis of a cohort of chronic PD patients, older than 16 years, who began PD in the period 1 January 1999 to 31 December 2015 at a Uruguayan PD center, with follow-up until 31 December 2016. RESULTS The population included 222 cases (219 patients, 128 men), median age 59 (interquartile range [IQR] 47.0 - 72.0) years, median time on PD 17.5 (IQR 6.0 - 36.2) months. Ninety-five patients suffered 1 or more episodes of peritonitis, and they had been on PD for a longer period and had nasal-positive culture more frequently. A NPEP started in September 2008; patients who trained with it, as well as younger patients, had longer peritonitis-free survival. After the NPEP, global peritonitis rates decreased significantly (from 0.48 to 0.29 episodes/patient-year, respectively), particularly gram-positive bacteria and Staphylococcus aureus / coagulase-negative (CoNS) (from 0.26 to 0.12 and 0.21 to 0.07 episodes/patient-year, respectively). In the multivariate Cox analysis of peritonitis risk factors, survival to first peritonitis was significantly associated only with age (hazard ratio [HR] 1.024, 95% confidence interval [CI] 1.007 - 1.397, p = 0.007) and the NPEP (HR 0.600, 95% CI 0.394 - 0.913, p = 0.017). CONCLUSION A multidisciplinary peritoneal educational program may improve peritonitis rates, independently of other risk factors.
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Affiliation(s)
- Liliana Gadola
- Centro de Diálisis Peritoneal, CASMU IAMPP, Montevideo, Uruguay .,Centro de Nefrología, Universidad de la República, Montevideo, Uruguay
| | - Carla Poggi
- Centro de Diálisis Peritoneal, CASMU IAMPP, Montevideo, Uruguay
| | | | - María V Poggio
- Centro de Diálisis Peritoneal, CASMU IAMPP, Montevideo, Uruguay
| | - Eliana Lungo
- Centro de Diálisis Peritoneal, CASMU IAMPP, Montevideo, Uruguay
| | - Claudia Cardozo
- Centro de Diálisis Peritoneal, CASMU IAMPP, Montevideo, Uruguay
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Lambert K, Mansfield K, Mullan J. Qualitative exploration of the experiences of renal dietitians and how they help patients with end stage kidney disease to understand the renal diet. Nutr Diet 2018; 76:126-134. [PMID: 29968271 DOI: 10.1111/1747-0080.12443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/17/2018] [Accepted: 05/21/2018] [Indexed: 10/28/2022]
Abstract
AIM Dietary modification is integral to the management of end stage kidney disease. However, adherence to the renal diet is poor. Few studies have explored the perspectives of renal dietitians and how they work with patients to facilitate dietary change. The objectives of this study were to explore the experiences of renal dietitians about educating patients with end stage kidney disease; and to describe the strategies perceived to help patients understand the renal diet. METHODS Semi-structured interviews based on Sensemaking theory were conducted with renal dietitians (n = 27) working in Australia and New Zealand from a range of metropolitan, regional and remote areas. RESULTS Five major themes across two categories were derived from the data. The renal dietitians in this study experienced feelings of frustration, frequently worked in practice environments with limited or inadequate resources and perceived that establishing trust and demonstrating empathy were important to sense making. Renal dietitians helped patients make sense of and understand the diet by clarifying ambiguities and conflicting information; and simplifying complexity by using simple explanations, individualised advice and practical support. These strategies were considered critical to the renal diet sense making process. CONCLUSIONS The experience of providing renal diet advice to adults with end stage kidney disease was emotionally and professionally challenging. Alternative approaches to patient education may help dietitians to empower patients to better understand the renal diet. Further research exploring the experiences of learning about the renal diet from the patient and carer perspective would also help to inform future alternative approaches.
