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Senteio CR, Ackerman MK. Count Me Out: Perceptions of Black Patients Who are on Dialysis but Who are Not on a Transplant Waitlist. HEALTH COMMUNICATION 2022; 37:1167-1179. [PMID: 34320893 DOI: 10.1080/10410236.2021.1940017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
End-stage renal disease (ESRD) is characterized by racial inequity; Blacks are 3 times more likely to develop ESRD than Whites. Transplant is the preferred treatment option since transplanted patients experience better clinical outcomes. Racial inequities persist at each of the steps required for transplantation. Despite the vast literature describing these racial inequities, it does not include dialysis patients' awareness and understanding of treatment options, specifically for transplant. To address this gap, we purposely sampled Blacks in Detroit who were receiving dialysis and who were not active on any transplant waitlist to investigate their understanding and perceptions of transplants. We used uncertainty management theory (UMT) to better understand perceived barriers to getting and remaining on a transplant waitlist. We aimed to address a critical gap in the literature to inform approaches addressing this enduring inequity. For this qualitative study, we conducted individual, semi-structured interviews with 24 Black ESRD patients, aged 34-73 years: 9 male and 15 female. Participants shared their experiences of being on dialysis, perceptions, and understanding of transplants. We describe two key findings: 1) uncertainty for these patients is prevalent and multi-layered and 2) social support can both dissuade an individual from pursuing transplant (i.e., reluctance to ask family members to be donors) and it can result in decreasing uncertainty (e.g., participants wanting to pursue transplant to be with family). We highlight the specific need to improve patient education regarding treatment options and enhancing how relevant health information can be communicated.
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A systematic review of information practices research. JOURNAL OF DOCUMENTATION 2022. [DOI: 10.1108/jd-02-2022-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis systematic literature review aims to elaborate the research progress of information practices to help other researchers attain a more holistic and comprehensive understanding of the field.Design/methodology/approachFollowing a systematic review protocol, 123 research articles from nine academic databases were included in the analysis.FindingsFour separate results can be outlined. First, practice theory, social constructionist theory and activity theory are often used as the theoretical basis for the study of information practices. Second, people will engage in specific information practice activities in different external and internal contexts. The external contexts include social and needs contexts. The internal contexts include information source horizons, user's affection and user's cognition. Third, the existing information practice models can be divided into static and dynamic types. These models mainly reflected activities and influencing factors of information practices. Fourth, qualitative methods were the most used in information practice research.Research limitations/implicationsThe field of information practices is a vast, expanding research field. This research will focus only on a specific section, namely concepts, activities, contexts and models. Researchers could contribute to exploring the concepts, components and mechanisms of information practices by combining theories from various disciplines, such as sociology and behavioral science.Originality/valueThis is the first study to reveal the general picture of information practices. It also elaborates the characteristics of people's information practices and shows the potential development direction for future research.
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Saglimbene VM, Su G, Wong G, Natale P, Ruospo M, Palmer SC, Craig JC, Carrero JJ, Strippoli GFM. Dietary intake in adults on hemodialysis compared with guideline recommendations. J Nephrol 2021; 34:1999-2007. [PMID: 33591554 PMCID: PMC8610942 DOI: 10.1007/s40620-020-00962-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022]
Abstract
Background Clinical practice guidelines of dietary management are designed to promote a balanced diet and maintain health in patients undergoing haemodialysis but they may not reflect patients’ preferences.
