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Sitanggang YF, Lin HR. Experiences of Indonesian women with breast cancer underwent treatment decision-making: A qualitative study. BELITUNG NURSING JOURNAL 2024; 10:456-463. [PMID: 39211453 PMCID: PMC11350343 DOI: 10.33546/bnj.3395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/19/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Background Patients with breast cancer face a complex situation upon receiving their diagnosis and considering future treatment options. In Indonesian culture, relatives and others significantly influence decision-making processes. Understanding the perspectives of Indonesian women with breast cancer regarding treatment decision-making can enhance satisfaction with the care provided. Objective This study aimed to explore the experiences of Indonesian women with breast cancer regarding treatment decision-making. Methods A qualitative descriptive study design was utilized. Purposive sampling was employed to select the study participants. In-depth interviews were conducted with 15 women with breast cancer between March and June 2023. The data were analyzed using thematic analysis. Results Three main themes were developed: 1) Emotional impact and uncertainty in cancer care, 2) Clear communication and support for patients, and 3) Family-centered decision-making in treatment planning. Conclusion This study highlights the perspectives of Indonesian women with breast cancer on treatment decision-making. Nurses play a crucial role in providing clear information to patients and their families during the decision-making process. Understanding the experiences of women with breast cancer can help support and empower patients through effective communication while they undergo treatment.
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Affiliation(s)
- Yenni Ferawati Sitanggang
- PhD Program, School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Faculty of Nursing, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Hung-Ru Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Akhtar T, Pienaar AJ, Asmat K, Sikander S, Khalil F. Lived experiences of village-based patients with chronic kidney disease receiving haemodialysis at Mirpur, Azad Kashmir, Pakistan: a transcendental phenomenology study protocol. BMJ Open 2024; 14:e084862. [PMID: 38977363 PMCID: PMC11256043 DOI: 10.1136/bmjopen-2024-084862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/21/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is one of the major health issues in Pakistan, exerting notable effects on both the physical and mental well-being of individuals undergoing haemodialysis. Of particular concern to healthcare professionals is the potential adverse influence of haemodialysis on the lives of patients with CKD residing in rural areas of the country. This study will explore and describe the lived experiences and needs of patients with CKD receiving haemodialysis from the perspectives of patients and their family caregivers. METHODS AND ANALYSIS Transcendental phenomenological research design will be used. Participants will be recruited from the dialysis centre of a tertiary hospital through purposive sampling based on specific inclusion criteria. In-depth unstructured interviews, observation and document analysis will be the methods for data collection. Data will be analysed using Colaizzi's approach following the transcription of the interviews. ETHICS AND DISSEMINATION The study has been approved by the Institutional Review Board (IRB) of Shifa Tameer-e-Millat University, Pakistan (IRB # 0307-23) and written permission was obtained from the administration of the study hospital. Before giving written and verbal consent, all participants will receive detailed information about the study. Participants will maintain the freedom to withdraw from the study at any point. Confidentiality of the participants will be ensured. The study findings will be disseminated to important stakeholders and published in scientific papers and conference proceedings.
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Affiliation(s)
- Tazeem Akhtar
- Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Abel J Pienaar
- Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Kainat Asmat
- Nursing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Siham Sikander
- Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Fareeha Khalil
- Nephrology, Shifa International Hospital, Islamabad, Pakistan
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Parviniannasab AM, Dehghani F, Hosseini SA. The mediating role of hope in the relation between uncertainty and social support with self-management among patients with ESKD undergoing hemodialysis. BMC Nephrol 2024; 25:129. [PMID: 38609885 PMCID: PMC11010407 DOI: 10.1186/s12882-024-03558-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Self-management behaviours are critical for patients requiring regular hemodialysis (HD) therapy. This study aimed to test the relationship between social support, uncertainty and self-management among HD patients and to explore whether hope plays a mediating role. METHODS In a cross-sectional study, a convenience sample of 212 HD patients from two hospitals completed the Perceived Social Support Scale (PSSS), Herth Hope Index (HHI), Short form Mishel Uncertainty in Illness Scale (SF-MUIS), and hemodialysis Self-Management Instrument (HD-SMI). Data were analysed using structural equation modelling. RESULTS The main finding indicated that social support positively affected self-management (β = 0.50, t = 4.97, p < 0.001), and uncertainty negatively affected self-management (β =-0.37, t=-4.12, p = < 0.001). In mediational model analysis, the effect of social support on self-management was fully mediated [(β = 0.12; 95% BC CI (0.047, 0.228)] by hope. Also, the effect of uncertainty on self-management was fully mediated [(β=- 0.014; 95% BC CI (-0.114, -0.003)] by hope. CONCLUSIONS "Considering factors influencing self-management in HD patients is crucial for improving quality of life. Receiving support and informational resources can not only foster hope but also reduce their uncertainty, thus aiding in enhancing clinical outcomes, quality of life, and reducing complications. "Health care providers, especially nurses were advised to accept the existence of uncertainty, help patients make optimal use of support resources, and give more importance to disambiguation to reassure them. Therefore, well-designed interventions that enhance social support and hope and reduce uncertainty may help improve self-management behaviour in HD patients.
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Affiliation(s)
| | - Fatemeh Dehghani
- Bachelor of Science in Nursing, Larestan University of Medical Sciences, Larestan, Iran
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Jui-Chin H, Fen-Fang C, Tso-Ying L, Pao-Yu W, Mei-Hsiang L. Exploring the care experiences of hemodialysis nurses: from the cultural sensitivity approach. BMC Nurs 2024; 23:17. [PMID: 38166820 PMCID: PMC10763141 DOI: 10.1186/s12912-023-01678-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Culturally sensitive care has been identified as a best-practice approach for improving health outcomes. Hemodialysis patients require culturally sensitive care because it involves totally changing their previous life. The purpose of this study was to explore the subjective experiences of hemodialysis nurses in providing culturally sensitive care to hemodialysis patients. METHODS A qualitative study was carried out in the hemodialysis center of a teaching hospital in northern Taiwan. Purposive sampling and semi-structured interview guidelines were employed to interview 23 hemodialysis nurses. The interviews were recorded and transcribed verbatim, and the resulting data were analyzed and summarized using content analysis by constant comparative methods. RESULTS Hemodialysis nurses exhibited the characteristics for delivering culturally sensitive care, which comprised five aspects: finding the true meaning of the behavior of the participants, recognizing and honoring individual psychological states, culturally sensitive communication in line with patients' values, customizing care content through cultural transformation strategies, and empowerment rather than prohibition. CONCLUSIONS The findings of this study on the culturally sensitive care provided by hemodialysis nurses can be utilized by nursing educators and administrators as a reference to develop and enhance the nursing education related to culturally sensitive care for hemodialysis professionals.
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Affiliation(s)
- Hsu Jui-Chin
- Hemodialysis Room, Cheng Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - Chung Fen-Fang
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan, R.O.C
| | - Lee Tso-Ying
- Nursing research center of Taipei Medical University Hospital, Taipei, Taiwan, R.O.C
| | - Wang Pao-Yu
- Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan, R.O.C
| | - Lin Mei-Hsiang
- EdD School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Mingde 1st Rd. Beitou Dist, Taipei, Taiwan, R.O.C..
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Ogwang AJ, Murungi EB, Vallence N, Esther B. Lived Experiences of Patients on Hemodialysis Treatment at Kiruddu National Referral Hospital: A Phenomenological Study. Patient Relat Outcome Meas 2023; 14:393-408. [PMID: 38107024 PMCID: PMC10725628 DOI: 10.2147/prom.s431746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Abstract
Background There is increasing number of patients undergoing hemodialysis globally. Patients on hemodialysis experience physical and emotional stress due to the changes brought by chronic kidney disease. Aim The study aimed at exploring the lived experiences of patients on hemodialysis treatment in Kiruddu National Referral Hospital. Methods The study employed a phenomenological design. Data was collected using audio tape recording of the interview from 9 participants selected through purposive sampling at Kiruddu National Referral Hospital. The thematic aspects of the lived experience were uncovered using Van Manen data analysis which included three approaches: the detailed or line-by-line approach, selective or highlighting approach and holistic approach. Results Six themes emerged during the analysis as hemodialysis prolongs survival; hemodialysis is indispensable, family financial support, physical limitations, emotional distress and adaptation. Conclusion It was concluded from the findings that the patients undergoing haemodialysis are facing a wide range of problems such as physical and emotional problems during the course of their treatment and think that haemodialysis is the only way of survival, and these problems need to be addressed. Understanding gained in this study can help nurses to utilize this information in improving the quality of nursing care and guide patients to provide positive reinforcement for their future living.