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Affiliation(s)
- Kelly Lambert
- Department of Clinical Nutrition, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Kylie Mansfield
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Judy Mullan
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.,Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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5
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Li PKT, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, Fish DN, Goffin E, Kim YL, Salzer W, Struijk DG, Teitelbaum I, Johnson DW. ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Perit Dial Int 2016; 36:481-508. [PMID: 27282851 PMCID: PMC5033625 DOI: 10.3747/pdi.2016.00078] [Citation(s) in RCA: 612] [Impact Index Per Article: 76.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 05/04/2016] [Indexed: 12/19/2022] Open
Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Cheuk Chun Szeto
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Beth Piraino
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Javier de Arteaga
- Department of Nephrology, Hospital Privado and Catholic University, Cordoba, Argentina
| | - Stanley Fan
- Department of Renal Medicine and Transplantation, Barts Health NHS Trust, London, UK
| | - Ana E Figueiredo
- Nursing School-FAENFI, Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Douglas N Fish
- Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA
| | - Eric Goffin
- Department of Nephrology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Belgium
| | - Yong-Lim Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Clinical Research Center for End Stage Renal Disease, Daegu, Korea
| | - William Salzer
- University of Missouri-Columbia School of Medicine, Department of Internal Medicine, Section of Infectious Disease, MI, USA
| | - Dirk G Struijk
- Department of Nephrology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - David W Johnson
- Department of Nephrology, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia
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Bergjan M, Schaepe C. Educational strategies and challenges in peritoneal dialysis: a qualitative study of renal nurses' experiences. J Clin Nurs 2016; 25:1729-39. [PMID: 27074958 DOI: 10.1111/jocn.13191] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2015] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of the study was to explore renal nurses' experiences, strategies and challenges with regard to the patient education process in peritoneal dialysis. BACKGROUND Patient education in peritoneal dialysis is essential to developing a successful home-based peritoneal dialysis program. In this area research is scarce and there is a particular lack of focus on the perspective of the renal nurse. DESIGN Qualitative design formed by thematic qualitative text analysis. METHODS Five group interviews (n = 20) were used to explore the challenges peritoneal dialysis nurses face and the training strategies they use. The interviews were analyzed with thematic qualitative content analysis using deductive and inductive subcategory application. RESULTS The findings revealed the education barriers perceived by nurses that patients may face. They also showed that using assessment tools is important in peritoneal dialysis patient education, as is developing strategies to promote patient self-management. There is a need for a deeper understanding of affective learning objectives, and existing teaching activities and materials should be revised to incorporate the patient's perspective. Patients usually begin having questions about peritoneal dialysis when they return home and are described as feeling overwhelmed. Adapting existing conditions is considered a major challenge for patients and nurses. CONCLUSIONS The results provided useful insights into the best approaches to educating peritoneal dialysis patients and served to raise awareness of challenges experienced by renal nurses. Findings underline the need for nosogogy - an approach of teaching adults (andragogy) with a chronic disease. Flexibility and cooperation are competencies that renal nurses must possess. RELEVANCE TO CLINICAL PRACTICE Still psychomotor skills dominate peritoneal dialysis patient training, there is a need of both a deeper understanding of affective learning objectives and the accurate use of (self-)assessment tools, particularly for health literacy.
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Affiliation(s)
- Manuela Bergjan
- Institute of Health and Nursing Science, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Christiane Schaepe
- Institute of Health and Nursing Science, Charité - Universitaetsmedizin Berlin, Berlin, Germany
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7
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Figueiredo AE, Bernardini J, Bowes E, Hiramatsu M, Price V, Su C, Walker R, Brunier G. A Syllabus for Teaching Peritoneal Dialysis to Patients and Caregivers. Perit Dial Int 2016; 36:592-605. [PMID: 26917664 DOI: 10.3747/pdi.2015.00277] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/10/2016] [Indexed: 01/16/2023] Open
Abstract
Being aware of controversies and lack of evidence in peritoneal dialysis (PD) training, the Nursing Liaison Committee of the International Society for Peritoneal Dialysis (ISPD) has undertaken a review of PD training programs around the world in order to develop a syllabus for PD training. This syllabus has been developed to help PD nurses train patients and caregivers based on a consensus of training program reviews, utilizing current theories and principles of adult education. It is designed as a 5-day program of about 3 hours per day, but both duration and content may be adjusted based on the learner. After completion of our proposed PD training syllabus, the PD nurse will have provided education to a patient and/or caregiver such that the patient/caregiver has the required knowledge, skills and abilities to perform PD at home safely and effectively. The course may also be modified to move some topics to additional training times in the early weeks after the initial sessions. Extra time may be needed to introduce other concepts, such as the renal diet or healthy lifestyle, or to arrange meetings with other healthcare professionals. The syllabus includes a checklist for PD patient assessment and another for PD training. Further research will be needed to evaluate the effect of training using this syllabus, based on patient and nurse satisfaction as well as on infection rates and longevity of PD as a treatment.
