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Erickson SJ, Yabes JG, Han Z, Roumelioti ME, Rollman BL, Weisbord SD, Steel JL, Unruh ML, Jhamb M. Associations between Social Support and Patient-Reported Outcomes in Patients Receiving Hemodialysis: Results from the TACcare Study. KIDNEY360 2024; 5:860-869. [PMID: 38704664 PMCID: PMC11219113 DOI: 10.34067/kid.0000000000000456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
Key Points Mean baseline levels of perceived social support (Multidimensional Scale of Perceived Social Support) were comparable with other chronically ill populations. Higher Multidimensional Scale of Perceived Social Support scores were correlated with lower levels of fatigue, pain, depressive symptoms, anxiety, better sleep quality, and health-related quality of life (Short Form-12 Mental Component Score). Moderation analyses revealed male sex and non-Hispanic ethnicity resulted in stronger positive associations of perceived social support with Short Form-12 Mental Component Score. Background Patients with ESKD experience high symptom burden, which has been associated with a negative effect on their interpersonal relationships. However, there is limited research exploring associations of social support and patient-reported outcomes among patients receiving hemodialysis. Methods This study is a secondary, cross-sectional analyses of the sociodemographic and clinical correlates of perceived social support (Multidimensional Scale of Perceived Social Support [MSPSS]) at baseline. The study examined the extent to which perceived social support is associated with pain, depression, fatigue, anxiety, sleep, and health-related quality of life (Short Form-12 [SF-12] Mental Component Score [MCS] and Physical Component Score. Results Of the 160 randomized patients, the mean (SD) age was 58±14 years; years on dialysis was 4.1±4.2; 45% were female; 29% Black, 13% American Indian, and 18% Hispanic; 88% had at least high school education; and 27% were married. Mean baseline levels of perceived social support were comparable with other chronically ill populations. At least high school education (P = 0.04) and being married (P = 0.05) were associated with higher total MSPSS scores. Higher MSPSS scores were correlated with lower levels of fatigue (r =0.21, P = 0.008; higher fatigue scores signify lower fatigue), pain (r =−0.17, P = 0.03), depressive symptoms (r =−0.26, P < 0.001), anxiety (r =−0.23, P = 0.004), better sleep quality (r =−0.32, P < 0.001), and SF-12 MCS (r =0.26, P < 0.001). Moderation analyses revealed male sex and non-Hispanic ethnicity resulted in stronger positive associations of perceived social support with SF-12 MCS. Conclusions The level of perceived social support observed among patients receiving thrice-weekly hemodialysis in Technology Assisted Stepped Collaborative Care was similar to those observed in other chronic conditions. Because of the associations between perceived social support and patient-reported outcomes, particularly psychosocial and behavioral health outcomes, targeting social support appears to be warranted among patients receiving hemodialysis. Clinical Trial registration number: ClinicalTrials.gov NCT03440853 .
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Affiliation(s)
- Sarah J. Erickson
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Jonathan G. Yabes
- Division of General Internal Medicine, Department of Medicine and Biostatistics, Center for Research on Heath Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Zhuoheng Han
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Maria-Eleni Roumelioti
- Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine Albuquerque, New Mexico
| | - Bruce L. Rollman
- Division of General Internal Medicine, Center for Behavioral Health, Media, and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Steven D. Weisbord
- Renal Section, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Jennifer L. Steel
- Department of Surgery, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mark L. Unruh
- Division of Nephrology, Department of Internal Medicine, University of New Mexico School of Medicine Albuquerque, New Mexico
| | - Manisha Jhamb
- Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Nassar MK, Tharwat S, Abdel-Gawad SM, Elrefaey R, Elsawi AA, Elsayed AM, Nagy E, Shabaka S, Shemies RS. Symptom burden, fatigue, sleep quality and perceived social support in hemodialysis patients with musculoskeletal discomfort: a single center experience from Egypt. BMC Musculoskelet Disord 2023; 24:788. [PMID: 37794377 PMCID: PMC10548648 DOI: 10.1186/s12891-023-06910-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 09/24/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND AND AIMS Musculoskeletal disorders (MSDs) are commonly encountered in hemodialysis (HD) patients. However, the causes linked to these disorders are still partially defined. The aim of this study was to determine the frequency of MSDs and their relationship to a variety of clinico-social characteristics such as sleep quality, mood disorders, fatigue, and social support, in addition to the patients' clinical and therapeutic profile. METHOD The study included 94 patients on maintenance HD. Clinical and Sociodemographic data was gathered. To investigate the prevalence and trends of MSDs, the Nordic Musculoskeletal Questionnaire (NMQ-E) was employed. Patients completed the modified Edmonton Symptom Assessment System, Pittsburgh Sleep Quality Index (PSQI), multidimensional Fatigue Inventory (MFI-20), and Perceived Social Support from Family Scales. Univariate and multivariate regression analysis were used to assess the determinants of MSDs. RESULTS The patients' mean age was 49.73 and 59.6% were males. Seventy-two percent of patients were afflicted by MSDs. Knee pain (48.9%), low back pain (43.6%), shoulder pain (41.6%), hip/thigh pain (35.1%), and neck pains (35.1%) were the most reported MSD domains. Pain (p = 0.001), fatigue (p = 0.01), depression (p = 0.015), and anxiety (p = 0.003) scores were substantially higher in patients with MSDs. Furthermore, patients with MSDs engaged in less physical activity (p = 0.02) and perceived less social support (p = 0.029). Patients with MSDs had lower subjective sleep quality, daytime dysfunction domains, and global PSQI scores (p = 0.02, 0.031, 0.036, respectively). Female gender (p = 0.013), fatigue (p = 0.012), depression (p = 0.014), anxiety (p = 0.004), lower activity (p = 0.029), and PSQI score (0.027), use of erythropoiesis-stimulating agents (ESAs), antihypertensive drugs, calcium and Iron supplementation were all significantly associated with MSDs. At the multivariable regression model, administration of ESAs (p = 0.017) and pain score (p = 0.040) were the only independent variables associated with the outcome. CONCLUSION MSDs are quite common among HD patients. Female gender, pain, fatigue, depression, anxiety, reduced activity, poor sleep quality, and use of ESAs are all significantly associated with MSDs in HD patients. Patients with MSD perceived less social support compared to the other group. Patients treated with antihypertensive drugs, calcium and iron supplements were more likely to suffer MSDs.
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Affiliation(s)
- Mohammed Kamal Nassar
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Samar Tharwat
- Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sara M Abdel-Gawad
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Rabab Elrefaey
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Alaa A Elsawi
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | | | - Eman Nagy
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Shimaa Shabaka
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt
| | - Rasha Samir Shemies
- Mansoura Nephrology & Dialysis Unit (MNDU), Faculty of Medicine, Mansoura University, El Gomhurria St, Mansoura, 35516, Egypt.
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3
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Longley RM, Harnedy LE, Ghanime PM, Arroyo-Ariza D, Deary EC, Daskalakis E, Sadang KG, West J, Huffman JC, Celano CM, Amonoo HL. Peer support interventions in patients with kidney failure: A systematic review. J Psychosom Res 2023; 171:111379. [PMID: 37270909 PMCID: PMC10340538 DOI: 10.1016/j.jpsychores.2023.111379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Peer support has been associated with improved health-related outcomes (e.g., psychological well-being and treatment adherence) among patients with serious, chronic conditions, including kidney disease. Yet, there is little existing research evaluating the effects of peer support programs on health outcomes among patients with kidney failure being treated with kidney replacement therapy. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a systematic review using five databases to assess the effects of peer support programs on health-related outcomes (e.g., physical symptoms, depression) among patients with kidney failure undergoing kidney replacement therapy. RESULTS Peer support in kidney failure was assessed across 12 studies (eight randomized controlled trials, one quasi-experimental controlled trial, and three single-arm trials) with 2893 patients. Three studies highlighted the links between peer support and improved patient engagement with care, while one found peer support did not significantly impact engagement. Three studies showed associations between peer support and improvements in psychological well-being. Four studies underscored the effects of peer support on self-efficacy and one on treatment adherence. CONCLUSIONS Despite preliminary evidence of the positive associations between peer support and health-related outcomes among patients with kidney failure, peer support programs for this patient population remain poorly understood and underutilized. Further rigorous prospective and randomized studies are needed to evaluate how peer support can be optimized and incorporated into clinical care for this vulnerable patient population.
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Affiliation(s)
- Regina M Longley
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Lauren E Harnedy
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Pia Maria Ghanime
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Daniel Arroyo-Ariza
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Emma C Deary
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Elizabeth Daskalakis
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Katrina G Sadang
- University of California San Francisco School of Medicine, San Francisco, CA, United States of America
| | - Jason West
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Jeff C Huffman
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Christopher M Celano
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Hermioni L Amonoo
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Dana-Farber Cancer Institute, Department of Psychosocial Oncology and Palliative Care, Boston, MA, United States of America.
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Turk RD, Li LT, Saini S, MacAskill M, Ross G, Shah SS. A Novel Comorbidity Risk Score for Predicting Post-Operative 30-day Complications in Total Shoulder Arthroplasty & Elucidation of Potential Racial Disparities. JSES Int 2022; 6:867-873. [PMID: 36353420 PMCID: PMC9637582 DOI: 10.1016/j.jseint.2022.08.013] [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] [Indexed: 11/19/2022] Open
Abstract
Background Efficient and effective preoperative identification of those patients with elevated risk may allow for more cost-effective interventions, accurate bundled payment adjustments, and overall improved patient care. Few comorbidity indices have provided clinical utility and adequate discriminative ability in the setting of complications after shoulder arthroplasty (SA). Methods The American College of Surgeons National Surgical Quality Improvement Program database was queried for anatomic and/or reverse SA procedures between 2010 and 2019. A subset of comorbidities were utilized including end-stage renal disease, history of hypertension, chronic obstructive pulmonary disease, functional status, history of bleeding disorder, and disseminated cancer. Results A total of 25,927 patients with an average age of 69.2 (standard deviation ±9.5) years were included in the study. Patients with a comorbidity risk score (CRS) at or above 2 were indicated to have at least a 29.6% 30-day postoperative complication rate after undergoing total shoulder arthroplasty, significantly higher than the described average of approximately 15%. The area under receiver operator curve for the novel CRS scoring system was 0.595, indicating fair discriminative ability to predict 30-day postoperative complications after SA. This illustrates a discriminative ability similar to that of the American Society of Anesthesiologists classification (0.584, confidence interval [CI] 0.578-0.589), modified Charlson Comorbidity Index (0.567, CI 0.561-0.573), and modified Frailty Index (0.534, CI 0.529-0.539), each of which are common comorbidity indices used for the National Surgical Quality Improvement Program database. The average CRS for the population was 0.8537 (CI 0.8011-0.8150; P < .05) while that for the Black demographic was 1.08 (CI 1.03-1.13; P < .001). Our results suggest that if the disparity in CRS among races was corrected, the average complication rate would be decreased by 2.0%. Discussion and Conclusion A higher CRS score resulted in higher rates of 30-day postoperative complications following SA. Black patients had a higher average CRS than all other races illustrating a racial disparity in comorbidity risk. Although the average complication rate of each race would still be unequal, this could mitigate some of the racial disparities observed and decrease the overall 30-day complication rate in SA. With the rise of bundled payments further increasing the need to preoperatively identify patients at high risk for costly complications, the CRS is based on easily identified, relevant comorbidities that may be an advantageous tool to identify patients at increased risk of complications following SA.