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Affiliation(s)
- Alobo Jennifer Ogwang
- Nursing Department, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Eric Baluku Murungi
- Nursing Department, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Niyonzima Vallence
- Nursing Department, Mbarara University of Science and Technology, Mbarara City, Uganda
| | - Beebwa Esther
- Nursing Department, Mbarara University of Science and Technology, Mbarara City, Uganda
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Rambod M, Pasyar N, Parviniannasab AM. A qualitative study on hope in iranian end stage renal disease patients undergoing hemodialysis. BMC Nephrol 2023; 24:281. [PMID: 37740202 PMCID: PMC10517523 DOI: 10.1186/s12882-023-03336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND End Stage Renal Disease (ESRD) patients undergoing hemodialysis are faced with serious problems in their lives. Hope, as a multifaceted factor, plays a critical role in these patients' lives. Given the multifaceted process of hope, this study aimed to describe hope and identify the challenges, strategies, and outcomes of hope in Iranian ESRD patients undergoing hemodialysis. METHODS This is a qualitative study using content analysis. The participants were selected using purposive sampling. The data were collected using deep, semi-structured interviews with 14 participants; it continued until reaching data saturation. Graneheim and Lundman content analysis approach was used to analyze the data. RESULTS Five main categories and twenty-two subcategories emerged; the categories consisted of (1) Hope described as a particular event to happen, (2) Opportunities and threats to achieve hope, (3) Negative emotions as barriers to achieve hope, (4) Positive coping strategies to achieve hope, and (5) Growth and excellence as the outcomes of hope. CONCLUSIONS Based on the findings, ESRD patients undergoing hemodialysis described hope as a positive feeling of expectation and desire for a special thing to happen. They faced threats and opportunities to achieve hope, which exposed them to negative emotions as barriers of hope. Thus, they make use of positive coping strategies to achieve hope. Moreover, hope led to growth and excellence. Through awareness of hope, definition and strategies to achieve it, and teaching them, physicians and nurses working in hemodialysis wards can enhance hope in patients.
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Affiliation(s)
- Masoume Rambod
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nilofar Pasyar
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Natale P, Ju A, Strippoli GF, Craig JC, Saglimbene VM, Unruh ML, Stallone G, Jaure A. Interventions for fatigue in people with kidney failure requiring dialysis. Cochrane Database Syst Rev 2023; 8:CD013074. [PMID: 37651553 PMCID: PMC10468823 DOI: 10.1002/14651858.cd013074.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND Fatigue is a common and debilitating symptom in people receiving dialysis that is associated with an increased risk of death, cardiovascular disease and depression. Fatigue can also impair quality of life (QoL) and the ability to participate in daily activities. Fatigue has been established by patients, caregivers and health professionals as a core outcome for haemodialysis (HD). OBJECTIVES We aimed to evaluate the effects of pharmacological and non-pharmacological interventions on fatigue in people with kidney failure receiving dialysis, including HD and peritoneal dialysis (PD), including any setting and frequency of the dialysis treatment. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies up to 18 October 2022 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA Studies evaluating pharmacological and non-pharmacological interventions affecting levels of fatigue or fatigue-related outcomes in people receiving dialysis were included. Studies were eligible if fatigue or fatigue-related outcomes were reported as a primary or secondary outcome. Any mode, frequency, prescription, and duration of therapy were considered. DATA COLLECTION AND ANALYSIS Three authors independently extracted data and assessed the risk of bias. Treatment estimates were summarised using random effects meta-analysis and expressed as a risk ratio (RR) or mean difference (MD), with a corresponding 95% confidence interval (CI) or standardised MD (SMD) if different scales were used. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS Ninety-four studies involving 8191 randomised participants were eligible. Pharmacological and non-pharmacological interventions were compared either to placebo or control, or to another pharmacological or non-pharmacological intervention. In the majority of domains, risks of bias in the included studies were unclear or high. In low certainty evidence, when compared to control, exercise may improve fatigue (4 studies, 217 participants (Iowa Fatigue Scale, Modified Fatigue Impact Scale, Piper Fatigue Scale (PFS), or Haemodialysis-Related Fatigue scale score): SMD -1.18, 95% CI -2.04 to -0.31; I2 = 87%) in HD. In low certainty evidence, when compared to placebo or standard care, aromatherapy may improve fatigue (7 studies, 542 participants (Fatigue Severity Scale (FSS), Rhoten Fatigue Scale (RFS), PFS or Brief Fatigue Inventory score): SMD -1.23, 95% CI -1.96 to -0.50; I2 = 93%) in HD. In low certainty evidence, when compared to no intervention, massage may improve fatigue (7 studies, 657 participants (FSS, RFS, PFS or Visual Analogue Scale (VAS) score): SMD -1.06, 95% CI -1.47, -0.65; I2 = 81%) and increase energy (2 studies, 152 participants (VAS score): MD 4.87, 95% CI 1.69 to 8.06, I2 = 59%) in HD. In low certainty evidence, when compared to placebo or control, acupressure may reduce fatigue (6 studies, 459 participants (PFS score, revised PFS, or Fatigue Index): SMD -0.64, 95% CI -1.03 to -0.25; I2 = 75%) in HD. A wide range of heterogenous interventions and fatigue-related outcomes were reported for exercise, aromatherapy, massage and acupressure, preventing our capability to pool and analyse the data. Due to the paucity of studies, the effects of pharmacological and other non-pharmacological interventions on fatigue or fatigue-related outcomes, including non-physiological neutral amino acid, relaxation with or without music therapy, meditation, exercise with nandrolone, nutritional supplementation, cognitive-behavioural therapy, ESAs, frequent HD sections, home blood pressure monitoring, blood flow rate reduction, serotonin reuptake inhibitor, beta-blockers, anabolic steroids, glucose-enriched dialysate, or light therapy, were very uncertain. The effects of pharmacological and non-pharmacological treatments on death, cardiovascular diseases, vascular access, QoL, depression, anxiety, hypertension or diabetes were sparse. No studies assessed tiredness, exhaustion or asthenia. Adverse events were rarely and inconsistently reported. AUTHORS' CONCLUSIONS Exercise, aromatherapy, massage and acupressure may improve fatigue compared to placebo, standard care or no intervention. Pharmacological and other non-pharmacological interventions had uncertain effects on fatigue or fatigue-related outcomes in people receiving dialysis. Future adequately powered, high-quality studies are likely to change the estimated effects of interventions for fatigue and fatigue-related outcomes in people receiving dialysis.
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Affiliation(s)
- Patrizia Natale
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J) Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Angela Ju
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Giovanni Fm Strippoli
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J) Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, Italy
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Jonathan C Craig
- Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Valeria M Saglimbene
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Mark L Unruh
- University of New Mexico, Department of Internal Medicine, Albuquerque, New Mexico, USA
| | - Giovanni Stallone
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Allison Jaure
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
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Kim S, Lee HZ. The Lived Self-Care Experiences of Patients Undergoing Long-Term Haemodialysis: A Phenomenological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4690. [PMID: 36981599 PMCID: PMC10048782 DOI: 10.3390/ijerph20064690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/04/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The study aims to understand the lived self-care experiences of patients who have undergone long-term haemodialysis. The study adopts a qualitative phenomenological design. Data were collected for six months, from 1 July to 31 December 2020. Out of 90 outpatients in a haemodialysis clinic at a university hospital in Seoul, Korea, 11 patients who had received haemodialysis for more than 10 years were purposefully selected, and 9 of them took part in in-depth interviews. The main research question was, 'What was the experience of surviving long-term haemodialysis?' The study revealed four main themes surrounding the topic of self-care: (A) the desire to keep living despite challenges, (B) creating one's own dietary principles, (C) moving one's body with the remaining strength, and (D) moving toward independence. In the long-term self-care of haemodialysis patients, they shared personal observations on their disease and treatment process and their struggles to try to manage their own physical and emotional self-care. By exploring the experience of long-term haemodialysis, it is possible to gain a deeper understanding of their perceptions, emotions, and motivations. With this information, healthcare professionals can develop interventions and support strategies that are tailored to the specific needs of haemodialysis patients.