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Affiliation(s)
- Ana E Figueiredo
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Elaine Bowes
- King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Valerie Price
- Atlantic Health Sciences Corporation, Saint John, New Brunswick, Canada
| | - Chunyan Su
- Peking University Third Hospital, Beijing, China
| | - Rachael Walker
- Hawke's Bay District Health Board, New Zealand, University of Sydney, Sydney, Australia
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Van den Bosch J, Warren DS, Rutherford PA. Review of predialysis education programs: a need for standardization. Patient Prefer Adherence 2015; 9:1279-91. [PMID: 26396500 PMCID: PMC4574882 DOI: 10.2147/ppa.s81284] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
To make an informed decision on renal replacement therapy, patients should receive education about dialysis options in a structured program covering all modalities. Many patients do not receive such education, and there is disparity in the information they receive. This review aims to compile evidence on effective components of predialysis education programs as related to modality choice and outcomes. PubMed MEDLINE, Cochrane Library, and Ovid searches (from January 1, 1995 to December 31, 2013) with the main search terms of "predialysis", "peritoneal dialysis", "home dialysis", "education", "information", and "decision" were performed. Of the 1,005 articles returned from the initial search, 110 were given full text reviews as they potentially met inclusion criteria (for example, they included adults or predialysis patients, or the details of an education program were reported). Only 29 out of the 110 studies met inclusion criteria. Ten out of 13 studies using a comparative design, showed an increase in home dialysis choice after predialysis education. Descriptions of the educational process varied and included individual and group education, multidisciplinary intervention, and varying duration and frequency of sessions. Problem-solving group sessions seem to be an effective component for enhancing the proportion of home dialysis choice. Evidence is lacking for many components, such as timing and staff competencies. There is a need for a standardized approach to evaluate the effect of predialysis educational interventions.
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Affiliation(s)
| | - D Simone Warren
- Pallas Health Research and Consultancy BV, Rotterdam, the Netherlands
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Lambert K, Mullan J, Mansfield K, Lonergan M. A Cross-Sectional Comparison of Health Literacy Deficits Among Patients With Chronic Kidney Disease. JOURNAL OF HEALTH COMMUNICATION 2015; 20 Suppl 2:16-23. [PMID: 26513027 DOI: 10.1080/10810730.2015.1080329] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Inadequate health literacy in people with chronic kidney disease (CKD) is associated with poorer disease management and greater complications. There are limited data on the health literacy deficits of people with CKD. The aim of this study was to investigate the types and extent of health literacy deficits in patients with CKD using the multidimensional Health Literacy Management Scale (HeLMS) and to identify associations between patient characteristics and the domains of health literacy measured by the HeLMS. Invitations to participate were sent to patients with CKD attending the renal unit of a regional Australian hospital. These patients included predialysis, dialysis (peritoneal and hemodialysis), and kidney transplant patients. This study identified that inadequate health literacy--especially in the domains relating to attending to one's health needs, understanding health information, social support, and socioeconomic factors--was common. Male gender and education level were significantly associated with inadequate health literacy. The type and extent of health literacy deficits varied among CKD groups, and transplant patients had more deficits than other CKD patient groups. This study provides useful information for health professionals treating patients with CKD, especially with regard to the design of self-management interventions and health information.