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Affiliation(s)
- Robby D. Turk
- Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC, USA
| | - Lambert T. Li
- Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA, USA
| | - Sundeep Saini
- Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA, USA
| | | | - Glen Ross
- Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA, USA
- New England Shoulder and Elbow Center, Brighton, MA, USA
| | - Sarav S. Shah
- Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA, USA
- New England Shoulder and Elbow Center, Brighton, MA, USA
- Corresponding author: Sarav Shah, MD, New England Baptist Hospital Sports Medicine Division 125 Parker Hill Ave Boston, MA 02120.
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Liu CK, Seo J, Lee D, Wright K, Kurella Tamura M, Moye J, Weiner DE, Bean JF. The Impact of Care Partners on the Mobility of Older Adults Receiving Hemodialysis. Kidney Med 2022; 4:100473. [PMID: 35663231 PMCID: PMC9157255 DOI: 10.1016/j.xkme.2022.100473] [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] [Indexed: 11/05/2022] Open
Abstract
Rationale & Objective Many older adults receiving hemodialysis have mobility limitations and rely on care partners, yet data are sparse regarding the support provided by care partners. Our aim was to examine how care partners support the mobility of an older adult receiving hemodialysis. Study Design Qualitative study. Setting & Participants Using purposive sampling, we recruited persons aged 60 years or more receiving maintenance hemodialysis and care partners aged 18 years or more who were providing support to an older adult receiving hemodialysis. We conducted in-person semi-structured interviews about mobility with each individual. Analytical Approach We conducted descriptive and focused coding of interview transcripts and employed thematic analysis. Our outcome was to describe perceived mobility supports provided by care partners using qualitative themes. Results We enrolled 31 older adults receiving hemodialysis (42% women, 68% Black) with a mean age of 73 ± 8 years and a mean dialysis duration of 4.6 ± 3.5 years. Of these, 87% of patients used assistive devices and 90% had care partners. We enrolled 12 care partners (75% women, 33% Black) with a mean age of 54 ± 16 years. From our patient and care partner interviews, we found three themes: (1) what care partners see, (2) what care partners do, and (3) what care partners feel. Regarding what they see, care partners witness a decline in patient mobility. Regarding what they do, care partners guide and facilitate activities and manage others who also assist. Regarding what they feel, care partners respect the patient’s autonomy but experience frustration and worry about the patient’s future mobility. Limitations Modest sample size; single geographic area. Conclusions In older adults receiving hemodialysis, care partners observe a decline in mobility and provide support for mobility. They respect the patient’s autonomy but worry about future mobility losses. Future research should incorporate care partners in interventions that address mobility in older adults receiving hemodialysis.
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Fuertes J, Rubinstein S, Yarandi N, Cohen SD. Social Support, Caregivers, and Chronic Kidney Disease. Semin Nephrol 2022; 41:574-579. [PMID: 34973701 DOI: 10.1016/j.semnephrol.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The morbidity and mortality associated with chronic kidney disease remains unacceptably high. Psychosocial issues in CKD patients are frequently overlooked yet are often modifiable risk factors for mortality. Addressing patient perception of social support can potentially improve patient outcomes.
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Abstract
Pediatric hemodialysis access is a demanding field. Procedures are infrequent, technically challenging, and associated with high complication and failure rates. Each procedure affects subsequent access and transplants sites. The choice is made easier and outcomes improved when access decisions are made by a multidisciplinary, pediatric, hemodialysis access team. This manuscript reviews the current literature and offers technical suggestions to improve outcomes.
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Noviana CM, Zahra AN. Social support and self-management among end-stage renal disease patients undergoing hemodialysis in Indonesia. J Public Health Res 2021; 11. [PMID: 35238191 PMCID: PMC8941312 DOI: 10.4081/jphr.2021.2733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Self-management is the latest multidisciplinary intervention that empowers end-stage renal disease (ESRD) patients to be active in maintaining their health status. The implementation of self-management among ESRD patients undergoing hemodialysis in Indonesia remains relatively low, contributing to the high prevalence of complications and morbidity. The social cognitive theory proposes that social support is one of the environmental factors affecting health behavior change. Therefore, this study aimed to investigate the association between social support and self-management among ESRD patients undergoing hemodialysis in Indonesia. Design and Methods: A cross-sectional study was conducted among 107 ESRD patients selected by consecutive sampling. Data were collected online from four chronic kidney disease communities in Indonesia in June 2020. Medical Outcome Study Social Support Survey and Hemodialysis Self-Management Instrument were used to measure patients’ functional social support and selfmanagement levels. Statistical analysis using the Chi-square test was applied to evaluate the association between social support and self-management. Results: More than half of the patients had high social support (51%) and good self-management (53%). There was a significant relationship between social support and self-management (p=0.027; α=0.05; odds ratio 95% CI = 2.386). Conclusions: Social support is a potential environmental factor that can be modified to enhance health behavior change among ESRD patients in Indonesia, with the specific behavior being selfmanagement. This study recommends functional social support as an integral part of self-management intervention provided through cooperation between health workers, chronic kidney disease community, and patient companions. Significance for public health The prevalence of end-stage renal disease (ESRD) has significantly increased year over year, yet more than 50% of ESRD patients still do not comply with the recommended lifestyle modifications. Self-management is a new multidisciplinary treatment that empowers ESRD patients to monitor and participate in health care and lifestyle modifications, replacing previous compliance-based treatments. However, the implementation of self-management in Indonesia is still far from ideal. This study indicates a significant relationship between social support on self-management among ESRD patients undergoing hemodialysis in Indonesia. This study can provide new insights for health workers and social networks active in the interaction and care of ESRD patients regarding functional forms of social support that can be applied to support self-management among ESRD patients undergoing hemodialysis.
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Lockwood MB, Steel JL, Doorenbos AZ, Contreras BN, Fischer MJ. Emerging Patient-Centered Concepts in Pain Among Adults With Chronic Kidney Disease, Maintenance Dialysis, and Kidney Transplant. Semin Nephrol 2021; 41:550-562. [PMID: 34973699 PMCID: PMC8740641 DOI: 10.1016/j.semnephrol.2021.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Patient reports of moderate to severe pain are common across the spectrum of chronic kidney disease. The synergistic effects of comorbid depression and anxiety can lead to maladaptive coping responses to pain, namely pain catastrophizing and illness-related post-traumatic stress disorder. If underlying depression and anxiety and associated maladaptive coping responses are not treated, patients can experience an increased perception of pain, worsened disability, decreased quality of life, withdrawal from social activities, and increased morbidity and mortality. Meanwhile, interest in nonpharmacologic treatments for pain that targets coping as well as comorbid anxiety and depression has been increasing, particularly given the significant societal damage that has resulted from the opioid epidemic. Evidence-based, nonpharmacologic treatments have shown promise in treating pain in areas outside of nephrology. Currently, little is known about the effects of these treatments among adults with CKD, and particularly end-stage kidney disease, when chronic pain can become debilitating. In this review, we examine patient-centered concepts related to pain that have received little attention in the nephrology literature. We also describe emerging areas of research, including omics technologies for biomarker discovery and advanced symptom clustering methods for symptom phenotyping, which may be useful to future kidney disease research and treatment.
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Affiliation(s)
- Mark B Lockwood
- Department of Behavioral Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, IL.
| | - Jennifer L Steel
- Center for Excellence in Behavioral Medicine, Department of Surgery, University of Pittsburg, Pittsburg, PA
| | - Ardith Z Doorenbos
- Department of Biobehavioral Nursing Science, University of Illinois Chicago, College of Nursing, Chicago, IL
| | - Blanca N Contreras
- Section of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Michael J Fischer
- Department of Internal Medicine, University of Illinois Hospital and Health Sciences Center, Chicago, IL; Renal Section, Medical Service, Jesse Brown VA Medical Center, Chicago, IL; Center of Innovation for Complex Chronic Health Care, Edward Hines, Jr. VA Hospital, Hines, IL
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10
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Dingwall KM, Sweet M, Cass A, Hughes JT, Kavanagh D, Howard K, Barzi F, Brown S, Sajiv C, Majoni SW, Nagel T. Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial. BMC Nephrol 2021; 22:136. [PMID: 33866968 PMCID: PMC8054368 DOI: 10.1186/s12882-021-02344-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high. Methods This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months. Results Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance. Conclusions Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components. Trial registration ACTRN12617000249358; 17/02/2017.
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Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, 0870, Australia.
| | - Michelle Sweet
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, 0870, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia
| | - Jaquelyne T Hughes
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia.,Division of Medicine, Royal Darwin Hospital, Darwin, NT, 0811, Australia.,Department of Nephrology, Royal Darwin Hospital, Northern Territory Department of Health, Darwin, NT, 0810, Australia
| | - David Kavanagh
- Centre for Children's Health Research and School of Psychology & Counselling, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, 4101, Australia
| | - Kirsten Howard
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Federica Barzi
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia
| | - Sarah Brown
- Western Desert Nganampa Walytija Palyantjaku Tjutaku, Alice Springs, NT, 0870, Australia
| | - Cherian Sajiv
- Central Australian Renal Services, Alice Springs Hospital, Northern Territory Department of Health, Alice Springs, NT, 0870, Australia
| | - Sandawana W Majoni
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia.,Department of Nephrology, Royal Darwin Hospital, Northern Territory Department of Health, Darwin, NT, 0810, Australia.,Northern Territory Medical Program, Flinders University, Darwin, NT, 0815, Australia
| | - Tricia Nagel
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, 0811, Australia
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11
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Alshraifeen A, Al‐Rawashdeh S, Alnuaimi K, Alzoubi F, Tanash M, Ashour A, Al‐Hawamdih S, Al‐Ghabeesh S. Social support predicted quality of life in people receiving haemodialysis treatment: A cross-sectional survey. Nurs Open 2020; 7:1517-1525. [PMID: 32802372 PMCID: PMC7424448 DOI: 10.1002/nop2.533] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/05/2020] [Accepted: 05/04/2020] [Indexed: 12/25/2022] Open
Abstract
Aims To examine levels of social support and quality of life (QOL) and to examine the association between social support and QOL in patients receiving haemodialysis (HD) treatment. Design A cross-sectional study. Method social support and QOL were measured using the Multidimensional Scale of Perceived social Support (MSPSS) and the World Health Organization QOL-BREF questionnaires, respectively. A convenience sample of 195 patients receiving HD from different dialysis units across Jordan completed the questionnaires. Results Respondents scored highest on the social relationships domain of QOL (55.5 SD 21.4) compared with the lowest mean scores of the physical and environmental domains (48.6 SD 20.4; 46.2 SD 17.3, respectively). social support had a positive significant association with quality of life. Multiple linear regression identified age and social support as influencing factors, explaining 24.6% of the total variance in the social domain of quality of life.Understanding the relationship between social support and QOL in patients receiving HD may provide guidance to the healthcare providers, family members and social services about the importance of social support to this group of patients.