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Affiliation(s)
- Sisook Kim
- Department of Nursing, Hwasung Medi-Science University, Hwaseong-si 18274, Republic of Korea
| | - Hyunsook Zin Lee
- College of Nursing, Kyungdong University, Wonju 24695, Republic of Korea
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Rosenburg M, Fagerström C, Tuvesson H, Lindqvist G. Daily life after healing of a venous leg ulcer: A lifeworld phenomenological study. Int J Qual Stud Health Well-being 2022; 17:2054080. [PMID: 35306967 PMCID: PMC8942520 DOI: 10.1080/17482631.2022.2054080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose Venous leg ulcer is a recognized condition, affecting people globally. Ulcers mainly affect the elderly and recurrences are not uncommon. There is knowledge about life with venous leg ulcers, but the situation after healing is unexplored. This paper explores and describes meanings of experiences of daily life after healing of a hard-to-heal venous leg ulcer. Methods Lived experiences of 15 individuals with healed hard-to-heal venous leg ulcers generated data for this study. Interviews were recorded for analysis using a reflective lifeworld research approach. An essence emerged, further described by its constituents. Results Memories of a difficult time with leg ulcer were ever present, in a way becoming part of the self. A striving for control in daily life entailed a struggle to do what was best for the own body. After healing, a new normal emerged in daily life, a reality that encompassed the risk for a new ulcer. The body had changed physically, with marks alongside those from ageing, in a life that still went on. Conclusions For those who had healed from a venous leg ulcer, life had changed. Even if they referred to life as normal, it was not the same normal as before.
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Affiliation(s)
- Marcus Rosenburg
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
- School of Health and Welfare, Department of Health and Nursing, Halmstad University, Halmstad, Sweden
| | - Cecilia Fagerström
- Department of Research, Region Kalmar County, Sweden
- Faculty of Health and Life Sciences, Departement of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Hanna Tuvesson
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Gunilla Lindqvist
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Atnafu R, Selfako AH, Mishna F, Regehr C, Soklaridis S, Kotecho MG. Challenges of End-Stage Renal Disease Patients in Ethiopia. HEALTH & SOCIAL WORK 2022; 47:292-300. [PMID: 36130406 DOI: 10.1093/hsw/hlac027] [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: 07/21/2021] [Revised: 09/17/2021] [Accepted: 11/03/2021] [Indexed: 06/15/2023]
Abstract
Affecting all aspects of patients' lives, end-stage renal disease (ESRD) presents significant challenges. Individuals with ESRD face biological, psychological, economic, and social issues. ESRD patients in Ethiopia bear multifaceted burdens of multiple medical conditions, including comorbid hypertension, diabetes, cardiac problems, anemia, gastrointestinal issues, and bone and mineral disorders. The aim of this study was to address the gap in research on patients in Ethiopia with ESRD and examine biopsychosocial and economic challenges. A qualitative hermeneutic phenomenology design was employed. In-depth interviews were held with 10 women and 10 men. Major themes include the physical corollary of ESRD (e.g., fatigue), and psychological (e.g., fear of loss of capacity and/or occupation) and socioeconomic challenges (e.g., difficulty obtaining social and economic support). Along with complications of ESRD and side effects of dialysis, patients face trauma and social and economic repercussions. Social workers are well positioned to help manage associated biopsychosocial and economic challenges. The findings indicate the need for policies that promote multidisciplinary teams in working with patients who are diagnosed with ESRD.
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Affiliation(s)
- Rahel Atnafu
- MSW, is an alumnus, School of Social Work, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andualem Hadero Selfako
- PhD, is assistant professor, Faculty of Humanities, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | - Faye Mishna
- PhD, is professor, Factor-Inwentash Faculty of Social Work
| | - Cheryl Regehr
- PhD, is provost and vice president, Department of Psychiatry, Centre for Addiction & Mental Health, and Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sophie Soklaridis
- PhD, is associate professor, Department of Psychiatry, Centre for Addiction & Mental Health, and Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Messay Gebremariam Kotecho
- PhD, is associate professor, School of Social Work, Addis Ababa University, Addis Ababa, Ethiopia, and research associate, Department of Social Work and Community Development, University of Johannesburg, South Africa
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Gender differences in experiences and expectations of haemodialysis in a frail and seriously unwell patient population. Kidney Int Rep 2022; 7:2421-2430. [DOI: 10.1016/j.ekir.2022.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022] Open
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Cahyati Y, Rosdiana I. Contribution of anxiety and dialysis factors to the event of fatigue in hemodialysis patient. ENFERMERÍA NEFROLÓGICA 2022. [DOI: 10.37551/2254-28842022017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: Fatigue is one of the most common symptoms felt by chronic renal failure patients undergoing hemodialysis (HD). The prevalence ranges from 42-97% with levels varying from low to severe. Fatigue is not only detrimental to physical and social functioning but is also associated with poor quality of life for HD patients and is associated with death in patients undergoing chronic hemodialysis. For this reason, it is necessary to know the factors associated with the incidence of fatigue so that appropriate interventions can be carried out, both pharmacologically and non-pharmacologically.Objective: To evaluate the influence of anxiety and dialysis factors on the incidence of fatigue in patients undergoing hemodialysis at Ciamis Hospital.Material and Method: A cross sectional approach with a total sample of 88 people was used.Results: The results showed that 78 respondents (88.6%) who experienced fatigue complaints and anxiety had a relationship with the incidence of fatigue (OR: 9.0; p=0.019).Conclusions: Psychological factors, such as anxiety, are associated with the fatigue experienced by patients on hemodialysis.
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Affiliation(s)
- Yanti Cahyati
- Poltekkes Kemenkes Tasikmalaya. Indonesia. Health and Disaster Emergency (HADE) Center. Center of Excellence. Poltekkes Kemenkes Tasikmalaya. Indonesia
| | - Ida Rosdiana
- Poltekkes Kemenkes Tasikmalaya. Indonesia. Centro de Emergencias Sanitarias y Catástrofes (HADE). Centro de Excelencia. Poltekkes Kemenkes Tasikmalaya. Indonesia
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Shouket H, Gringart E, Drake D, Steinwandel U. “Machine-Dependent”: The Lived Experiences of Patients Receiving Hemodialysis in Pakistan. Glob Qual Nurs Res 2022; 9:23333936221128240. [PMID: 36405243 PMCID: PMC9669685 DOI: 10.1177/23333936221128240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/25/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore the lived experiences of patients receiving
maintenance hemodialysis in Pakistan. Purposive sampling was used to recruit 24
patients and six healthcare professionals, each participated in a
semi-structured interview. Interpretive Phenomenological Analysis was used to
analyze interviews’ data. Two superordinate themes, “The experience of
hemodialysis” and “The conceptualizations of hemodialysis” as well as six
sub-themes were identified. The experience of hemodialysis was related to, the
implications of HD procedure on everyday life, social, cognitive, emotional,
financial, and occupational influences. While all participants recognized the
importance of hemodialysis for their survival, their conceptualizations of the
treatment varied. Despite facing multiple challenges, optimism and independence
were observed among participants. Stigma related to hemodialysis, and role
adaptation, which appear unique to the Pakistani context, highlight a need for
tailored interventions designed to enhance and maintain the mental health of
patients receiving hemodialysis in Pakistan.
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Affiliation(s)
- Haseeba Shouket
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Eyal Gringart
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Dierdre Drake
- Edith Cowan University, Joondalup, Western Australia, Australia
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Matthews M, Reid J, McKeaveney C, Noble H. Knowledge Requirements and Unmet Needs of Informal Caregivers of Patients with End-Stage Kidney Disease (ESKD) Receiving Haemodialysis: A Narrative Review. Healthcare (Basel) 2021; 10:healthcare10010057. [PMID: 35052221 PMCID: PMC8775298 DOI: 10.3390/healthcare10010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Patients with end-stage kidney disease receiving haemodialysis rely heavily on informal caregivers to support them living at home. Informal caregiving may exact a toll on caregivers’ physical, emotional, and social well-being, impacting negatively on their overall quality of life. The aim of this narrative review is to report knowledge requirements and needs of informal caregivers of patients with end stage kidney disease (ESKD) receiving haemodialysis. Methods: The review followed the Preferred Reporting Items for Reporting Systematic Reviews and Meta-analyses (PRISMA). Five electronic databases were searched: Web of Science, PsycINFO, Embase, Medline, and CINAHL to identify the experiences and unmet needs of informal caregivers of patients with end stage kidney disease (ESKD) receiving haemodialysis. Results: Eighteen papers were included in the review and incorporated a range of methodological approaches. There are several gaps in the current literature around knowledge and informational needs and skills required by informal caregivers, such as signs and symptoms of potential complications, dietary requirements, and medication management. Although most research studies in this review illustrate the difficulties and challenges faced by informal caregivers, there is a paucity of information as to which support mechanisms would benefit caregivers. Conclusion: Informal caregivers provide invaluable assistance in supporting people with ESKD undergoing haemodialysis. These informal caregivers however experience multiple unmet needs which has a detrimental effect on their health and negatively influences the extent to which they can adequately care for patients. The development of supportive interventions is essential to ensure that informal caregivers have the requisite knowledge and skills to allow them to carry out their vital role.