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Affiliation(s)
- Kelly Lambert
- a School of Medicine , University of Wollongong , Wollongong , New South Wales , Australia
- b Department of Clinical Nutrition , Illawarra Shoalhaven Local Health District , Wollongong , New South Wales , Australia
| | - Judy Mullan
- c Graduate School of Medicine , University of Wollongong , Wollongong , New South Wales , Australia
| | - Kylie Mansfield
- c Graduate School of Medicine , University of Wollongong , Wollongong , New South Wales , Australia
| | - Maureen Lonergan
- d Renal Medicine , Illawarra Shoalhaven Local Health District , Wollongong , New South Wales , Australia
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10
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Sturesson A, Ziegert K. Prepare the patient for future challenges when facing hemodialysis: nurses' experiences. Int J Qual Stud Health Well-being 2014; 9:22952. [PMID: 24717268 PMCID: PMC3982113 DOI: 10.3402/qhw.v9.22952] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Chronic kidney disease is a major health problem due to the significant financial burden for the healthcare system and likewise for the patient who needs the treatment. The patient's whole life situation is turned upside down with chronic kidney disease when they are confronted with the forced change to start treatment with hemodialysis. Patients with chronic kidney disease experience a lack of adequate emotional support from nurses during the transition to hemodialysis. The purpose of this study was to explore nurses' experiences of giving support to patients during the transition to hospital-bound hemodialysis. The study had a qualitative descriptive design with a content analysis approach; eight nurses from four hospitals in the south of Sweden participated. The results showed that the nurses gave threshold support with an openness and awareness of the patient's individual needs during the transition, except that there seemed to be a lack of knowledge and ability to provide emotional support. Patient support during the transition could therefore be absent. Education, at local and national levels, is needed for the nurse to be able to give professional emotional support. Further research is also desired in order to provide nurses with the tools they need to give emotional support, which is of utmost importance.
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Affiliation(s)
- Anna Sturesson
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
| | - Kristina Ziegert
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden;
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11
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Duteau J. Improving the Uptake of Independent Dialysis using the Humanbecoming Theoretical Approach. Semin Dial 2013; 26:180-3. [DOI: 10.1111/sdi.12079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Kazancioglu R. IMPROVING THE QUALITY OF A PERITONEAL DIALYSIS SERVICE: LEARNING FROM EXPERIENCE. J Ren Care 2013; 39 Suppl 1:42-9. [DOI: 10.1111/j.1755-6686.2013.00335.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Rumeyza Kazancioglu
- Faculty of Medicine, Department of Nephrology; Bezmialem Vakif University; Istanbul; Turkey
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13
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Gadola L, Poggi C, Poggio M, Sáez L, Ferrari A, Romero J, Fumero S, Ghelfi G, Chifflet L, Borges PL. Using a multidisciplinary training program to reduce peritonitis in peritoneal dialysis patients. Perit Dial Int 2012; 33:38-45. [PMID: 22753455 DOI: 10.3747/pdi.2011.00109] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The present study evaluated the tool used to assess patients' skills and the impact on peritonitis rates of a new multidisciplinary peritoneal dialysis (PD) education program (PDEP). METHODS After the University Hospital Ethics Committee approved the study, the educational and clinical records of PD patients were retrospectively analyzed in two phases. In phase I, an Objective Structured Assessment (OSA) was used during August 2008 to evaluate the practical skills of 25 patients with adequate Kt/V and no mental disabilities who had been on PD for more than 1 month. Test results were correlated with the prior year's peritonitis rate. In phase II, the new PDEP, consisting of individual lessons, a retraining schedule, and group meetings, was introduced starting 1 September 2008. Age, sex, years of education, time on PD, number of training sessions, and peritonitis episodes were recorded. Statistical analyses used t-tests, chi-square tests, and Poisson distributions; a p value of less than 0.05 was considered significant. RESULTS In phase I, 25 patients [16 men, 9 women; mean age: 54 ± 15 years (range: 22 - 84 years); mean time on PD: 35 ± 30 months (range: 1 - 107 months)] were studied. The OSA results correlated with peritonitis rates: patients who passed the test had experienced significantly lower peritonitis rates during the prior year (p < 0.05). In phase II, after the new PDEP was introduced, overall peritonitis rates significantly declined (to 0.28 episodes/patient-year from 0.55 episodes/patient-year, p < 0.05); the Staphylococcus peritonitis rate also declined (to 0.09 episodes/patient-year from 0.24 episodes/patient-year, p < 0.05). CONCLUSIONS The OSA is a reliable tool for assessing patients' skills, and it correlates with peritonitis rates. The multidisciplinary PDEP significantly improved outcomes by further lowering peritonitis rates.