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Affiliation(s)
- Ali Alshraifeen
- Adult Health Nursing DepartmentFaculty of NursingThe Hashemite UniversityZarqaJordan
| | - Sami Al‐Rawashdeh
- Department of Community and Mental HealthFaculty of NursingThe Hashemite UniversityZarqaJordan
| | - Karimeh Alnuaimi
- Department of Maternal and Child HealthFaculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - Fatmeh Alzoubi
- Department of Community and Mental Health NursingFaculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - Muath Tanash
- Adult Health Nursing DepartmentFaculty of NursingThe Hashemite UniversityZarqaJordan
| | - Ala Ashour
- Adult Health Nursing DepartmentFaculty of NursingThe Hashemite UniversityZarqaJordan
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12
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Nagel T, Sweet M, Dingwall KM, Puszka S, Hughes JT, Kavanagh DJ, Cass A, Howard K, Majoni SW. Adapting wellbeing research tools for Aboriginal and Torres Strait Islander people with chronic kidney disease. BMC Nephrol 2020; 21:130. [PMID: 32293331 PMCID: PMC7161120 DOI: 10.1186/s12882-020-01776-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic kidney disease is an increasingly common health problem for Aboriginal and Torres Strait Islander people. It is associated with multiple concurrent psychosocial stressors frequently resulting in negative impacts on emotional and social wellbeing. There is need for well-designed intervention studies to provide evidence of effective treatment for comorbid depression or other mental illness in this setting. Attention to early phase piloting and development work is recommended when testing complex interventions. This paper documents feasibility testing and adaptation of an existing culturally responsive brief wellbeing intervention, the Stay Strong App, and three commonly used wellbeing outcome measures, in preparation for a clinical trial testing effectiveness of the intervention. METHODS The Stay Strong App, which has not been used in the setting of Chronic Kidney Disease before, is reviewed and adapted for people with comorbid wellbeing concerns through expert consensus between research team and an Expert Panel. The outcome measures (Kessler 10, Patient Health Questionnaire 9, and EuroQoL) are valid, reliable, and commonly used tools to assess various aspects of wellbeing, which have also not been used in this context before. Feasibility and acceptability are examined and developed through 3 stages: Pilot testing in a purposive sample of five haemodialysis patients and carers; translation of outcome measures through collaboration between the Aboriginal Interpreter Service, Aboriginal and Torres Strait Islander research officers and the research team; and conversion of translated outcome measures to electronic format. RESULTS Research team and expert panel consensus led to adaptation of the Stay Strong App for renal patients through selective revision of words and images. Pilot testing identified challenges in delivery of the wellbeing measures leading to word changes and additional prompts, integration of audio translations in 11 local Indigenous languages within an interactive Outcome Measures App, and related research protocol changes. CONCLUSION Modelling the complex intervention prior to full-scale testing provided important information about the design of both the outcome measures and the intervention. These changes are likely to better support success in conduct of the clinical trial and future implementation of the intervention in clinical settings.
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Affiliation(s)
- Tricia Nagel
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia.
| | - Michelle Sweet
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Kylie M Dingwall
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Stefanie Puszka
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Jaquelyne T Hughes
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
- Division of Medicine, Royal Darwin Hospital, Darwin, NT, 0811, Australia
| | - David J Kavanagh
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, 4101, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Kirsten Howard
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Sandawana W Majoni
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
- Top End Renal Services, Royal Darwin Hospital, Northern Territory Department of Health, Darwin, NT, 0810, Australia
- Northern Territory Medical Program, Flinders University, Darwin, NT, 0815, Australia
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13
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Yang JY, Huang JW, Peng YS, Chiang SS, Yang CS, Yang CC, Chen HW, Wu MS, Wu KD, Tsai TJ, Chen WY. Quality of Sleep and Psychosocial Factors for Patients Undergoing Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080702700614] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives Sleep disorders are common in end-stage renal disease patients. This study examined the relationship between self-reported quality of sleep (QoS) and certain psychosocial domains for patients on peritoneal dialysis (PD). Methods The study subjects included 190 PD patients from 7 urban dialysis clinics in Northern Taiwan, from whom we obtained biochemical parameters and demographic data. QoS, quality of life (QoL), religious/spiritual activity, and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Medical Outcomes Study Short Form (SF-36) for QoL, the Royal Free Questionnaire, and the Beck Depression Inventory, respectively. Results The average PSQI score was 9.1 ± 4.1 and, in total, 85.8% of all patients were poor sleepers (global PSQI ≥ 5). There was no difference in age, gender, and mode or duration of PD between good and poor sleepers. Biochemical data did not differ between the two groups. Widowed patients experienced significantly poorer QoS than patients with other marital status (PSQI scores: 12.3 ± 4.9 vs 8.88 ± 4.0, p = 0.006). The percentage of patients that held a bachelor's degree or above was significantly higher in good sleepers (55.6% vs 29.4%, p = 0.008). The PSQI value correlated negatively with the QoL scale in both physical ( r = –0.295, p < 0.001) and mental domains ( r = –0.410, p < 0.001), and correlated positively with the depression scale ( r = 0.351, p < 0.001). There appeared to be no association between QoS and spiritual/religious activity ( r = –0.097, p = 0.223). Conclusions Psychosocial factors including depression, patients’ perceptions regarding QoL, marital status, and educational background correlated significantly to the subjective QoS for PD patients. When dealing with sleep disorders in PD patients, physicians should pay considerable attention to their psychosocial backgrounds.
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Affiliation(s)
- Ju-Yeh Yang
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin
| | - Jenq-Wen Huang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Yu-Sen Peng
- Far Eastern Memorial Hospital, He-Ping Branch
| | | | | | | | - Huey-Wen Chen
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiou Wu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Kwan-Dun Wu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Tun-Jun Tsai
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Wan-Yu Chen
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
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14
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Glavinovic T, Hurst H, Hutchison A, Johansson L, Ruddock N, Perl J. Prescribing high-quality peritoneal dialysis: Moving beyond urea clearance. Perit Dial Int 2020; 40:293-301. [PMID: 32063213 DOI: 10.1177/0896860819893571] [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: 11/15/2022] Open
Abstract
Urea removal in peritoneal dialysis (PD) has been a primary measure of dialysis adequacy, but its utility remains limited due to its poor correlation with the clearance of other important uraemic retention solutes and the low certainty of evidence relating peritoneal urea clearance and survival of individuals doing PD. Indeed, clearances of other uraemic solutes, electrolyte imbalances, hypoalbuminaemia and nutritional status, may provide a more holistic measure of dialysis adequacy when evaluating individuals on PD in addition to focusing on person-centred outcomes. Here, we review the history of the urea and creatinine-centric approach to dialysis adequacy and explore the potential importance of other uraemic retention solutes, electrolyte disturbances, phosphorus control, peritoneal protein losses and hypoalbuminaemia, as well as nutritional management to promote a broader multidimensional concept of clearance for PD.
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Affiliation(s)
- Tamara Glavinovic
- Division of Nephrology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Helen Hurst
- Manchester Academic Health Science Centre, The University of Manchester, Manchester University NHS Trust, UK
| | - Alastair Hutchison
- Manchester Academic Health Science Centre, The University of Manchester, Manchester University NHS Trust, UK
| | - Lina Johansson
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | | | - Jeffrey Perl
- Division of Nephrology, Department of Medicine, University of Toronto, Ontario, Canada.,Department of Medicine, Division of Nephrology, St. Michael's Hospital and the Keenan Research Center, Li Ka Shing Knowledge Institute, University of Toronto, Ontario, Canada
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15
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Sousa H, Ribeiro O, Paúl C, Costa E, Miranda V, Ribeiro F, Figueiredo D. Social support and treatment adherence in patients with end‐stage renal disease: A systematic review. Semin Dial 2019; 32:562-574. [DOI: 10.1111/sdi.12831] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Helena Sousa
- School of Health Sciences University of Aveiro (ESSUA) Aveiro Portugal
- Center for Health Technology and Services Research (CINTESIS.UA) Aveiro Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA) Aveiro Portugal
- Department of Education and Psychology University of Aveiro Aveiro Portugal
| | - Constança Paúl
- Institute of Biomedical Sciences Abel Salazar University of Porto Porto Portugal
- Center for Health Technology and Services Research (CINTESIS) Porto Portugal
| | - Elísio Costa
- Faculty of Pharmacy University of Porto Porto Portugal
- UCIBIO, REQUIMTE University of Porto Porto Portugal
| | | | - Fernando Ribeiro
- School of Health Sciences University of Aveiro (ESSUA) Aveiro Portugal
- Institute of Biomedicine – iBiMED, University of Aveiro Aveiro Portugal
| | - Daniela Figueiredo
- School of Health Sciences University of Aveiro (ESSUA) Aveiro Portugal
- Center for Health Technology and Services Research (CINTESIS.UA) Aveiro Portugal
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16
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Hsu HJ, Wu IW, Hsu KH, Sun CY, Hung MJ, Chen CY, Tsai CJ, Wu MS, Lee CC. The association between chronic musculoskeletal pain and clinical outcome in chronic kidney disease patients: a prospective cohort study. Ren Fail 2019; 41:257-266. [PMID: 31014149 PMCID: PMC6493273 DOI: 10.1080/0886022x.2019.1596817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background and objectives: Chronic musculoskeletal (MS) pain is common in chronic kidney disease (CKD) patients. The association of chronic MS pain and CKD progression has not yet been established. Method: We conducted a prospective cohort study to evaluate the association of chronic MS pain and CKD progression of pre-dialysis CKD patients. Result: A total of 53.2% of pre-dialysis CKD patients had chronic MS pain. Patients classified as progression and non-progression had a similar prevalence of chronic MS pain at baseline, and similar baseline use of NSAIDs and Chinese herbal medicines. Univariate Cox analysis indicated that chronic MS pain and baseline NSAID or Chinese herbal medicine use were not significantly associated with progression of CKD. But multivariate Cox regression found chronic MS pain was independently significantly associated with all-cause mortality (HR, 2.912, 95% CI, 1.004–8.444; p = .049). However, serum levels of hs-CRP were similar between those chronic MS pain patients and without chronic MS pain patients (4.96 ± 9.4 vs. 4.25 ± 13.3 mg/L, p = .535). Conclusion: The CKD patients with chronic MS pain was independently and significantly associated with all-cause mortality, but not independently and significantly associated with CKD progression and composite endpoints. The inflammatory marker-hs-CRP was similar between CKD patients with and without chronic MS pain.