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Self-Participation Experiences among Well-Adapted Hemodialysis Patients. Healthcare (Basel) 2021; 9:healthcare9121742. [PMID: 34946468 PMCID: PMC8701990 DOI: 10.3390/healthcare9121742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/27/2022] Open
Abstract
A successful self-participation experience empowers patients to adapt to living with hemodialysis. However, few studies regarding the subjective experiences of such patient participation have been conducted. This study’s purpose was to describe hemodialysis patients’ perspectives on integrating hemodialysis into a new life regarding self-participation experience. A qualitative study using the grounded theory method was applied. Thirty-two well-adaptive hemodialysis Taiwanese patients attended in-depth interviews. “Integrating hemodialysis into a new life journey” was identified as the core category guiding the entire self-participation experience of hemodialysis patients. The three antecedent themes were “Sense of worthlessness”, “Life is still worth living”, and “Friendly and joyful atmosphere of the hemodialysis room”. Once the patients went through the three antecedent themes, they gradually began making efforts to participate more fully in their hemodialysis. Within this participation experience, the hemodialysis patients exhibited these four interactive themes: “Overcoming one’s predicament”, “Integrating self-care skills into my life”, “Resuming previous roles and tasks”, and “Adapting to independent living”. Finally, most adaptive patients master the hemodialysis life. Encouraging patients to discover that their life is worth living and providing a friendly and joyful atmosphere in hemodialysis units are the keys to facilitating patients’ self-participation more fully.
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16
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Hejazi SS, Hosseini M, Ebadi A, Alavi Majd H. Components of quality of life in hemodialysis patients from family caregivers' perspective: a qualitative study. BMC Nephrol 2021; 22:379. [PMID: 34774021 PMCID: PMC8590210 DOI: 10.1186/s12882-021-02584-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients' quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients' disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers' perspective. METHODS In this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas' method. RESULTS A total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs). CONCLUSION Family caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients' quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients' quality of life and even reduce the caregivers' burden.
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Affiliation(s)
- Sima Sadat Hejazi
- Ph.D. Student in Nursing, Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr Ave., Niayesh Cross Road, Niayesh Complex, Tehran, Iran.
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Palliative Care in Patients with End-Stage Renal Disease: A Meta Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010651. [PMID: 34682395 PMCID: PMC8535479 DOI: 10.3390/ijerph182010651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 01/20/2023]
Abstract
End-stage renal disease is the last stage of chronic kidney disease and is associated with a decreased quality of life and life expectancy. This study aimed to explore palliative care with end-stage renal disease. Qualitative meta-synthesis was used as the study design. The search was performed for qualitative studies published until June 2021 and uses reciprocal translation and synthesis of in vivo and imported concepts. Five themes were included: Struggling to face the disease, experiencing deterioration, overcoming the challenges of dialysis, leading to a positive outlook, and preparing for the end of life. In facing chronic disease with life-limiting potential, patients experienced some negative feelings and deterioration in their quality of life. Adaptation to the disease then leads patients to a better outlook through increased spirituality and social status. Furthermore, by accepting the present condition, they started to prepare for the future. Increasing awareness of mortality leads them to discuss advance care (ACP) planning with healthcare professionals and families.
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18
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Hu CW, Chang KH, Hsish HC, Chang HC, Yu S. Social Support as a Mediator of the Relationship between Hope and Decisional Conflict in Patients Deciding Whether to Receive Dialysis. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5607219. [PMID: 34630988 PMCID: PMC8494545 DOI: 10.1155/2021/5607219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/18/2021] [Indexed: 11/23/2022]
Abstract
Background The incidence rate of end-stage renal disease (ESRD) in Taiwan is the highest worldwide. Patients often hesitate and feel helpless when deciding whether to receive dialysis. However, the resulting delay in starting dialysis can potentially threaten patients' lives. Purpose This study aimed to understand the current situation and correlations between hope, social support, and decisional conflict among patients with ESRD deciding whether to receive dialysis. In addition, the role of social support as a mediating variable of the relationship between hope and decisional conflict was investigated. Methods This study was a cross-sectional, descriptive correlation study. Data, including demographic information, were collected from 85 patients with ESRD who were deciding whether to receive dialysis. Research tools included the Chinese versions of the Herth Hope Index, the Interpersonal Support Evaluation List, and the Decisional Conflict Scale. Results When deciding whether to receive dialysis, patients with ESRD felt a low sense of hope, a moderate degree of social support, and a moderate degree of decisional conflict. Hope was significantly correlated with social support and decisional conflict. Social support demonstrated a full mediating effect of 47.7% (P < 0.001). Conclusions Patients with ESRD facing the decision to receive dialysis felt a low sense of hope and exhibited decisional conflict. Social support was found to be a mediating variable of the relationship between hope and decisional conflict; therefore, medical personnel should increase the social support of patients with ESRD who are deciding whether to commence dialysis to promote patients' hope and reduce their decisional conflict.
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Affiliation(s)
- Ching-Wen Hu
- Department of Nursing, Tungs' Taichung MetroHarbor Hospital, 433 Taichung City, Taiwan
- School of Nursing, National Yang Ming Chiao Tung University, 112 Taipei, Taiwan
| | - Kuang-Hsi Chang
- Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, 433 Taichung City, Taiwan
| | - Hsiu-Chuan Hsish
- Department of Nursing, Tungs' Taichung MetroHarbor Hospital, 433 Taichung City, Taiwan
| | - Hui-Chen Chang
- Department of Dialysis Center, Tungs' Taichung MetroHarbor Hospital, 433 Taichung City, Taiwan
| | - Shu Yu
- School of Nursing, National Yang Ming Chiao Tung University, 112 Taipei, Taiwan
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Kim EY, Son YJ. Developing a conceptual model of older patients' decision-making process in choosing dialysis or conservative care using meta-ethnography. J Adv Nurs 2021; 78:1-13. [PMID: 34227152 DOI: 10.1111/jan.14945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/13/2021] [Accepted: 06/15/2021] [Indexed: 01/23/2023]
Abstract
AIMS To systematically review and synthesize qualitative evidence related to decision-making for treatment modalities among older adults with end-stage renal disease. DESIGN A meta-synthesis of the qualitative research was conducted. DATA SOURCES A comprehensive literature review using PubMed, CINAHL, PsycINFO, Embase, Web of Sciences and Cochrane was systematically conducted. Qualitative studies published in English from January 2010 to October 2020 were considered. REVIEW METHODS Qualitative studies were systematically identified and critically appraised. Data synthesis was performed independently by two reviewers. This review followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement. RESULTS Seven qualitative studies, with publication years ranging from 2015 to 2019, were included in the analysis. Overall, the review comprised studies with a total of 133 participants aged between 61 and 93 years. Through meta-synthesis, three themes were identified: 'reflecting on treatment options', 'confronting difficult decisions' and 'maintaining hope in everyday life'. CONCLUSION Our findings reflect that older adults have varying preferences for treatment options. These preferences are influenced by various factors such as considering the possibility of opting for dialysis and the practical applicability of treatment options. The synthesized conceptual model serves as the first step towards the conceptualization of the treatment-related decision-making process facilitated by adequate communication, in which patients should be encouraged to speak up, and healthcare providers should listen actively to their patients. This review can provide a strategy for providers to communicate treatment options with older patients with ESRD. IMPACT Healthcare providers should be sensitive to older adults' preferences, priorities and treatment goals related to worrying about burdening their families and their outlook on life before deciding treatment modality. Our findings highlight that shared decision-making should be tailored to each of the older patients to provide comprehensive and individualized patient-centred care.