We aimed to investigate the consistency between the dietary intake of patients on maintenance haemodialysis and guideline recommendations. Methods Cross-sectional analysis of the DIET-HD study, which included 6,906 adults undergoing haemodialysis in 10 European countries. Dietary intake was determined using the Global Allergy and Asthma European Network (GA2LEN) Food Frequency Questionnaire (FFQ), and compared with the European Best Practice Guidelines. Consistency with guidelines was defined as achieving the minimum daily recommended intake for energy (≥ 30 kcal/kg) and protein (≥ 1.1 g/kg), and not exceeding the maximum recommended daily intake for phosphate (≤ 1000 mg), potassium (≤ 2730 mg), sodium (≤ 2300 mg) and calcium (≤ 800 mg). Results Overall, patients’ dietary intakes of phosphate and potassium were infrequently consistent with guidelines (consistent in 25% and 25% of patients, respectively). Almost half of the patients reported that energy (45%) and calcium intake (53%) was consistent with the guidelines, while the recommended intake of sodium and protein was consistent in 85% and 67% of patients, respectively. Results were similar across all participating countries. Intake was consistent with all six guideline recommendations in only 1% of patients. Conclusion Patients on maintenance haemodialysis usually have a dietary intake which is inconsistent with current recommendations, especially for phosphate and potassium. Supplementary Information The online version contains supplementary material available at 10.1007/s40620-020-00962-3.
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Affiliation(s)
- Valeria M Saglimbene
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy
| | - Guobin Su
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou City, Guangdong Province, China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Germaine Wong
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
- Department of Renal Medicine, Westmead Hospital, Westmead, Australia
| | - Patrizia Natale
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy
| | - Marinella Ruospo
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy
| | - Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Juan J Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni F M Strippoli
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia.
- Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124, Bari, Italy.
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Hwang SJ, Tan NC, Yoon S, Ramakrishnan C, Paulpandi M, Gun S, Lee JY, Chang ZY, Jafar TH. Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study. BMJ Open 2020; 10:e041788. [PMID: 33067304 PMCID: PMC7569996 DOI: 10.1136/bmjopen-2020-041788] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To outline the facilitators and barriers to patients' self-management of predialysis chronic kidney disease (CKD). DESIGN Qualitative. SETTING Three polyclinics in a public primary care institution in Singapore. PARTICIPANTS 20 patients entered and completed the study. Inclusion criteria were: (1) English speaking, (2) aged 40 years and above, (3) identified by clinical coding as 'DM (diabetes mellitus) nephropathy-overt' and 'DM nephropathy-incipient', by their physicians in the polyclinic, with an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2 (based on electronic health records) and (4) aware of their CKD illness. Exclusion criteria were: (1) receiving dialysis or had received a kidney transplant, (2) suffered from any visual, auditory or cognitive impairment which could hinder their ability to participate in the study or (3) pregnant. RESULTS We found that the major barriers to CKD management were a lack of knowledge and awareness of CKD, a passive attitude toward self-management and insufficient patient-physician communication. Major facilitators included patient trust and satisfaction with the physician and family support. Many patients reported that there was an overload of information and too little guidance on how to manage their condition, especially regarding dietary recommendations. CONCLUSION We identified several barriers and facilitators to the management of predialysis CKD among patients. A multi-pronged approach for raising CKD awareness is required: improving patient-physician communication, implementing CKD workshops and home-visits and disseminating accurate online information about CKD. Strategies should also focus on increasing patient engagement and optimising family support by involving family members in patients' care. Furthermore, clear dietary recommendations and patient-specific advice are needed to empower patients to manage their own condition.