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Affiliation(s)
- Heng-Jung Hsu
- a Division of Nephrology , Chang Gung Memorial Hospital , Keelung , Taiwan.,b Taoyuan School of Medicine , the Graduate institute of Clinical Medical Sciences, Chang Gung University Medical College , Keelung , Taiwan
| | - I-Wen Wu
- a Division of Nephrology , Chang Gung Memorial Hospital , Keelung , Taiwan
| | - Kuang-Hung Hsu
- c Laboratory of Epidemiology, Department of Health Care Management , Chang Gung University , Taipei , Taiwan
| | - Chiao-Yin Sun
- a Division of Nephrology , Chang Gung Memorial Hospital , Keelung , Taiwan
| | - Ming-Jui Hung
- d Division of Cardiology , Chang Gung Memorial Hospital , Keelung , Taiwan
| | - Chun-Yu Chen
- a Division of Nephrology , Chang Gung Memorial Hospital , Keelung , Taiwan
| | - Chi-Jen Tsai
- a Division of Nephrology , Chang Gung Memorial Hospital , Keelung , Taiwan
| | - Mai-Szu Wu
- e Division of Nephrology , Taipei Medical University Hospital , Taipei , Taiwan.,f Department of Internal Medicine , Taipei Medical University , Taipei , Taiwan
| | - Chin-Chan Lee
- a Division of Nephrology , Chang Gung Memorial Hospital , Keelung , Taiwan
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17
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Sharma S, King M, Mooney R, Davenport A, Day C, Duncan N, Modi K, Da Silva-Gane M, Wellsted D, Farrington K. How do patients from South Asian backgrounds experience life on haemodialysis in the UK? A multicentre qualitative study. BMJ Open 2019; 9:e024739. [PMID: 31101693 PMCID: PMC6530367 DOI: 10.1136/bmjopen-2018-024739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES End-stage kidney disease disproportionately affects people of South Asian origin. This study aimed to uncover the lived experiences of this group of patients on centre-based haemodialysis (HD), the most prevalent dialysis modality. DESIGN The study utilised a qualitative focus group methodology. Seven focus groups were conducted across four NHS Trusts in the UK including three in Gujarati and two each in Punjabi and Urdu. This provided an inclusive opportunity for South Asian patients to contribute in their language of origin. A total of 24 patients participated. Focus groups were facilitated by bilingual project workers and data were forward translated and analysed using thematic analysis. RESULTS Four themes were identified. This included (1) 'treatment imposition', which comprised of the restrictive nature of HD, the effects of treatment and the feeling of being trapped in an endless process. (2) The 'patient-clinician relationship' centred around the impact of a perceived lack of staff time, and inadequacies in the quality of interactions. (3) 'Coping strategies' highlighted the role of cognitive reappraisal, living in the moment and family support networks in facilitating adjustment. (4) 'Pursuit of transplantation' included equating this form of treatment with restoring normality, alongside cultural factors limiting hopefulness for receiving an organ. CONCLUSIONS In general, the experiences of South Asian patients receiving HD were not unique to this ethnic group. We did find distinct issues in relation to interactions with healthcare professionals, views on access to transplantation and the importance of family support networks. The study provides useful insights which may help enhance culturally tailored renal care.
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Affiliation(s)
- Shivani Sharma
- Psychology and Sports Sciences, University of Hertfordshire, Hatfield, UK
| | - Madeline King
- Psychology and Sports Sciences, University of Hertfordshire, Hatfield, UK
| | - Roisin Mooney
- Psychology and Sports Sciences, University of Hertfordshire, Hatfield, UK
| | - Andrew Davenport
- Edgware Kidney Care Unit, Royal Free NHS Foundation Trust, London, UK
| | - Clara Day
- Renal Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Neill Duncan
- Northwick Park Hospital Dialysis Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Kirit Modi
- National Kidney Federation, Nottingham, UK
| | | | - David Wellsted
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
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18
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Dingwall KM, Nagel T, Hughes JT, Kavanagh DJ, Cass A, Howard K, Sweet M, Brown S, Sajiv C, Majoni SW. Wellbeing intervention for chronic kidney disease (WICKD): a randomised controlled trial study protocol. BMC Psychol 2019; 7:2. [PMID: 30621791 PMCID: PMC6325814 DOI: 10.1186/s40359-018-0264-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/23/2018] [Indexed: 11/20/2022] Open
Abstract
Background Incidence of end stage kidney disease (ESKD) for Indigenous Australians is especially high in remote and very remote areas of Australia (18 and 20 times the rate of comparable non-Indigenous people). Relocating away from family and country for treatment, adjusting to life with a chronic condition and time lost to dialysis cause grief and sadness which have immense impact on quality of life and challenges treatment adherence. We describe the first randomised controlled trial to address both chronic disease and mental health in Indigenous people with ESKD, which is the first to test the effectiveness of a culturally adapted e-mental health intervention in this population. It builds on an existing program of mental health research with demonstrated efficacy – the Aboriginal and Islander Mental Health Initiative (AIMhi) – to test the newly developed electronic motivational care planning (MCP) therapy – the AIMhi Stay Strong App. Methods This is a 3-arm, waitlist, single-blind randomised controlled trial testing the efficacy of the Stay Strong App in improving psychological distress, depressive symptoms, quality of life and treatment adherence among Indigenous clients undergoing haemodialysis for ESKD in Alice Springs and Darwin with follow up over two periods of 3 months (total of 6 months observation). The study compares the efficacy of MCP using the AIMhi Stay Strong App with two control groups (control app intervention and treatment as usual) on participant-reported psychological distress (the primary outcome) using the Kessler Distress Scale (K10); depressive symptoms using the adapted Patient Health Questionnaire (PHQ-9); quality of life using the EuroQoL instrument (EQ5D) and adherence to dialysis treatment planning through file audit. Participants are randomised to receive MCP either at baseline (early treatment) or after 3 months (delayed treatment). The study also examines the cost effectiveness of this therapy in this setting through examination of health care service utilisation across groups during the first 3 months. Discussion This project will contribute much needed evidence on the efficacy of an electronic wellbeing intervention for Indigenous people with ESKD – a group in which distress is likely to be unacceptably high, yet relatively untreated. Trial registration Australian New Zealand Clinical Trial Registry; ACTRN12617000249358; Date registered: 17/02/2017.
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Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 4066, Alice Springs, NT, 0870, Australia.
| | - Tricia Nagel
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, 0811, Australia
| | - Jaquelyne T Hughes
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, 0811, Australia.,Division of Medicine, Royal Darwin Hospital, Darwin, NT, 0811, Australia
| | - David J Kavanagh
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, 4101, Australia
| | - Alan Cass
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, 0811, Australia
| | - Kirsten Howard
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Michelle Sweet
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 4066, Alice Springs, NT, 0870, Australia
| | - Sarah Brown
- Western Desert Nganampa Walytija Palyantjaku Tjutaku, Alice Springs, NT, 0870, Australia
| | - Cherian Sajiv
- Central Australian Renal Services, Alice Springs Hospital, Northern Territory Department of Health, Alice Springs, NT, 0870, Australia.,Top End Renal Services, Royal Darwin Hospital, Northern Territory Department of Health, Darwin, NT, 0810, Australia.,Flinders University, Adelaide, SA, 5042, Australia
| | - Sandawana W Majoni
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 4066, Alice Springs, NT, 0870, Australia.,Top End Renal Services, Royal Darwin Hospital, Northern Territory Department of Health, Darwin, NT, 0810, Australia.,Northern Territory Medical Program, Flinders University, Darwin, NT, 0815, Australia
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19
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Al-Ghabeesh SH, Alshraifeen AA, Saifan AR, Bashayreh IH, Alnuaimi KM, Masalha HA. Spirituality in the Lives of Patients with End-Stage Renal Disease: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2018; 57:2461-2477. [PMID: 29671169 DOI: 10.1007/s10943-018-0622-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of this systematic review was to answer these questions: What does spirituality means to patients with end-stage renal disease (ESRD)? And are there associations between spirituality and the health outcomes and general well-being of patients with ESRD? Thirty-three studies met the review criteria. Meaning of spirituality for patients with ESRD and spirituality in the lives of patients with ESRD were the main themes emerged. There is growing evidence that suggests a positive relationship between spirituality and the health outcomes and well-being of ESRD patients. However, the evidence is incomplete and there is a need for further research to enhance our understanding of the role of spirituality in improving the health outcomes and well-being of ESRD patients.