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Affiliation(s)
- Eun Young Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
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20
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Awuviry-Newton K, Tavener M, Wales K, Byles J. Interpretative Phenomenological Analysis of the Lived Experiences of Older Adults Regarding Their Functional Activities in Ghana. J Prim Care Community Health 2021; 11:2150132720931110. [PMID: 32584195 PMCID: PMC7318820 DOI: 10.1177/2150132720931110] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction: Research on disability largely draws on epidemiological data, often conducted in more developed countries. To date, there is little research related to older adults in Ghana, Africa. The purpose of this study was to strengthen understanding of how older adults in Ghana perform functional activities, referenced against the World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF) framework. Methods: Interpretative phenomenological analysis (IPA) of semistructured interview data was employed as the methodological approach. Using purposive criterion sampling, 8 older adults admitted to Komfo Anokye Teaching Hospital in Ghana, presenting with any identified health condition and/or frailty were recruited. Results: Analysis of interview data identified 5 interrelated themes: (1) feeling anxious, (2) feeling restricted, (3) understanding and admitting difficulty, (4) striving to be healthy and being productive, and (5) managing functional difficulty. These concerns were classified and related to the WHO-ICF, particularly the contextual factors. Discussion: This study examined in detail experiences of older adults performing functional activities. Our study highlights the relevance of the WHO-ICF framework for understanding the health needs of older adults, emphasizing the functional, social, and environmental factors influencing the functional status of older adults. The findings offer unique insight into the health needs of older adults, drawing attention to the implications for policy and care.
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Affiliation(s)
- Kofi Awuviry-Newton
- The Priority Research Centre for Generational Health and Ageing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Meredith Tavener
- The Priority Research Centre for Generational Health and Ageing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kylie Wales
- The Priority Research Centre for Generational Health and Ageing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Julie Byles
- The Priority Research Centre for Generational Health and Ageing, The University of Newcastle, Callaghan, New South Wales, Australia
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Marrocco AM, El-Masri MM. Exploring the Application of Interpretive Description in Chronic Illness: A Scoping Review. Res Theory Nurs Pract 2021; 35:RTNP-D-20-00022. [PMID: 34162757 DOI: 10.1891/rtnp-d-20-00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Chronic illness is a complex condition that affects over one billion people. To develop a deeper insight of the needs of this patient population, interpretive description uses disciplinary knowledge as the source of understanding. This methodology is a pragmatic approach to research without focusing on a strict methodological directive. The aims of this scoping review are twofold, (a) to describe the findings of studies that have used Thorne's interpretive description to research chronic illness and (b) to discuss the application of interpretive description in clinical research. Thereby, showing interpretive description as a valuable tool to advance nursing knowledge and patient care. METHODS The methodological framework for this review was based on the Johanna Briggs Institute guidelines for scoping reviews. RESULTS To develop an understanding of interpretive description, it is essential to examine the results of studies which have applied the methodology. Our scoping review showed that researchers utilizing interpretive description identified four common challenges experienced by individuals living with chronic illness: symptom management, education and knowledge, supportive care, and cultural disadvantages. By demonstrating how interpretive description is applied, it shows how it can be used to understand and interpret clinical phenomena to improve practice. IMPLICATION FOR PRACTICE This scoping review demonstrates how interpretive description was used to develop knowledge about chronic illness. The premise of interpretive description is that disciplinary knowledge offers a sufficient foundation to develop meaningful research to support health practices. By approaching research from a disciplinary perspective, new knowledge can be discovered to complex health problems.
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Affiliation(s)
- Anna M Marrocco
- Cardiovascular Intensive Care, Henry Ford Health System, Detroit, MI
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Carswell CE, Reid J, Walsh I, Johnston W, Lee JB, McAneney H, Mullan R, Nelson H, Matthews M, Weatherup E, Spencer A, Michelo J, Quail A, Kielty G, Mackenzie A, Elliott J, Noble H. Development of a complex arts-based intervention for patients with end-stage kidney disease whilst receiving haemodialysis. Pilot Feasibility Stud 2021; 7:127. [PMID: 34134778 PMCID: PMC8207758 DOI: 10.1186/s40814-021-00868-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/07/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Patients with end-stage kidney disease who receive haemodialysis experience a protracted treatment regimen that can result in an increased risk of depression and anxiety. Arts-based interventions could address this unique issue; however, no arts-based interventions have been developed for delivery within a haemodialysis unit and evaluation within a randomised controlled trials (RCTs). AIM To develop a complex arts-based intervention for patients with end-stage kidney disease whilst receiving haemodialysis. METHODS The development process utilised the Arts in Health framework (Fancourt, 2017). The framework was addressed through the establishment of an interdisciplinary advisory group, collaboration and consultation with stakeholders, a scoping and realist review, shadowing of artists-in-residence, personal arts practice and logic modelling. RESULTS The intervention involved six 1-h long, one-to-one facilitated sessions focused on creative writing and visual art. Patients could choose between art form and self-select a subject matter. The sessions had a primary focus on skill development and were delivered using principles derived from the psychological theory of flow. CONCLUSION The Arts in Health framework provided an appropriate and pragmatic approach to intervention development. Complex arts-based interventions can be developed for the purpose of evaluation within a trial framework. This intervention was designed to strike a balance between standardised components, and a person-centred approach necessary to address existential boredom.
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Affiliation(s)
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Ian Walsh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | | | - Jenny B Lee
- College of the Arts, Center for Arts in Medicine, University of Florida, Gainesville, USA
| | - Helen McAneney
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Robert Mullan
- Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - Hugh Nelson
- Northern Health and Social Care Trust, Antrim, UK
| | - Michael Matthews
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Jean Michelo
- Northern Ireland Kidney Patient Association, Belfast, UK
| | | | | | | | | | - Helen Noble
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Montalescot L, Rascle N, Combe C, Untas A. Patients' experience one year after dialysis initiation: a lexicometric analysis. Health Psychol Behav Med 2021; 9:380-397. [PMID: 34104566 PMCID: PMC8158193 DOI: 10.1080/21642850.2021.1918552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Dialysis implies huge changes in patients' lives. Yet, there is a need to better understand patients' experience in the time following dialysis initiation. OBJECTIVE The objective of this study was to investigate patients' experience of dialysis a year after treatment initiation and the associations between patients' discourse and their anxiety and depression symptoms. METHODS Twenty two patients (mean age 63.4; 68% men) took part in a semi-directed interview about their experience with dialysis. Participants completed the Hospital Anxiety and Depression Scale (HADS). Interviews were analyzed using a lexicometric analysis. RESULTS The analysis generated five classes: experience with nephrological care, facing loss and family relationships, family and acceptance, implementation of a new routine and making sense of the end-stage renal disease experience. Patients' felt very passive in their experience with care. They reported the importance of integrating dialysis in their lives and the role of family support when facing treatment initiation. Depressed patients were more likely to describe their nephrological monitoring very factually and to talk about what they lost with dialysis initiation. CONCLUSION Dialysis initiation is a hard time for patients during which they face many challenges. This first year represents a time of adaptation, in which family seems essential.
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Affiliation(s)
| | - Nicole Rascle
- Inserm U1219 ‘Bordeaux Population Health Research Center’ Team ‘Psychoepidemiology of Aging & Chronic Diseases’, University of Bordeaux, Bordeaux, France
| | - Christian Combe
- Department of Nephrology Transplantation Dialysis, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- Inserm U1026, University of Bordeaux, Bordeaux, France
| | - Aurélie Untas
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France
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Nandi M, Kurschner S, Wilcox K, Flood D, Montano CM, Barnoya J, Rohloff P, Chary A. Perceptions of chronic kidney disease among at-risk adults in rural Guatemala. Glob Public Health 2021; 16:623-638. [PMID: 33161879 PMCID: PMC8005433 DOI: 10.1080/17441692.2020.1839529] [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: 12/05/2019] [Accepted: 09/23/2020] [Indexed: 11/11/2022]
Abstract
This qualitative study explores perceptions of chronic kidney disease (CKD) among adults with abnormal estimated glomerular filtration rate (eGFR) in Guatemala, where the burden of CKD is rising. Qualitative semi-structured interviews were conducted with 39 individuals screened for CKD and found to have abnormal eGFR (defined as <90 mL/min/1.73 m2, per Kidney Disease Improving Global Outcomes [KDIGO] guidelines). Interviews occurred in participants' homes in Spanish or Kaqchikel Mayan. Interview notes were coded for dominant themes through an inductive approach. Interviewees had limited awareness of diabetes and hypertension as CKD risk factors, but appreciated the progressive nature of the disease. While most reported willingness to pursue renal replacement therapies, if necessary, they anticipated economic and geographic barriers. Public health interventions should focus on the association between diabetes, hypertension, and CKD. Improvement of primary care and screening infrastructure is imperative in CKD prevention in low- and middle-income countries (LMICs).