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Affiliation(s)
- Sun Joon Hwang
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Ngiap Chuan Tan
- Department of Research, SingHealth Polyclinics, Singapore
- General Practice, SingHealth Polyclinics, Singapore
| | - Sungwon Yoon
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | | | | | - Shihying Gun
- General Practice, SingHealth Polyclinics, Singapore
| | - Jia Ying Lee
- General Practice, SingHealth Polyclinics, Singapore
| | | | - Tazeen H Jafar
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
- Department of Renal Medicine, Singapore General Hospital, Singapore
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Stømer UE, Wahl AK, Gøransson LG, Urstad KH. Exploring health literacy in patients with chronic kidney disease: a qualitative study. BMC Nephrol 2020; 21:314. [PMID: 32727397 PMCID: PMC7392653 DOI: 10.1186/s12882-020-01973-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022] Open
Abstract
Background Patients with chronic kidney disease make day-to-day decisions about how to self-manage their disease. Chronic kidney disease (CKD) includes a risk for progression towards end-stage renal disease and the development of comorbidities, such as cardiovascular disease, which represents the leading cause of death among these patients. To reduce these risks, CKD patients are recommended to follow a healthy lifestyle with physical activity, food and fluid restrictions, and adherence to complex medication regimes throughout all phases of the disease. To manage the complexity of this health situation, health literacy (HL) is considered essential. The current prevailing understanding is that HL is a multidimensional concept and comprises a range of cognitive, affective, social, and personal skills that determine the motivation and ability to gain access to, understand, and use health information. Recently, we investigated multiple aspects of HL in CKD patients in a quantitative cross-sectional study utilizing the Health Literacy Questionnaire (HLQ) and observed that finding good health information and appraising health information were the most challenging aspects of HL. This study aimed to explore CKD patients’ lived experiences of different dimensions of HL presented in the HLQ. Methods This qualitative study utilized in-depth semistructured interviews. Twelve patients with different levels of HL were included. The interviews were analyzed using thematic analysis as described by Braun and Clarke. Results We identified three main themes that were significant for CKD patients’ HL: 1. Variation in people’s attitudes and behavior as health information seekers, 2. The problem of fragmented healthcare in the context of multimorbidity makes the healthcare system challenging to navigate, and 3. The value of a good relationship with healthcare providers. Conclusion CKD patients take different approaches to health information. Limiting or avoiding health information may be a strategy used by some individuals to cope with the disease and does not necessarily mean that health information is inaccessible or difficult to understand. Comorbidity and a fragmented healthcare system can make the healthcare system challenging to navigate. A good and trusting relationship with healthcare providers seems to promote several aspects of HL and should be promoted to optimize CKD patients’ HL.
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Affiliation(s)
- Une Elisabeth Stømer
- Faculty of Health Science, University of Stavanger, Stavanger, Norway. .,Department of Nephrology, Stavanger University Hospital, Stavanger, Norway.
| | | | - Lasse Gunnar Gøransson
- Department of Nephrology, Stavanger University Hospital, Stavanger, Norway.,Faculty of Medicine, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Cousins M, Bradshaw J, Bonner A. Professional relationships between nephrology clinicians and patients: a systematic review. J Ren Care 2020; 46:206-215. [PMID: 32141236 DOI: 10.1111/jorc.12323] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nephrology nurses and patients expressed that the clinician-patient relationship in a haemodialysis (HD) unit might be best described as being part of an extended family. However, there is a risk that professional boundaries may become blurred due to the perceived closeness of this relationship. OBJECTIVE This systematic review sought to explore the experiences of nephrology clinicians in establishing and maintaining a professional relationship with people experiencing end-stage kidney disease who are receiving HD treatment. METHOD A search strategy was created using JBI systematic review guidelines for six databases (PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library and JBI library). Qualitative studies were eligible for inclusion when the participants were nephrology clinicians who provided HD treatment or management of patients in a hospital outpatient HD unit or a community HD centre. RESULTS Three studies met the inclusion criteria and the findings were synthesised into two themes (1) establishing a professional relationship and (2) coping mechanisms. All three studies focused on nephrology clinicians realising the importance of treating patients as individuals. Nephrology clinicians demonstrated advanced communication skills, empathy and compassion when interacting with patients, which seemed to contribute to patient satisfaction. This systematic review found some qualitative evidence to explain how nephrology clinicians establish and maintain a professional clinician-patient relationship with patients in the HD unit. CONCLUSION This review highlighted a significant gap in research concerning the trajectory of the clinician-patient relationship across all members of the renal multidisciplinary health care team.