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Affiliation(s)
| | - Ali Ahmad Alshraifeen
- Department of Adult Health, School of Nursing, Hashemite University, Abdallah Ghosheh Street, P.O. Box 330127, Zarqa, 13133, Az-Zarqa, Jordan.
| | | | | | - Karimeh Mousa Alnuaimi
- School of Nursing, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan
| | - Haya Ali Masalha
- Faculty of Arts, Al-Zaytoonah University of Jordan, Airport Street, Amman, Jordan
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20
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ZENGİN O, Erbay E, Yıldırım B. Anxiety, Coping and Social Support among Parents having Children with Chronic Kidney Disease. KONURALP TIP DERGISI 2018. [DOI: 10.18521/ktd.304201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Lambert K, Mansfield K, Mullan J. How do patients and carers make sense of renal dietary advice? A qualitative exploration. J Ren Care 2018; 44:238-250. [DOI: 10.1111/jorc.12260] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Kelly Lambert
- Department of Clinical Nutrition, Wollongong Hospital; Illawarra Shoalhaven Local Health District; Wollongong New South Wales Australia
| | - Kylie Mansfield
- Graduate Medicine, Faculty of Science, Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
| | - Judy Mullan
- Graduate Medicine, Faculty of Science, Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
- Director Illawarra Health Information Platform, Australian Health Services Research Institute; University of Wollongong; Wollongong New South Wales Australia
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22
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Chan KM, Cheung CY, Chan YH, Chan HW, Chak WL, Chau KF. Prevalence and impact of anxiety and depression in Chinese peritoneal dialysis patients: A single centre study. Nephrology (Carlton) 2018; 23:155-161. [PMID: 27859921 DOI: 10.1111/nep.12970] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 10/26/2016] [Accepted: 11/09/2016] [Indexed: 11/30/2022]
Abstract
AIM Anxiety and depression are prevalent among patients with end stage renal failure. However, data concerning their role in the subsequent peritonitis and hospitalization was scarce. The aim of this study was to examine the prevalence of psychological problems in our Chinese peritoneal dialysis (PD) patients and its association with subsequent clinical outcome. METHODS This was a single-centre prospective cohort study. All patients newly started on PD between 1 September 2012 and 31 December 2014 were recruited. Hospital Anxiety Depression Scale was used to categorize the patients into high score group (HSG) and low score group (LSG). Higher score reflects higher emotional distress. RESULTS A total of 132 patients were recruited. Seventy-five patients (55%) were categorized as HSG. Higher overall peritonitis rate and Gram-positive organism associated peritonitis rate were observed in HSG (P = 0.012 and P = 0.016, respectively). The hospitalization rates in HSG and LSG were 1.20 episodes per patient-year and 1.05 episodes per patient-year respectively. Both high CCI (OR 1.33, 95% CI 1.10-1.62, P < 0.01) and HSG (OR 3.17, 95% CI 1.27-7.93, P = 0.01) were independent risk factors for PD peritonitis. CONCLUSION Anxiety and depression were also common among Chinese PD patients. Those in HSG were more likely to develop PD peritonitis. These psychological symptoms deserved early detection. Further studies are needed to investigate whether intervention can improve the clinical outcome of these patients.
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Affiliation(s)
- Koon Ming Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
| | - Chi Yuen Cheung
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
| | - Yiu Han Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
| | - Hoi Wong Chan
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
| | - Wai Leung Chak
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
| | - Ka Foon Chau
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR
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23
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Jasinski MJ, Lumley MA, Soman S, Yee J, Ketterer MW. Family Consultation to Reduce Early Hospital Readmissions among Patients with End Stage Kidney Disease: A Randomized Controlled Trial. Clin J Am Soc Nephrol 2018; 13:850-857. [PMID: 29636355 PMCID: PMC5989676 DOI: 10.2215/cjn.08450817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 03/22/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The US Centers for Medicare and Medicaid Services have mandated reducing early (30-day) hospital readmissions to improve patient care and reduce costs. Patients with ESKD have elevated early readmission rates, due in part to complex medical regimens but also cognitive impairment, literacy difficulties, low social support, and mood problems. We developed a brief family consultation intervention to address these risk factors and tested whether it would reduce early readmissions. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS One hundred twenty hospitalized adults with ESKD (mean age=58 years; 50% men; 86% black, 14% white) were recruited from an urban, inpatient nephrology unit. Patients were randomized to the family consultation (n=60) or treatment-as-usual control (n=60) condition. Family consultations, conducted before discharge at bedside or via telephone, educated the family about the patient's cognitive and behavioral risk factors for readmission, particularly cognitive impairment, and how to compensate for them. Blinded medical record reviews were conducted 30 days later to determine readmission status (primary outcome) and any hospital return visit (readmission, emergency department, or observation; secondary outcome). Logistic regressions tested the effects of the consultation versus control on these outcomes. RESULTS Primary analyses were intent-to-treat. The risk of a 30-day readmission after family consultation (n=12, 20%) was 0.54 compared with treatment-as-usual controls (n=19, 32%), although this effect was not statistically significant (odds ratio, 0.54; 95% confidence interval, 0.23 to 1.24; P=0.15). A similar magnitude, nonsignificant result was observed for any 30-day hospital return visit: family consultation (n=19, 32%) versus controls (n=28, 47%; odds ratio, 0.53; 95% confidence interval, 0.25 to 1.1; P=0.09). Per protocol analyses (excluding three patients who did not receive the assigned consultation) revealed similar results. CONCLUSIONS A brief consultation with family members about the patient's cognitive and psychosocial risk factors had no significant effect on 30-day hospital readmission in patients with ESKD.
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Affiliation(s)
- Matthew J. Jasinski
- Department of Psychology, Wayne State University, Detroit, Michigan; and Departments of
| | - Mark A. Lumley
- Department of Psychology, Wayne State University, Detroit, Michigan; and Departments of
| | | | | | - Mark W. Ketterer
- Psychiatry, Henry Ford Hospital, Henry Ford Health System, Detroit, Michigan
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Hettiarachchi R, Abeysena C. Association of Poor Social Support and Financial Insecurity with Psychological Distress of Chronic Kidney Disease Patients Attending National Nephrology Unit in Sri Lanka. Int J Nephrol 2018; 2018:5678781. [PMID: 29888004 PMCID: PMC5977053 DOI: 10.1155/2018/5678781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with high morbidity and mortality. Hence, CKD patients are often in chronic psychological distress. The objective of the study was to describe factors associated with psychological distress of CKD patients attending National Nephrology Unit. METHODS A descriptive cross-sectional study was conducted among 382 CKD patients above 18 years of age applying systematic sampling. The data was collected using self-administered questionnaires to assess the psychological distress (GHQ-12), social support (SSQ6), coping strategies (BRIEFCOPE), pain (0 to 10 numeric pain rating scale), and physical role limitation due to ill health (SF36QOL). Sociodemographic and disease-related data were collected using an interviewer administered questionnaire and a data extraction sheet. Multiple logistic regression was applied for determining the associated factors. The results were expressed as adjusted odds ratio (AOR) and 95% confidence intervals (95% CI). RESULTS Percentage of psychological distress was 55.2% (95% CI: 48.4% to 62%). Poor social support (AOR = 1.81, 95% CI: 1.14-2.88), low satisfaction with the social support received (AOR = 4.14, 95% CI: 1.59-10.78), stages IV and V of CKD (AOR = 2.67, 95% CI: 1.65-4.20), presence of comorbidities (AOR = 2.38, 95% CI: 1.21-4.67), within one year of diagnosis (AOR = 2.23, 95% CI: 1.36-3.67), low monthly income (AOR = 2.26, CI: 1.26-4.06), higher out-of-pocket expenditure per month (AOR = 1.75, 95% CI: 1.75-1.99), and being a female (AOR = 2.95, 95% CI: 1.79-4.9) were significantly associated with psychological distress. CONCLUSIONS More than half of the CKD patients were psychologically distressed. Factors such as financial and social support will be worth considering early because of their modifiability.
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Affiliation(s)
- Ramya Hettiarachchi
- Community Medicine, Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Chrishantha Abeysena
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
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DASS21: A Useful Tool in the Psychological Profile Evaluation of Dialysis Patients. Am J Med Sci 2018; 355:322-330. [DOI: 10.1016/j.amjms.2017.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/22/2017] [Accepted: 11/27/2017] [Indexed: 11/23/2022]
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Saadat S, Aziz A, Ahmad H, Imtiaz H, Sohail ZS, Kazmi A, Aslam S, Naqvi N, Saadat S. Predicting Quality of Life Changes in Hemodialysis Patients Using Machine Learning: Generation of an Early Warning System. Cureus 2017; 9:e1713. [PMID: 29188157 PMCID: PMC5703595 DOI: 10.7759/cureus.1713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective To predict changes in the quality of life scores of hemodialysis patients for the coming month and the development of an early warning system using machine learning Methods It was a prospective cohort study (one-month duration) at the dialysis center of a tertiary care hospital in Pakistan. The study started on 1st October 2016. About 78 patients have been enrolled till now. Bachelor of Medicine and Bachelor of Surgery (MBBS) qualified doctors administered a proforma with demographics and the validated Urdu version of World Health Organization Quality Of Life-BREF (WHOQOL-BREF). It was to be repeated after one month to the same patient by the same investigator. Simple statistics were computed using SPSS version 24 (IBM Corp., Armonk, NY) while machine learning was performed using R (version 3.0) and Orange (version 3.1). Results Using machine learning algorithms, two models (classification tree and Naïve Bayes) were generated to predict an increase or decrease of 5% in a patient’s WHOQOL-BREF score over one month. The classification tree was selected as the most accurate model with an area under curve (AUC) of 83.3% (accuracy: 81.9%) for the prediction of 5% increase in QOL and an AUC of 76.2% (accuracy: 81.8%) for the prediction of 5% decrease in QOL over the coming month. The factors associated with an increase of QOL by 5% or more over the next month included younger age (<19 years) and higher iron sucrose doses (>278mg/month). Drops in psychological, physical, and social domain scores lead to a decrease of 5% or more in QOL scores over the following month. Conclusion An early warning system, dialysis data interpretation for algorithmic-prediction on quality of life (DIAL) was built for the early detection of deteriorating QOL scores in the hemodialysis population using machine learning algorithms. The model pointed out that working on psychological and environmental domains, in particular, may prevent the drop in QOL scores from occurring. DIAL, if implemented on a larger scale, is expected to help patients in terms of ensuring a better QOL and in reducing the financial burden in the long term.
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Affiliation(s)
- Shoab Saadat
- Department of Nephrology, Shifa International Hospital, Islamabad, Pakistan
| | - Ayesha Aziz
- Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Hira Ahmad
- Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Hira Imtiaz
- Medicine, Shifa College of Medicine, Islamabad, Pakistan
| | - Zara S Sohail
- Medicine, Shifa College of Medicine, Islamabad, Pakistan
| | - Alvina Kazmi
- Medicine, Shifa College of Medicine, Islamabad, Pakistan
| | - Sanaa Aslam
- Medicine, Shifa College of Medicine, Islamabad, Pakistan
| | - Naveen Naqvi
- Medicine, Amna Inyat Medical College, Lahore, Pakistan
| | - Sidra Saadat
- Medicine, Rawalpindi Medical College, Rawalpindi, Pakistan
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Ratti MM, Rossi A, Delli Zotti GB, Sarno L, Spotti D. Social support, psychological distress and depression in hemodialysis patients. ACTA ACUST UNITED AC 2017. [DOI: 10.3280/pds2017-001006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Lai C, Aceto P, Luciani M, Fazzari E, Cesari V, Luciano S, Fortini A, Berloco D, Canulla F, Bruzzese V, Lai S. Emotional management and biological markers of dietetic regimen in chronic kidney disease patients. Ren Fail 2016; 39:173-178. [PMID: 27846784 PMCID: PMC6014342 DOI: 10.1080/0886022x.2016.1256312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of the study was to investigate the association between psychological characteristics and biological markers of adherence in chronic kidney disease patients receiving conservative therapy, hemodialysis, peritoneal dialysis (PD), or kidney transplantation. Seventy-nine adult patients were asked to complete the following questionnaires: Toronto Alexithymia scale, Snaith–Hamilton Pleasure Scale, and Short Form Health Survey. Biological markers of adherence to treatment were measured. Peritoneal dialysis patients showed a lower capacity to feel pleasure from sensorial experience (p = .011) and a higher values of phosphorus compared to the other patients’ groups (p = .0001). The inability to communicate emotions was negatively correlated with hemoglobin levels (r = −(0).69; p = .001) and positively correlated with phosphorus values in the PD patients (r = .45; p = .050). Findings showed higher psychological impairments and a lower adherence to the treatment in PD patients and suggest the implication of emotional competence in adherence to treatment.