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Affiliation(s)
- Meghna Nandi
- The Warren Alpert Medical School at Brown University, Rhode Island, USA
- Center for Research in Indigenous Health, Wuqu’ Kawoq | Maya Health Alliance, Guatemala
| | - Sophie Kurschner
- Center for Research in Indigenous Health, Wuqu’ Kawoq | Maya Health Alliance, Guatemala
| | - Katharine Wilcox
- Center for Research in Indigenous Health, Wuqu’ Kawoq | Maya Health Alliance, Guatemala
- Weill Cornell School of Medicine, New York, USA
| | - David Flood
- Center for Research in Indigenous Health, Wuqu’ Kawoq | Maya Health Alliance, Guatemala
- National Clinicians Scholars Program, University of Michigan, Ann Arbor, Michigan
| | - Carlos Mendoza Montano
- Institute of Nutrition of Central America and Panama (Instituto de Nutrición de Centroamérica y Panamá, INCAP), Guatemala
| | - Joaquin Barnoya
- Institute of Research and Higher Studies in Health Sciences (El Instituto de Investigación y Estudios Superiores en Ciencias de la Salud, IECIS), Rafael Landívar University
| | - Peter Rohloff
- Center for Research in Indigenous Health, Wuqu’ Kawoq | Maya Health Alliance, Guatemala
- Department of Medicine, Department of Global Health Equity, Brigham and Women’s Hospital, Boston, USA
| | - Anita Chary
- Center for Research in Indigenous Health, Wuqu’ Kawoq | Maya Health Alliance, Guatemala
- Departments of Emergency Medicine, Massachusetts General Hospital, Brigham and Women’s Hospital, Boston, USA
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25
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Ahmadi M, Gheibizadeh M, Rassouli M, Ebadi A, Asadizaker M, Jahanifar M. Experience of Uncertainty in Patients with Thalassemia Major: A Qualitative Study. Int J Hematol Oncol Stem Cell Res 2020; 14:237-247. [PMID: 33603985 PMCID: PMC7876423 DOI: 10.18502/ijhoscr.v14i4.4479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major. Materials and Methods: The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software. Results: Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients’ experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'. Conclusion: According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.
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Affiliation(s)
- Mehrnaz Ahmadi
- Department of Nursing, Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rassouli
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Marziyeh Asadizaker
- Nursing Care Research Center in Chronic Diseases, Jundishapur University of Medical Sciences, Ahvaz, Iran
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The Effects of Shared Decision Making on Different Renal Replacement Therapy Decisions in Patients With Chronic Kidney Disease. J Nurs Res 2020; 28:e109. [DOI: 10.1097/jnr.0000000000000386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Zhang F, Bai Y, Zhao X, Huang L, Zhang Y, Zhang H. The impact of exercise intervention for patients undergoing hemodialysis on fatigue and quality of life: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21394. [PMID: 32702938 PMCID: PMC7373554 DOI: 10.1097/md.0000000000021394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study aims to determine the therapeutic efficacy of exercise interventions for patients undergoing hemodialysis (HD) on fatigue and health-related quality of life (HRQoL). METHODS This review will only include randomized controlled trials (RCTs). The search strategy will be performed in 4 English databases, 4 Chinese databases, Clinical Trials.gov, and the Chinese Clinical Trial Registry. All English or Chinese RCTs, published from inception to May 31, 2020, will be sought. Two reviewers will screen, select studies, extract data, and assess quality independently. Primary outcome is fatigue assessed by questionnaire. The methodological quality including the risk of bias of the included studies will be evaluated using the Physiotherapy Evidence Database scale. Stata 12.0 software will be used for heterogeneity assessment, generating funnel-plots, data synthesis, subgroup analysis, and sensitivity analysis. RESULTS We will provide some more practical and targeted results investigating the effect of exercise interventions for patients undergoing HD on fatigue and HRQoL in the current meta-analysis, and point out the main limitation of previous studies. CONCLUSION The study will provide recent evidence for evaluating the therapeutic efficacy of exercise interventions for patients undergoing HD on fatigue and HRQoL. REGISTRATION NUMBER INPLASY202050071 (DOI: 10.37766/inplasy2020.5.0071).
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Affiliation(s)
| | - Yan Bai
- Shanghai University of Traditional Chinese Medicine
| | - Xing Zhao
- Shanghai University of Traditional Chinese Medicine
| | | | - Ying Zhang
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huachun Zhang
- Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Chou HY, Chen SC, Yen TH, Han HM. Effect of a Virtual Reality-Based Exercise Program on Fatigue in Hospitalized Taiwanese End-Stage Renal Disease Patients Undergoing Hemodialysis. Clin Nurs Res 2020; 29:368-374. [PMID: 30009636 DOI: 10.1177/1054773818788511] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
The purpose of this study was to evaluate the short-term effect of a virtual reality-based exercise program on fatigue in patients with end-stage renal disease (ESRD) who receive hemodialysis (HD). In this quasi-experimental study design, an experimental group (n = 32) received virtual reality training that promoted exercise, and a control group (n = 32) received routine care (advice on physical activities). Fatigue and physiologic parameters were assessed pretest (before intervention) as well as posttest (4 weeks after the onset of intervention). Our results showed that patients in the experimental group had significantly lower levels of overall fatigue, reduction in vigor and motivation, distress and loss of control in mood, and higher hemoglobin levels compared with the control group. ANCOVA revealed that there were no differences in overall fatigue and different domains of fatigue. Exercise only increased the blood urea nitrogen (BUN) and creatinine levels significantly in the intervention group.
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Affiliation(s)
- Hsiao-Yu Chou
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Tzung-Hai Yen
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University, Taoyuan, Taiwan
| | - Hui-Mei Han
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Rezaei Z, Jalali A, Jalali R, Sadeghi M. Haemodialysis patients' experience with fatigue: a phenomenological study. ACTA ACUST UNITED AC 2020; 29:684-690. [PMID: 32579460 DOI: 10.12968/bjon.2020.29.12.684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fatigue is one of the main and serious problems that affects haemodialysis patients' quality of life. It should be actively evaluated and, in this process, cooperation between the patient, their family, and healthcare staff is needed to examine fatigue and improve the quality of healthcare and the patient's life. The aim of the present research was to investigate haemodialysis patients' experiences of fatigue. In this qualitative phenomenological study, 12 participants were selected from haemodialysis patients in two health centres in Iran through purposeful sampling. Data were collected through semi-structured in-depth interviews and the collected data were analysed using Colaizzi's method. Two main themes, the nature of fatigue and the perception of fatigue, were found. In addition, the results revealed six secondary themes: physical problems, psychosocial problems, behavioural problems, limitations, need for support, and burnout. The results help to clarify the concept and nature of fatigue for this group of haemodialysis patients.
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Affiliation(s)
- Zahra Rezaei
- Psychiatric nurse, Psychiatric Nursing Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Jalali
- Associate Professor (Faculty member), Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Associate Professor (Faculty member), Nursing Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Assistant Professor (Faculty member), Medical Ethics Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Ramírez-Perdomo CA, Perdomo-Romero AY, Rodriguez-Vélez ME. El sistema de salud: barreras para los usuarios con insuficiencia renal crónica. AVANCES EN ENFERMERÍA 2020. [DOI: 10.15446/av.enferm.v38n2.83555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: comprender la experiencia vivida por un grupo de personas con insuficiencia renal crónica que recibieron un trasplante de órgano frente a los servicios de salud y lossignificados del cuidado de la salud realizados por enfermeras y familiares.Materiales y métodos: estudio cualitativo con enfoque fenomenológico-hermenéutico. La muestra se compone de 11 personas con insuficiencia renal crónica trasplantadas, cincocuidadores y cinco enfermeras. Entrevistas recolectadas y grabadas entre diciembre de 2015 y enero de 2017. Para el análisis se empleó el método propuesto por Van Manen.Resultados: uno de los temas que emerge es la experiencia de encontrarse y vivir con insuficiencia renal crónica, del cual se extrae el subtema relacionado con la vivencia en elsistema de salud por parte de las personas enfermas, sus cuidadores y los profesionales de enfermería.Conclusiones: la insuficiencia renal crónica asume un significado complejo y multidimensional para la persona con la enfermedad, sus cuidadores familiares y las enfermeras que asumen el cuidado de este grupo de personas, que los lleva a experimentar el sistema de salud con un efecto adverso que deshumaniza el cuidado de las personas.