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Affiliation(s)
- Marina Cousins
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, QLD, Australia
| | - Julie Bradshaw
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, QLD, Australia
| | - Ann Bonner
- School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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Costello KL, Veinot TC. A spectrum of approaches to health information interaction: From avoidance to verification. J Assoc Inf Sci Technol 2019. [DOI: 10.1002/asi.24310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Kaitlin L. Costello
- School of Communication and Information, RutgersThe State University of New Jersey New Brunswick New Jersey
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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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Lambert K, Mullan J, Mansfield K, Owen P. Should We Recommend Renal Diet-Related Apps to Our Patients? An Evaluation of the Quality and Health Literacy Demand of Renal Diet-Related Mobile Applications. J Ren Nutr 2018; 27:430-438. [PMID: 29056159 DOI: 10.1053/j.jrn.2017.06.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/17/2017] [Accepted: 06/09/2017] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Mobile phone applications (apps) are increasingly being used by patients with chronic kidney disease (CKD). We sought to describe the main purpose of commonly available renal diet apps and to quantify the accuracy of information, technical quality, and health literacy demand of renal diet apps. DESIGN The design was content analysis. All eligible renal diet apps in the Australian Apple App Store, Google Play, Windows Phone, and Blackberry App World were evaluated. SUBJECTS Eligible apps were in English and were related to kidney disease in humans (of any type or stage). Exclusion criteria included apps which were prohibited because of password protection. MAIN OUTCOME MEASURE Renal diet information in the apps was compared with evidence-based guidelines for the management of kidney disease to quantify information accuracy. App information was evaluated using the Silberg Scale. Technical quality and health literacy demand were evaluated using the Mobile Application Rating Scale. RESULTS A total of 21 apps were eligible for evaluation. The main purpose of these apps was to provide food and nutrition information (57.1%) or for educative purposes for CKD patients (38.1%). Only 47.6% (10/21) of apps contained accurate evidence-based information. Overall, app technical quality was considered acceptable (mean Mobile Application Rating Scale score 3.19 ± 0.35 out of 5), with 80.9% of apps scoring acceptable or greater for app technical quality. Scores for health literacy demand also indicated that most apps (15/21, 71.4%) were acceptable. CONCLUSIONS A range of apps currently exist that may provide individuals with CKD with useful food and nutrition information or increase their knowledge of the renal diet. These apps are also mainly of acceptable technical quality and health literacy demand. However, caution is required when using renal diet apps because more than half of the apps evaluated were not accurate and evidence based.
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Affiliation(s)
- Kelly Lambert
- Department of Clinical Nutrition, Wollongong Hospital, Wollongong, New South Wales, Australia; School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
| | - Judy Mullan
- School of Medicine, Faculty of Science, Medicine and Health, and Director of Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kylie Mansfield
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Paris Owen
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Stenberg J, Henriksson C, Lindberg M, Furuland H. Perspectives on clinical use of bioimpedance in hemodialysis: focus group interviews with renal care professionals. BMC Nephrol 2018; 19:121. [PMID: 29792174 PMCID: PMC5966881 DOI: 10.1186/s12882-018-0907-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/26/2018] [Indexed: 02/02/2023] Open
Abstract
Background Inadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals’ perceived barriers and facilitators for use of bioimpedance in clinical practice. Methods Qualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device. The participants were connected to each other and a moderator via equipment for telemedicine and the sessions were recorded. The interviews were semi-structured, focusing on the participants’ perceptions of use of bioimpedance in clinical practice. Thematic content analysis was performed in consecutive steps, and data were extracted by employing an inductive, interactive, comparative process. Results Several barriers and facilitators to the use of bioimpedance in clinical practice were identified, and a multilevel approach to examining barriers and incentives for change was found to be applicable to the ideas and categories that arose from the data. The determinants were categorized on five levels, and the different themes of the levels illustrated with quotations from the focus groups participants. Conclusions Determinants for use of bioimpedance were identified on five levels: 1) the innovation itself, 2) the individual professional, 3) the patient, 4) the social context and 5) the organizational context. Barriers were identified in the areas of credibility, awareness, knowledge, self-efficacy, care processes, organizational structures and regulations. Facilitators were identified in the areas of the innovation’s attractiveness, advantages in practice, and collaboration. Motivation, team processes and organizational capacities appeared as both barriers and facilitators. Electronic supplementary material The online version of this article (10.1186/s12882-018-0907-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jenny Stenberg
- Department of Medical Sciences, University Hospital, Entrance 40, 751 85, Uppsala, Sweden.