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Affiliation(s)
- Carlo Lai
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Paola Aceto
- b Department of Anesthesiology and Intensive Care , A. Gemelli University Hospital , Rome , Italy
| | - Massimiliano Luciani
- c Department of Neuroscience , Catholic University of Sacred Heart of Rome , Rome , Italy
| | - Erika Fazzari
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | - Valerio Cesari
- a Department of Dynamic and Clinical Psychology , Sapienza University of Rome , Rome , Italy
| | | | | | | | | | | | - Silvia Lai
- f Department of Clinical Medicine , Sapienza University of Rome , Rome , Italy
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Seminars in Dialysis: The 100 Most Highly Cited Papers. Semin Dial 2016; 29:518-520. [PMID: 27774673 DOI: 10.1111/sdi.12536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Alexopoulou M, Giannakopoulou N, Komna E, Alikari V, Toulia G, Polikandrioti M. THE EFFECT OF PERCEIVED SOCIAL SUPPORT ON HEMODIALYSIS PATIENTS' QUALITY OF LIFE. Mater Sociomed 2016; 28:338-342. [PMID: 27999480 PMCID: PMC5149438 DOI: 10.5455/msm.2016.28.338-342] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 10/11/2016] [Indexed: 11/13/2022] Open
Abstract
Background: Association between perceived social support and quality of life in hemodialysis patients represents a new area of interest. Aim: The aim of this study was to explore the effect of social support on the quality of life of hemodialysis patients. Material and Methods: In this study 258 hemodialysis patients were enrolled. Data was collected using a questionnaire which consisted of three parts: a) the Multidimensional Scale of Perceived Social Support (MSPSS) to assess perceived social support, b) the Missoula-VITAS Quality of Life Index (MVQOLI–15) to assess quality of patients’ life and c) the socio-demographic, clinical and other variables of patients. To test the existence of association between quality of life and social support the correlation coefficient of Spearman was used. Multiple linear regression was performed to estimate the effect of social support on quality of life (dependent variable), adjusted for potential confounders. The analysis was performed on SPSS v20. Results: Patients felt high support from significant others and family and less from friends (median 6, 6 and 4.5 respectively). Patients evaluated their quality of life in its entirety as moderate in the total and “overall quality of life” score (median 17.2 and 3 respectively). Regarding the association between social support and quality of life, results showed that the more support patients had from their significant others, family and friends, the better quality of life they had. (rho =0,395, rho =0,399 and rho=0,359, respectively). Conclusions: Understanding the relation between social support and quality of life should prompt health professionals to provide beneficial care to hemodialysis patients.
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Affiliation(s)
- Margarita Alexopoulou
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | | | - Eleni Komna
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | - Victoria Alikari
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | - Georgia Toulia
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | - Maria Polikandrioti
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
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Psychosocial Factors in End-Stage Kidney Disease Patients at a Tertiary Hospital in Australia. Int J Nephrol 2016; 2016:2051586. [PMID: 27807482 PMCID: PMC5078664 DOI: 10.1155/2016/2051586] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/02/2016] [Accepted: 09/14/2016] [Indexed: 11/17/2022] Open
Abstract
Aim. This study seeks to review the psychosocial factors affecting patients with end-stage kidney disease (ESKD) from a tertiary hospital in Australia. Methods. We audited patients with ESKD, referred to social work services from January 2012 to December 2014. All patients underwent psychosocial assessments by one, full-time renal social worker. Patient demographics, cumulative social issues, and subsequent interventions were recorded directly into a database. Results. Of the 244 patients referred, the majority were >60 years (58.6%), male (60.7%), born in Australia (62.3%), on haemodialysis (51.6%), and reliant on government financial assistance (88%). Adjustment issues (41%), financial concerns (38.5%), domestic assistance (35.2%), and treatment nonadherence (21.3%) were the predominant reasons for social work consultation. Younger age, referral prior to start of dialysis, and unemployment were significant independent predictors of increased risk of adjustment issues (p = 0.004, <0.001, and =0.018, resp.). Independent risk factors for treatment nonadherence included age and financial and employment status (p = 0.041, 0.052, and 0.008, resp.). Conclusion. Psychosocial and demographic factors were associated with treatment nonadherence and adjustment difficulties. Additional social work support and counselling, in addition to financial assistance from government and nongovernment agencies, may help to improve adjustment to the diagnosis and treatment plans as patients approach ESKD.
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Hypertension Impact on Health-Related Quality of Life: A Cross-Sectional Survey among Middle-Aged Adults in Chongqing, China. Int J Hypertens 2016; 2016:7404957. [PMID: 27630771 PMCID: PMC5005589 DOI: 10.1155/2016/7404957] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/05/2016] [Accepted: 07/28/2016] [Indexed: 12/21/2022] Open
Abstract
Hypertension is a major risk factor of cardiovascular disease in China, and yet little is known about health-related quality of life (HRQOL) and its associations with demographic and social-economic characteristics in middle-aged patients with hypertension. A cross-sectional survey was undertaken in Chongqing, China, using a multistage stratified random sampling methodology. Data was collected on 1,224 eligible adults, aged between 45 and 53 years, including the Medical Outcomes Survey Short Form-36 to measure HRQOL. Hypertension was associated with poor state of physical functioning, role-physical, bodily pain, general health, vitality, and social function (p < 0.05 for all). In multivariable analyses, education level, job conditions, average monthly income, smoking status, sleep quality, perception of relationship with family, childhood breastfeeding history, and body mass index were associated with domains of SF36 among those with hypertension (p < 0.05 for all). Hypertensive respondents with high education, marital status, breastfeeding, higher incomes, good quality of sleep, positive relationship with family, and higher body mass index have better HRQOL in middle-aged people with hypertension. Those unemployed had a better state of general health and had a poorer state of social function. Nonsmokers had a poorer state of bodily pain than smokers. This study provides detailed information of the implications for health care providers to gain a more complete picture of their hypertension patients' health.
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Veater NL, East L. EXPLORING DEPRESSION AMONGST KIDNEY TRANSPLANT RECIPIENTS: A LITERATURE REVIEW. J Ren Care 2016; 42:172-84. [PMID: 27220908 DOI: 10.1111/jorc.12162] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite the benefits of receiving a donor kidney, there is evidence of persistent depression amongst the transplant population. Healthcare professionals should endeavour to put in place strategies for the prevention, identification and management of depression. OBJECTIVES To critically examine recent research concerning the prevalence, detection and impact of depression amongst kidney transplant recipients, leading to recommendations for practice improvement. DESIGN The 'matrix method' was used to identify and review relevant literature. An online search was performed using three electronic databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE® and Web of Science. The search limits were that the papers reported the findings of primary research studies, published in English in a peer-reviewed journal; involved adult participants and were published between 2000 and 2015. Following critical appraisal of the included studies, a review matrix was produced that identified four emerging themes. RESULTS The review confirmed that kidney transplant recipients experience less depression than those who receive other renal replacement therapies. However, depressive illness is still more common amongst kidney transplant recipients than the general population. There are many risk factors for depression and there is evidence of an association between depression and mortality in the transplant population. Routine screening for depression is highly recommended yet rarely seen in practice. CONCLUSION Increasing awareness and educating healthcare professionals about depression amongst kidney transplant recipients is essential to allow for earlier identification and treatment. Screening could provide earlier detection of depression and allow for higher social and psychological support for these patients. Further intervention studies and longitudinal assessments would enhance the understanding of the development and effective management of depressive symptoms.
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Affiliation(s)
| | - Linda East
- School of Health Sciences, Queen's Medical Centre, Nottingham, UK
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Ibrahim MK, Elshahid AR, El Baz TZ, Elazab RM, Elhoseiny SA, Elsaie ML. Impact of Uraemic Pruritus on Quality of Life among End Stage Renal Disease Patients on Dialysis. J Clin Diagn Res 2016; 10:WC01-5. [PMID: 27134981 DOI: 10.7860/jcdr/2016/16273.7488] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/25/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Uraemic pruritus is significant complication in (ESRD) patients and substantially impairs their quality of life (QOL). ESRD is a bothersome problem with attempts being made to increase the survival of patients on dialysis. AIM An attempt was made to compare the QOL of haemodialysis patients and suffering from uraemic pruritus with the QOL of those on haemodialysis but with no presenting uraemic pruritus. MATERIALS AND METHODS A cross-sectional study was conducted to evaluate the QOL of haemodialysis patients suffering from uraemic pruritus. The WHOQOL-BREF questionnaire was used to assess the QOL. Haemodialysis patients with pruritus who had completed three months of maintenance haemodialysis (n=100) were enrolled into the study and 100 controls (n=100) on haemodialysis but with no pruritus were further enrolled. RESULTS The QOL of haemodialysis patients with pruritus was found to be significantly impaired (p < 0.05) in comparison to those on haemodialysis with no prutitis, particularly with respect to all the four WHOQOL-BREF domains. CONCLUSION Quality of life of ESRD patients on dialsysis was siginificantly affected by pruritis.