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Existential Contradictions in Living With End-Stage Renal Disease: A Qualitative Metasynthesis. ANS Adv Nurs Sci 2020; 43:159-171. [PMID: 32345802 DOI: 10.1097/ans.0000000000000312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
A qualitative metasynthesis following Sandelowski and Barroso's method was conducted to explore what characterizes the existential experiences of individuals living with end-stage renal disease. The findings show that patients with end-stage renal disease live with several existential contradictions characterized by the following: perception of the body-oscillating between connection and separation, maintaining life-oscillating between freedom and captivity, uncertainty-oscillating between hope and despair, and enduring technology-oscillating between being perceived as an object and subject. Consequently, living with end-stage renal disease is challenging for patients; hence, the support of nurses is important to alleviate patients' vulnerability.
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Raj R, Brown B, Ahuja K, Frandsen M, Jose M. Enabling good outcomes in older adults on dialysis: a qualitative study. BMC Nephrol 2020; 21:28. [PMID: 31996167 PMCID: PMC6988330 DOI: 10.1186/s12882-020-1695-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 01/20/2020] [Indexed: 12/19/2022] Open
Abstract
Background Older patients on dialysis may not have optimal outcomes, particularly with regards to quality of life. Existing research is focused mainly on survival, with limited information about other outcomes. Such information can help in shared decision-making around dialysis initiation; it can also be used to improve outcomes in patients established on dialysis. We used qualitative research methods to explore patient perspectives regarding their experience and outcomes with dialysis. Methods Semi-structured interviews with participants aged ≥70, receiving dialysis at a regional Australian hospital, were recorded and transcribed. From participants’ responses, we identified descriptive themes using a phenomenological approach, with verification by two researchers. Factors affecting outcomes were derived reflexively from these themes. Results Seventeen interviews were analysed prior to saturation of themes. Participants (12 on haemodialysis, 5 on peritoneal dialysis) had spent an average of 4.3 years on dialysis. There were 11 males and 6 females, with mean age 76.2 years (range 70 to 83). Experiences of dialysis were described across four domains - the self, the body, effects on daily life and the influences of others; yielding themes of (i) responses to loss (of time, autonomy, previous life), (ii) responses to uncertainty (variable symptoms; unpredictable future; dependence on others), (iii) acceptance / adaptation (to life on dialysis; to ageing) and (iv) the role of relationships / support (family, friends and clinicians). Conclusions Older patients experience the effects of dialysis across multiple domains in their lives. They endure feelings of loss and persistent uncertainty, but may also adapt successfully to their new circumstances, aided by the support they receive from family, health professionals and institutions. From these insights, we have suggested practical measures to improve outcomes in older patients.
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Affiliation(s)
- Rajesh Raj
- School of Medicine, University of Tasmania, Hobart, Australia. .,Launceston General Hospital, Launceston, Tasmania, 7250, Australia.
| | - Bridget Brown
- Launceston General Hospital, Launceston, Tasmania, 7250, Australia
| | - Kiran Ahuja
- School of Health Sciences, University of Tasmania, Hobart, Australia
| | - Mai Frandsen
- Faculty of Health, University of Tasmania, Hobart, Australia
| | - Matthew Jose
- School of Medicine, University of Tasmania, Hobart, Australia
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Illness Perceptions, Self-Care Management, and Clinical Outcomes According to Age-Group in Korean Hemodialysis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224459. [PMID: 31766240 PMCID: PMC6888085 DOI: 10.3390/ijerph16224459] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/03/2019] [Accepted: 11/12/2019] [Indexed: 12/29/2022]
Abstract
Illness perception, formed in social-cultural contexts, is the driving force for health behavior. Age difference can affect health outcomes due to its association with socioeconomic status. The purpose of this study is to determine the relationship between illness perception, self-care management, and clinical outcomes according to the age group in hemodialysis patients. A cross-sectional study was conducted. Using the Brief Illness Perception Questionnaire (BIPQ) and Patient Activation Measure (PAM) 13, clinical outcomes, such as serum phosphorus, potassium, hemoglobin, and albumin were investigated in maintenance hemodialysis patients. Illness perception, self-care management, and clinical outcomes in 189 hemodialysis patients were different according to age group. Younger hemodialysis patients had the lowest illness perception and the highest serum phosphorus. Illness perception was associated with self-care management and clinical outcomes. After the adjusted age, the association between illness perception and self-care management and the association between illness perception and phosphorus were reduced, while the association between illness perception and potassium increased. Uncontrolled phosphorus in younger hemodialysis patients can increase the risk of cardiovascular complications and mortality. To improve self-care management and clinical outcomes in hemodialysis patients, reconstruction, or expansion of illness perception needs to be differentiated according to age group.
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Ng CZ, Tang SC, Chan M, Tran BX, Ho CS, Tam WW, Ho RC. A systematic review and meta-analysis of randomized controlled trials of cognitive behavioral therapy for hemodialysis patients with depression. J Psychosom Res 2019; 126:109834. [PMID: 31525637 DOI: 10.1016/j.jpsychores.2019.109834] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/08/2019] [Accepted: 09/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to examine the efficacy of cognitive behavioral therapy (CBT) for hemodialysis patients with comorbid depression and to identify which other aspects, including anxiety and quality of life, can be improved through intervention. METHODS A systematic literature review was performed using multiple databases (PubMed, EMBase, PsycINFO, CENTRAL). The inclusion criteria included randomized controlled trials (RCTs) of CBT conducted in hemodialysis patients with depression. Study reporting quality was assessed with the Cochrane tool and Review Manager version 5.3 was used to obtain pooled results. RESULTS Eight RCTs, with a total sample size of 540 participants, met the inclusion criteria. Compared with control groups, the CBT groups had statistically significant improvements in depression (standardized mean differences [SMD] = -0.68, 95% confidence interval [CI] (-0.94 to -0.42), P < .001), anxiety (SMD = -0.99, 95%CI (-1.99 to 0.00), P = .05) and quality of life (SMD = 0.34, 95%CI (0.13 to 0.54), P < .001). CONCLUSIONS The results of this meta-analysis showed that CBT could have an effective role in reducing symptoms of depression and anxiety as well as improving quality of life in hemodialysis patients with comorbid depression.
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Affiliation(s)
- Chong Zheng Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sydney C Tang
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Meanne Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Bach X Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Viet Nam; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Cyrus S Ho
- Department of Psychological Medicine, National University Health System, Singapore
| | - Wilson W Tam
- Alice Lee School of Nursing, National University of Singapore, Singapore
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 119077, Singapore; Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, 119228, Singapore; Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Viet Nam; Faculty of Education, Huaibei Normal University, 100 Dongshan Road, Huaibei, Anhui 235000, China.
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Álvarez-Villarreal M, Velarde-García JF, Chocarro-Gonzalez L, Pérez-Corrales J, Gueita-Rodriguez J, Palacios-Ceña D. Body Changes and Decreased Sexual Drive after Dialysis: A Qualitative Study on the Experiences of Women at an Ambulatory Dialysis Unit in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173086. [PMID: 31450673 PMCID: PMC6747238 DOI: 10.3390/ijerph16173086] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 01/07/2023]
Abstract
Chronic kidney disease (CKD) has considerable effects on the quality of life of patients, impairing everyday activities and leading to lifestyle changes, as well as affecting body image and intimate relationships. Our aim was to describe the experience of female patients with CKD at an ambulatory dialysis unit regarding body changes and sexuality. A qualitative phenomenological study exploring how 18 female patients, treated at the dialysis unit of a Spanish hospital, perceived their sexuality and intimate relationships. Data were collected using in-depth interviews, researcher field notes, and patients’ personal letters. A thematic analysis was performed. Four main themes arose from the data describing the experience of how CKD impacts body changes and sexuality: (a) Accepting body changes, (b) The catheter, the fistula, and body image, (c) Experiencing a different sexuality, and (d) The catheter, the fistula, and sexuality. Patients experienced changes in their body, perceiving it as being bloated or deformed, together with overall decline. The catheter and/or the fistula triggered changes in the way the women dress in an attempt to hide port sites. Women experience sexuality changes, affecting sexual desire and satisfaction. The presence of catheters was found to be the most cumbersome during sexual acts.