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Affiliation(s)
- Liliana Gadola
- Centro de Nefrología, Hospital de Clínicas, Universidad de la República, Uruguay.
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14
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Piraino B, Bernardini J, Brown E, Figueiredo A, Johnson DW, Lye WC, Price V, Ramalakshmi S, Szeto CC. ISPD position statement on reducing the risks of peritoneal dialysis-related infections. Perit Dial Int 2011; 31:614-30. [PMID: 21880990 DOI: 10.3747/pdi.2011.00057] [Citation(s) in RCA: 209] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Beth Piraino
- University of Pittsburgh School of Medicine,1 Pittsburgh, Pennsylvania, USA.
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15
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Vilaplana JMG, Zampieron A, Craver L, Buja A. EVALUATION OF PSYCHOLOGICAL OUTCOMES FOLLOWING THE INTERVENTION ‘TEACHING GROUP’: STUDY ON PREDIALYSIS PATIENTS. J Ren Care 2009; 35:159-64. [DOI: 10.1111/j.1755-6686.2009.00113.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Chow KM, Szeto CC, Law MC, Fun Fung JS, Kam-Tao Li P. Influence of peritoneal dialysis training nurses' experience on peritonitis rates. Clin J Am Soc Nephrol 2007; 2:647-52. [PMID: 17699477 DOI: 10.2215/cjn.03981206] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study examined the clinical impact of peritoneal dialysis (PD) training nurses regarding Gram-positive peritonitis among incident dialysis patients. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS This study included 200 consecutive inception PD patients in a single center from September 1999 through April 2003. Effects of PD nurse trainers on the clinical outcomes of Gram-positive peritonitis were evaluated. RESULTS A total of 81 patients of 200 incident PD patients (mean age 56.9 yr) developed Gram-positive peritonitis. Mean Gram-positive peritonitis-free time for patients who were trained by nurses with years of experience in the lowest tertile was 58.8 mo, as compared with 47.0 mo in those who were trained by nurses within the intermediate tertile of experience (log-rank test, P = 0.044). After adjustment for diabetes and relevant coexisting medical factors, PD trainers' having > or =3 yr of experience, body mass index, and baseline serum albumin were the only independent risk factors for the time to a first Gram-positive peritonitis. Training nurses with > or =3 yr of experience was associated with more than two-fold increased likelihood of subsequent Gram-positive peritonitis, with an adjusted hazard ratio of 2.24 (95% confidence interval [CI] 1.14 to 4.41; P = 0.020). When the lowest tertile group of trainers was used as the reference group in the Cox proportional hazards regression model, the hazard ratio was 1.94 (95% CI 1.04 to 3.61) for the intermediate tertile and 2.13 (95% CI 1.12 to 4.06) for the highest tertile. Experience of the PD trainers was not predictive of Gram-negative peritonitis. CONCLUSIONS The finding of negative association between the trainers' length of time in practice and peritonitis incidence reminds us that active continued learning and applying principles of adult learning might be the answers for the nurses to teach the patients.
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Affiliation(s)
- Kai Ming Chow
- Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong, China.
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