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Affiliation(s)
- Mohamed K Ibrahim
- Professor, Department of Dermatology, Al azhar University , Cairo Egypt
| | - Ahmed R Elshahid
- Assistant Professor, Department of Dermatology, Al azhar University , Cairo Egypt
| | - Tarek Z El Baz
- Consultant, Department of Dermatology, Al azhar University , Cairo Egypt
| | - Raed M Elazab
- Consultant, Department of Dermatology, Al azhar University , Cairo Egypt
| | - Sara A Elhoseiny
- Specialist, Department of Dermatology, Al azhar University , Cairo Egypt
| | - Mohamed L Elsaie
- Lecturer, Department of Dermatology, National Research Centre , Egypt
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Murakami N, Siktel HB, Lucido D, Winchester JF, Harbord NB. Disaster Preparedness and Awareness of Patients on Hemodialysis after Hurricane Sandy. Clin J Am Soc Nephrol 2015; 10:1389-96. [PMID: 26220814 PMCID: PMC4527030 DOI: 10.2215/cjn.10181014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 04/20/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients with ESRD on dialysis live in a complex sociomedical situation and are dependent on technology and infrastructure, such as transportation, electricity, and water, to sustain their lives. Interruptions of this infrastructure by natural disasters can result in devastating outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Between November of 2013 and April of 2014, a cross-sectional survey was conducted of patients who received maintenance hemodialysis before and after the landfall of Hurricane Sandy on October 29, 2012 in lower Manhattan, New York. The primary outcome was the number of missed dialysis sessions after the storm. Dialysis-specific and general disaster preparedness were assessed using checklists prepared by the National Kidney Foundation and US Homeland Security, respectively. RESULTS In total, 598 patients were approached, and 357 (59.7%) patients completed the survey. Participants were 60.2% men and 30.0% black, with a median age of 60 years old; 94 (26.3%) participants missed dialysis (median of two sessions [quartile 1 to quartile 3 =1-3]), and 236 (66.1%) participants received dialysis at nonregular dialysis unit(s): 209 (58.5%) at affiliated dialysis unit(s) and 27 (7.6%) at emergency rooms. The percentages of participants who carried their insurance information and detailed medication list were 75.9% and 44.3%, respectively. Enhancement of the dialysis emergency packet after the hurricane was associated with a significantly higher cache of medical records at home at follow-up survey (P<0.001, Fisher's exact test). Multivariate Poisson regression analysis showed that dialysis-specific preparedness (incidence rate ratio, 0.91; 95% confidence interval, 0.87 to 0.98), other racial ethnicity (incidence rate ratio, 0.34; 95% confidence interval, 0.20 to 0.57), dialysis treatment in affiliated units (incidence rate ratio, 0.69; 95% confidence interval, 0.51 to 0.94), and older age (incidence rate ratio, 0.98; 95% confidence interval, 0.97 to 0.99) were associated with a significantly lower incidence rate ratio of missed dialysis. CONCLUSIONS There is still room to improve the preparedness for natural disasters of patients with ESRD. Provider- or facility-oriented enhancement of awareness of the disease and preparedness should be a priority.
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Affiliation(s)
- Naoka Murakami
- Division of Nephrology and Hypertension, Department of Medicine and
| | - Hira Babu Siktel
- Division of Nephrology and Hypertension, Department of Medicine and
| | - David Lucido
- Office of Graduate Medical Education, Mount Sinai Beth Israel, New York, New York
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Ibrahim N, Teo SSL, Che Din N, Abdul Gafor AH, Ismail R. The Role of Personality and Social Support in Health-Related Quality of Life in Chronic Kidney Disease Patients. PLoS One 2015; 10:e0129015. [PMID: 26131714 PMCID: PMC4488553 DOI: 10.1371/journal.pone.0129015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/04/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is commonly associated with various negative health outcomes. The aim of this study was to examine the influence of personality and social support on health-related quality of life in patients with chronic kidney disease. Health-related quality of life (HRQoL) is the quality of life studied in relation to health, and it provides important information of patients' coping with their health issues. METHOD Participants comprised of 200 patients experiencing various stages of chronic kidney disease. All participants completed the Short-Form 36 (SF-36), Big Five Inventory (BFI) and the Medical Outcomes Study (MOS) Social Support questionnaires. RESULTS Participants consisted of 108 males (54.0%) and 92 females (46.0%) with the mean age of 59.3 years (SD 14.5). Results showed that higher levels of extraversion and lower perceived affectionate social support were associated with higher physical HRQoL, whereas higher levels of neuroticism were associated with poorer mental HRQoL. CONCLUSION The current study found that certain personality traits, namely extraversion and neuroticism, were found to be associated with HRQoL. In addition, affectionate social support was also associated with higher HRQoL. Therefore, special attention should be paid to the personality of CKD patients, as well as the type of social support that they have, in planning interventions to improve their health outcomes.
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Affiliation(s)
- Norhayati Ibrahim
- Health Psychology Programme, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Sharlene S. L. Teo
- Health Psychology Programme, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Abdul Halim Abdul Gafor
- Nephrology and SLE Unit, Faculty of Medicine, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Rozmi Ismail
- School of Psychology and Human Development, Faculty of Social Sciences and Humanities, The National University of Malaysia (UKM), Bangi, Selangor, Malaysia
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Brick LA, Sorensen D, Robbins ML, Paiva AL, Peipert JD, Waterman AD. Invariance of measures to understand decision-making for pursuing living donor kidney transplant. J Health Psychol 2015; 21:2912-2922. [PMID: 26113527 DOI: 10.1177/1359105315589390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Living donor kidney transplant is the ideal treatment option for end-stage renal disease; however, the decision to pursue living donor kidney transplant is complex and challenging. Measurement invariance of living donor kidney transplant Decisional Balance and Self-Efficacy across gender (male/female), race (Black/White), and education level (no college/college or higher) were examined using a sequential approach. Full strict invariance was found for Decisional Balance and Self-Efficacy for gender and partial strict invariance was found for Decisional Balance and Self-Efficacy across race and education level. This information will inform tailored feedback based on these constructs in future intervention studies targeting behavior change among specific demographic subgroups.
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Toulabi T, Kalaveh SM, Ghasemi F, Anbari K. The impact of multidisciplinary rehabilitation on the quality of life of hemodialysis patients in Iran. J Formos Med Assoc 2015; 115:553-9. [PMID: 26100468 DOI: 10.1016/j.jfma.2015.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 03/30/2015] [Accepted: 05/14/2015] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND/PURPOSE Hemodialysis contributes to changes in lifestyle and the health status of patients. The aim of this study was to evaluate the impact of participatory rehabilitation on the quality of life of patients. METHODS This quasi-experimental before and after study was conducted on 30 patients in the hemodialysis center at Hazrat-e-Rasoul Hospital in Javanrood during 2013. The rehabilitation program was executed with participation of experts in the fields of nursing, physiotherapy, and clinical psychology for 8 weeks. The instrument used for data collection was the hemodialysis version of Ferrans and Powers Quality of Life Index (QLI) which was completed by the research assistant by interview before and after the rehabilitation program. RESULTS The mean age of patients was 55.8 ± 14.3 years, 60% were male, and 93.3% were married. The average duration of hemodialysis was 3 ± 2.4 years. The quality of life score of all patients before the intervention was between 10 and 19 (moderate level), which after intervention, improved to a good level in half of the patients (p < 0.001). CONCLUSION Rehabilitation programs improve the quality of life of hemodialysis patients. By this finding, implementation of rehabilitation programs is recommended in hemodialysis centers with participation of experts from different fields including nurses, physiotherapists, and clinical psychologists.
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Affiliation(s)
- Tahereh Toulabi
- Department of Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Shirin Mohammadi Kalaveh
- Department of Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Fatemeh Ghasemi
- Department of Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Khatereh Anbari
- Department of Social Medicine, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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Theofilou P. Translation and Cultural Adaptation of the Multidimensional Scale of Perceived Social Support for Greece. Health Psychol Res 2015; 3:1061. [PMID: 26973954 PMCID: PMC4768538 DOI: 10.4081/hpr.2015.1061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 03/02/2013] [Indexed: 12/04/2022] Open
Abstract
Recently, there is a surge of interest in the use of the Multidimensional Scale of Perceived Social Support (MSPSS) to measure perceived social support across cultures. The objective of this study was to translate and make the cultural adaptation of the Greek version of the MSPSS. The study counted with a sample of 10 patients diagnosed with multiple sclerosis. The process involved the following steps of translation back translation and semantic evaluation. The former revealed good acceptance of the translated version of the instrument, which participants considered having items of easy understanding. After completing the process of validation in the country, the instrument will become available to Greek researchers to measure social support, as well as to compare results from Greece to that of other cultures in which the instrument has already been validated.
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Grubbs V, Moss AH, Cohen LM, Fischer MJ, Germain MJ, Jassal SV, Perl J, Weiner DE, Mehrotra R. A palliative approach to dialysis care: a patient-centered transition to the end of life. Clin J Am Soc Nephrol 2014; 9:2203-9. [PMID: 25104274 DOI: 10.2215/cjn.00650114] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
As the importance of providing patient-centered palliative care for patients with advanced illnesses gains attention, standard dialysis delivery may be inconsistent with the goals of care for many patients with ESRD. Many dialysis patients with life expectancy of <1 year may desire a palliative approach to dialysis care, which focuses on aligning patient treatment with patients' informed preferences. This commentary elucidates what comprises a palliative approach to dialysis care and describes its potential and appropriate use. It also reviews the barriers to integrating such an approach into the current clinical paradigm of care and existing infrastructure and outlines system-level changes needed to accommodate such an approach.
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Affiliation(s)
- Vanessa Grubbs
- Division of Nephrology, University of California, San Francisco, San Francisco, California; Division of Nephrology, San Francisco General Hospital, San Francisco, California;
| | - Alvin H Moss
- Section of Nephrology, Department of Medicine, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Lewis M Cohen
- Department of Psychiatry, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts
| | - Michael J Fischer
- Division of Nephrology, Jesse Brown Veterans Affairs Medical Center, University of Illinois Hospital and Health Sciences Center, Chicago, Illinois
| | - Michael J Germain
- Division of Nephrology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts
| | | | - Jeffrey Perl
- Division of Nephrology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Daniel E Weiner
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts; and
| | - Rajnish Mehrotra
- Division of Nephrology, University of Washington, Seattle, Washington
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Yang ZK, Han QF, Zhu TY, Ren YP, Chen JH, Zhao HP, Chen MH, Dong J, Wang Y, Hao CM, Zhang R, Zhang XH, Wang M, Tian N, Wang HY. The associations between the family education and mortality of patients on peritoneal dialysis. PLoS One 2014; 9:e95894. [PMID: 24797080 PMCID: PMC4010396 DOI: 10.1371/journal.pone.0095894] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/01/2014] [Indexed: 11/25/2022] Open
Abstract
AIMS To investigate whether education level of family members predicts all-cause and cardiovascular death and initial-episode peritonitis in patients on peritoneal dialysis (PD). METHODS A total of 2264 patients on chronic PD were collected from seven centers affiliated with the Socioeconomic Status on the Outcome of Peritoneal Dialysis (SSOP) Study. All demographic, socioeconomic and laboratory data of patients and the education level of all family members were recorded at baseline. Multivariate Cox regression was used to calculate the hazard ratio (HR) of all-cause and cardiovascular mortality, and initial-episode peritonitis with adjustments for recognized traditional factors. RESULTS There were no significant differences in baseline characteristics between patients with (n = 1752) and without (n = 512) complete education information. According to the highest education level of patients' family, included 1752 patients were divided into four groups, i.e. elementary or lower (15%), middle (27%), high (24%) and more than high school (34%). The family highest education (using elementary school or lower group as reference, hazard ratio and 95% confidence interval of middle school group, high school group and more than high school group was 0.68[0.48-0.96], 0.64[0.45-0.91], 0.66[0.48-0.91], respectively) rather than their average education level or patients' or spouse's education was significantly associated with the higher mortality. Neither patients' nor family education level did correlate to the risk for cardiovascular death or initial-episode peritonitis. CONCLUSIONS Family members' education level was found to be a novel predictor of PD outcome. Family, as the main source of health care providers, should be paid more attention in our practice.