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Affiliation(s)
| | - Juan Francisco Velarde-García
- Department of Nursing, Spanish Red Cross, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Autonoma de Madrid, 28009 Madrid, Spain.
| | - Lourdes Chocarro-Gonzalez
- Palliative Pediatric Care Unit. Hospital Universitario Infantil Niño Jesús, Avenida de Menéndez Pelayo, 65, 28009 Madrid, Spain
| | - Jorge Pérez-Corrales
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Avenida Atenas s/n, 28922 Alcorcón, Spain
| | - Javier Gueita-Rodriguez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Avenida Atenas s/n, 28922 Alcorcón, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Avenida Atenas s/n, 28922 Alcorcón, Spain
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Quiñoa-Salanova C, Porta-Sales J, Monforte-Royo C, Edo-Gual M. The experiences and needs of primary family caregivers of patients with multiple myeloma: A qualitative analysis. Palliat Med 2019; 33:500-509. [PMID: 30761947 DOI: 10.1177/0269216319830017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Family caregivers play a key role in the lives of patients with multiple myeloma. However, very little is known about the impact that the disease (its diagnosis, course and prognosis) has on the main family caregiver. AIM To achieve a deeper understanding of the lived experience of individuals who are the primary caregiver of a relative with multiple myeloma and to shed light on their needs. DESIGN Interpretative phenomenological study. SETTING AND PARTICIPANTS A total of 12 individuals who were the main family caregivers of a relative with multiple myeloma who was under outpatient follow-up at a cancer unit in Barcelona were recruited via purposive sampling until data saturation was reached. In semi-structured in-depth interviews, participants described their experiences of caring for their relative with multiple myeloma. Interviews were recorded, transcribed and analysed using ATLAS.ti v7.2. The seven steps proposed by Colaizzi were used for data analysis, and the relationships among emerging themes were examined. FINDINGS Four main themes emerged: (a) a new life, adapting to the disease, (b) commitment to the patient, (c) the emotional sphere and (d) experiences in relation to the care and support received. The analysis also revealed a core overarching theme: uncertainty. CONCLUSION Primary family caregivers experienced intense uncertainty, and they described a strong need to air their feelings. Specific practical initiatives, targeting both health-related and logistical aspects of care, need to be developed in order to support family caregivers of myeloma patients.
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Affiliation(s)
- Carmen Quiñoa-Salanova
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,2 Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Josep Porta-Sales
- 3 Palliative Care Service, Institut Català d'Oncologia (ICO), Barcelona, Spain.,4 Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,5 Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Montserrat Edo-Gual
- 6 Department of Nursing, Escola Universitària d'Infermeria Gimbernat, Barcelona, Spain
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Roberti J, Cummings A, Myall M, Harvey J, Lippiett K, Hunt K, Cicora F, Alonso JP, May CR. Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies. BMJ Open 2018; 8:e023507. [PMID: 30181188 PMCID: PMC6129107 DOI: 10.1136/bmjopen-2018-023507] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/28/2018] [Accepted: 08/08/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) requires patients and caregivers to invest in self-care and self-management of their disease. We aimed to describe the work for adult patients that follows from these investments and develop an understanding of burden of treatment (BoT). METHODS Systematic review of qualitative primary studies that builds on EXPERTS1 Protocol, PROSPERO registration number: CRD42014014547. We included research published in English, Spanish and Portuguese, from 2000 to present, describing experience of illness and healthcare of people with CKD and caregivers. Searches were conducted in MEDLINE, Embase, CINAHL Plus, PsycINFO, Scopus, Scientific Electronic Library Online and Red de Revistas Científicas de América Latina y el Caribe, España y Portugal. Content was analysed with theoretical framework using middle-range theories. RESULTS Searches resulted in 260 studies from 30 countries (5115 patients and 1071 carers). Socioeconomic status was central to the experience of CKD, especially in its advanced stages when renal replacement treatment is necessary. Unfunded healthcare was fragmented and of indeterminate duration, with patients often depending on emergency care. Treatment could lead to unemployment, and in turn, to uninsurance or underinsurance. Patients feared catastrophic events because of diminished financial capacity and made strenuous efforts to prevent them. Transportation to and from haemodialysis centre, with variable availability and cost, was a common problem, aggravated for patients in non-urban areas, or with young children, and low resources. Additional work for those uninsured or underinsured included fund-raising. Transplanted patients needed to manage finances and responsibilities in an uncertain context. Information on the disease, treatment options and immunosuppressants side effects was a widespread problem. CONCLUSIONS Being a person with end-stage kidney disease always implied high burden, time-consuming, invasive and exhausting tasks, impacting on all aspects of patients' and caregivers' lives. Further research on BoT could inform healthcare professionals and policy makers about factors that shape patients' trajectories and contribute towards a better illness experience for those living with CKD. PROSPERO REGISTRATION NUMBER CRD42014014547.
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Affiliation(s)
- Javier Roberti
- FINAER, Foundation for Research and Assistance of Kidney Disease, Buenos Aires, Argentina
| | - Amanda Cummings
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Michelle Myall
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Jonathan Harvey
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Kate Lippiett
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Katherine Hunt
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Federico Cicora
- FINAER, Foundation for Research and Assistance of Kidney Disease, Buenos Aires, Argentina
| | - Juan Pedro Alonso
- Faculty of Social Sciences, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carl R May
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
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Older people living with chronic illness. Geriatr Nurs 2018; 39:513-520. [DOI: 10.1016/j.gerinurse.2018.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/29/2018] [Accepted: 02/05/2018] [Indexed: 11/24/2022]
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Ju A, Strippoli GFM, Craig JC, Tong A, Saglimbene VM, Unruh ML. Interventions for fatigue in people with chronic kidney disease requiring dialysis. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2018. [DOI: 10.1002/14651858.cd013074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Angela Ju
- The Children's Hospital at Westmead; Centre for Kidney Research; Westmead NSW Australia 2145
- The University of Sydney; Sydney School of Public Health; Sydney NSW Australia 2006
| | - Giovanni FM Strippoli
- The University of Sydney; Sydney School of Public Health; Sydney NSW Australia 2006
- University of Bari; Department of Emergency and Organ Transplantation; Bari Italy
- Diaverum; Medical Scientific Office; Lund Sweden
- Diaverum Academy; Bari Italy
- The Children's Hospital at Westmead; Cochrane Kidney and Transplant, Centre for Kidney Research; Westmead NSW Australia 2145
| | - Jonathan C Craig
- The Children's Hospital at Westmead; Cochrane Kidney and Transplant, Centre for Kidney Research; Westmead NSW Australia 2145
- Flinders University; College of Medicine and Public Health; Adelaide SA Australia 5001
| | - Allison Tong
- The Children's Hospital at Westmead; Centre for Kidney Research; Westmead NSW Australia 2145
- The University of Sydney; Sydney School of Public Health; Sydney NSW Australia 2006
| | - Valeria M Saglimbene
- The Children's Hospital at Westmead; Centre for Kidney Research; Westmead NSW Australia 2145
- The University of Sydney; Sydney School of Public Health; Sydney NSW Australia 2006
- Diaverum; Medical Scientific Office; Lund Sweden
| | - Mark L Unruh
- Department of Internal Medicine; University of New Mexico; 1 University of New Mexico Albuquerque New Mexico USA 87131
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Bento SR, Ottaviani AC, Brigola AG, Neris VPDA, Orlandi FDS, Pavarini SCI. Use of digital game therapy among elderly persons undergoing dialytic treatment: cognitive aspects and depressive symptoms. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2018. [DOI: 10.1590/1981-22562018021.170184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective :to evaluate the presence of depressive symptoms and cognitive disorders before and after an intervention program with a digital therapeutic game among elderly persons undergoing hemodialysis. Method: a quasi-experimental study was carried out with 26 elderly patients on hemodialysis. For the data collection, a questionnaire relating to sociodemographic and health conditions, the Geriatric Depression Scale - 15 items and Addenbrooke’s Cognitive Examination Revised were used. The intervention with the digital therapeutic game was performed over 5 sessions. Results: of the participants, 80.8% were male, with a mean age of 66.7 (± 5.8) years. The mean pre-intervention depressive symptom score was 3.9 (± 3.0) while post-intervention it was 2.8 (± 2.9), representing a statistically significant difference (p = 0.005). Regarding cognitive function, there was no statistically significant difference before and after the intervention. There was a statistically significant difference in the mean of the depressive symptom scores, which were lower after the intervention. In addition, there was no statistically significant difference in the mean of the cognitive assessments. Conclusion: intervention studies with patients undergoing hemodialysis treatment are still scarce and this study describes the positive results of an intervention with a digital therapeutic game, demonstrating improvement in the depressive symptoms of the participants.
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