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Affiliation(s)
- Zhi-Kai Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Qing-Feng Han
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Tong-Ying Zhu
- Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China
| | - Ye-Ping Ren
- Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Jiang-Hua Chen
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hui-Ping Zhao
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Meng-Hua Chen
- Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China
| | - Jie Dong
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Yue Wang
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Chuan- Ming Hao
- Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China
| | - Rui Zhang
- Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China
| | - Xiao-Hui Zhang
- Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Mei Wang
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Na Tian
- Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China
| | - Hai-Yan Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
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Barnieh L, King-Shier K, Hemmelgarn B, Laupacis A, Manns L, Manns B. Views of Canadian patients on or nearing dialysis and their caregivers: a thematic analysis. Can J Kidney Health Dis 2014; 1:4. [PMID: 25780599 PMCID: PMC4346298 DOI: 10.1186/2054-3581-1-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 02/24/2014] [Indexed: 02/03/2023] Open
Abstract
Background Quality of life of patients receiving dialysis has been rated as poor. Objective To synthesize the views of Canadian patients on or nearing dialysis, and those who care for them. Design Secondary analysis of a survey, distributed through dialysis centres, social media and the Kidney Foundation of Canada. Setting Pan-Canadian convenience sample. Participants Patients, their caregivers and health-care providers. Measurements Text responses to open-ended questions on topics relevant to end-stage renal disease. Methods Statements related to needs, beliefs or feelings were identified, and were analysed by thematic content analysis. Results A total of 544 relevant statements from 189 respondents were included for the thematic content analysis. Four descriptive themes were identified through the content analysis: gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care. Respondents primarily identified a need for more information, better communication, increased psychosocial and financial support for patients and their families and a strong desire to maintain their previous lifestyle. Limitations Convenience sample; questions were originally asked with a different intent (to identify patient-important research issues). Conclusions Patients on or nearing dialysis and their caregivers identified four major themes, gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care, several of which could be addressed by the health care system without requiring significant resources. These include the development of patient materials and resources, or sharing of existing resources across Canadian renal programs, along with adopting better communication strategies. Other concerns, such as the need for increased psychosocial and financial support, require consideration by health care funders.
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Affiliation(s)
- Lianne Barnieh
- Department of Medicine, University of Calgary, Calgary, Alberta Canada ; Interdisciplinary Chronic Disease Collaboration, Kragujevac, Alberta Canada
| | - Kathryn King-Shier
- Department of Community Health Sciences, University of Calgary, Calgary, Canada ; Faculty of Nursing, University of Calgary, Calgary, Alberta Canada
| | - Brenda Hemmelgarn
- Department of Medicine, University of Calgary, Calgary, Alberta Canada ; Interdisciplinary Chronic Disease Collaboration, Kragujevac, Alberta Canada ; Department of Community Health Sciences, University of Calgary, Calgary, Canada ; Libin Cardiovascular Institute and Institute of Public Health, University of Calgary, Calgary, Canada
| | - Andreas Laupacis
- Keenan Research Centre, Li-Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario Canada ; Faculty of Medicine, University of Toronto, Kragujevac, Ontario Canada
| | - Liam Manns
- Department of Medicine, University of Calgary, Calgary, Alberta Canada ; Interdisciplinary Chronic Disease Collaboration, Kragujevac, Alberta Canada
| | - Braden Manns
- Department of Medicine, University of Calgary, Calgary, Alberta Canada ; Interdisciplinary Chronic Disease Collaboration, Kragujevac, Alberta Canada ; Department of Community Health Sciences, University of Calgary, Calgary, Canada ; Libin Cardiovascular Institute and Institute of Public Health, University of Calgary, Calgary, Canada ; Foothills Medical Centre, 1403 29th St., NW, Calgary, Alberta T2N 2T9 Canada
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Clark S, Farrington K, Chilcot J. Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants. Semin Dial 2013; 27:42-9. [PMID: 24164416 DOI: 10.1111/sdi.12159] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Nonadherence to aspects of the management of End-Stage Kidney Disease (ESKD) is common. Estimates of nonadherence vary with assessment method. Whilst readily available and free from report bias, physiological proxies-frequently used as measures of adherence-are often confounded by clinical factors including residual kidney function and dialysis adequacy. Despite variation in estimates of its prevalence, it is clear that suboptimal adherence to dialysis prescriptions, medication and diet can lead to adverse clinical outcomes. Several factors can help explain nonadherence in ESKD including mood, self-efficacy, social support, illness, and treatment perceptions. Psychological interventions have been shown to improve ESKD adherence, yet achieving long-term behavior change remains challenging. Identifying individuals who struggle to adhere to aspects of the dialysis regime, and tailoring theory-led interventions to improve and support adherence is a clear clinical need requiring further empirical enquiry.
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Affiliation(s)
- Sarah Clark
- School of Medicine, University of Leeds, Leeds, United Kingdom
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Vásquez V, Novarro N, Valdés RA, Britton GB. Factors associated to depression in renal transplant recipients in Panama. Indian J Psychiatry 2013; 55:273-8. [PMID: 24082249 PMCID: PMC3777350 DOI: 10.4103/0019-5545.117148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AIM High rates of affective disorders have been reported in kidney transplant recipients treated for end-stage renal disease. Latin America has experienced a significant increase in transplant activity in recent decades, but there is a dearth of data regarding psychosocial issues following kidney transplantation. The aim of this study was to measure the prevalence of depression and the demographic factors associated to depression among renal transplant recipients in Panama. MATERIALS AND METHODS This cross-sectional study was conducted between March to May 2010 in a hospital setting during routine outpatient evaluations. The study included 119 renal transplant recipients (58 males, 61 females). Depressive symptoms were measured using the self-report Hospital Anxiety and Depression Scale and diagnoses were established by a trained psychiatrist using the Mini-International Neuropsychiatric Interview. Regression models were used to explore the association between depression and sociodemographic variables. RESULTS The prevalence of depression was 11.8% among transplant recipients. Linear regression indicated that the presence of an anxiety disorder, increasing age, and lower education levels were significantly and independently associated with depressive symptoms. Logistic regression analysis confirmed that anxiety and a perception of negative social support significantly increased the likelihood of depression. CONCLUSIONS These findings have important clinical implications. Depression after kidney transplantation has been shown to affect health outcomes adversely. Our results underscore the need to assess depressive symptoms as well as other affective disorders as part of the screening and treatment of renal transplant patients in Panama.
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Affiliation(s)
- Vivian Vásquez
- Department of Psychiatry, Complejo Hospitalario Dr. Arnulfo Arias Madrid, Social Security, Panama, Panama
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Theofilou P. Multidimensional Scale of Perceived Social Support: A Contribution to the Investigation of Quality of Life. PSYCHOLOGICAL THOUGHT 2013. [DOI: 10.5964/psyct.v6i1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Karadag E, Kilic SP, Metin O. Relationship between fatigue and social support in hemodialysis patients. Nurs Health Sci 2013; 15:164-71. [DOI: 10.1111/nhs.12008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 09/14/2012] [Accepted: 09/21/2012] [Indexed: 12/11/2022]
Affiliation(s)
- Ezgi Karadag
- Department of Internal Medicine Nursing; Tunceli University Health High School; Tunceli
| | - Serap Parlar Kilic
- Department of Internal Medicine Nursing; Gaziantep University Faculty of Health Sciences; Gaziantep
| | - Ozgur Metin
- Turgut Özal Tıp Merkezi; Malatya Inonu University; Malatya; Turkey
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Abstract
Connecting patients to appropriate information-and to each other for social support-can help them self-manage chronic kidney disease (CKD) more effectively. For CKD patients, the Internet offers a wealth of resources to meet many educational needs. Understanding the types of Internet sources CKD patients use today can help renal professionals point patients in the right direction. This article will briefly review the state of CKD patient education and social support in the United States, then outline types of Internet-based patient education, and review the value of each type for both education and social support.
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Affiliation(s)
- Dori Schatell
- Medical Education Institute, Inc., Madison, Wisconsin, USA.
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Cohen SD. Social Support Interventions will improve the Quality of Life of ESRD Patients. Semin Dial 2013; 26:262-5. [DOI: 10.1111/sdi.12064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tong A, Lesmana B, Johnson DW, Wong G, Campbell D, Craig JC. The perspectives of adults living with peritoneal dialysis: thematic synthesis of qualitative studies. Am J Kidney Dis 2012. [PMID: 23177729 DOI: 10.1053/j.ajkd.2012.08.045] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Most patients with end-stage renal disease require dialysis to survive because they are unable to access kidney transplantation. Peritoneal dialysis (PD) is recommended by some clinical practice guidelines as the dialysis treatment of choice for adults without significant comorbid conditions or those with residual kidney function. This study aims to synthesize published qualitative studies of patients' experiences, beliefs, and attitudes about PD. METHODS We conducted a systematic review and thematic synthesis of qualitative studies of adult perspectives of living with PD. Databases (MEDLINE, Embase, PsycINFO, and CINAHL), theses, and reference lists were searched to November 2011. RESULTS 39 studies involving 387 participants were included. We identified 7 themes: resilience and confidence (determination and overcoming vicissitudes), support structures (strong family relationship, peer support, professional dedication, social abandonment, and desire for holistic care), overwhelming responsibility (disruptive intrusion, family burden, and onerous treatment regimen), control (gaining bodily awareness, achieving independence and self-efficacy, and information seeking), freedom (flexibility and autonomy, retaining social functioning, and ability to travel), sick identity (damage to self-esteem and invisible suffering), and disablement (physical incapacitation and social loss and devaluation). CONCLUSIONS PD can offer patients a sense of control, independence, self-efficacy, and freedom. However, holistic and multidisciplinary care is needed to mitigate the risks of impaired self-esteem, physical incapacitation, reduced social functioning, and poor sense of self-worth. Strategies that aim to strengthen social support and promote resilience and confidence in patients are integral to achieving positive adjustment, improved psychosocial outcomes, and treatment satisfaction.
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Affiliation(s)
- Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia.
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Zalai D, Szeifert L, Novak M. Psychological Distress and Depression in Patients with Chronic Kidney Disease. Semin Dial 2012; 25:428-38. [DOI: 10.1111/j.1525-139x.2012.01100.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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