| | | | - Magnus Lindberg
- Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Hans Furuland
- Department of Medical Sciences, University Hospital, Entrance 40, 751 85, Uppsala, Sweden
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Lambert K, Mullan J, Mansfield K. An integrative review of the methodology and findings regarding dietary adherence in end stage kidney disease. BMC Nephrol 2017; 18:318. [PMID: 29061163 PMCID: PMC5653982 DOI: 10.1186/s12882-017-0734-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 09/27/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Dietary modification is an important component of the management of end stage kidney disease (ESKD). The diet for ESKD involves modifying energy and protein intake, and altering sodium, phosphate, potassium and fluid intake. There have been no comprehensive reviews to date on this topic. The aims of this integrative review were to (i) describe the methods used to measure dietary adherence (ii) determine the rate of dietary adherence and (iii) describe factors associated with dietary adherence in ESKD. METHODS The Web of Science and Scopus databases were searched using the search terms 'adherence' and 'end stage kidney disease'. Of the 787 potentially eligible papers retrieved, 60 papers of 24,743 patients were included in this review. Of these papers, 44 reported the rate of dietary adherence and 44 papers described factors associated with adherence. RESULTS Most of the evidence regarding dietary adherence is derived from studies of hemodialysis patients (72% of patients). The most common method of measuring dietary adherence in ESKD was subjective techniques (e.g. food diaries or adherence questionnaires). This was followed by indirect methods (e.g. serum potassium, phosphate or interdialytic weight gain). The weighted mean adherence rate to ESKD dietary recommendations was 31.5% and 68.5% for fluid recommendations. Adherence to protein, sodium, phosphate, and potassium recommendations were highly variable due to differences in measurement methods used, and were often derived from a limited evidence base. Socioeconomic status, age, social support and self-efficacy were associated with dietary adherence. However, factors such as taste, the impact of the diet on social eating occasions; and dietetic staffing also appear to play a role in dietary adherence. CONCLUSION Dietary adherence rates in people with ESKD are suboptimal. Further research is required on dietary adherence in patients with ESKD from different social, educational, economic and ethnic groups. This research may identify other factors which may impact upon adherence, and could be used to inform the design of future strategies to improve dietary adherence. Future research that reports not just the rate of adherence to individual components of the nutrient prescription but also the overall quality of the diet would be useful.
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Affiliation(s)
- Kelly Lambert
- Department of Clinical Nutrition, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Level 5, Block C, Crown Street, Wollongong, NSW 2500 Australia
| | - Judy Mullan
- Centre for Health Research Illawarra Shoalhaven Population (CHRISP), Australian Health Services Research Institute, University of Wollongong, iC Enterprise 1, Innovation Campus, Wollongong, New South Wales 2522 Australia
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, New South Wales 2522 Australia
| | - Kylie Mansfield
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, New South Wales 2522 Australia
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Lambert K, Mullan J, Mansfield K, Koukomous A, Mesiti L. Evaluation of the quality and health literacy demand of online renal diet information. J Hum Nutr Diet 2017; 30:634-645. [DOI: 10.1111/jhn.12466] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. Lambert
- Department of Clinical Nutrition; Wollongong Hospital; Illawarra Shoalhaven Local Health District, Wollongong NSW Australia
- School of Medicine, Faculty of Science, Medicine and Health; University of Wollongong; Wollongong NSW Australia
| | - J. Mullan
- Discipline of Medicine, Faculty of Science, Medicine and Health; University of Wollongong; Wollongong NSW Australia
- Australian Health Services Research Institute, University of Wollongong; Wollongong NSW Australia
| | - K. Mansfield
- Discipline of Medicine, Faculty of Science, Medicine and Health; University of Wollongong; Wollongong NSW Australia
| | - A. Koukomous
- School of Medicine, Faculty of Science, Medicine and Health; University of Wollongong; Wollongong NSW Australia
| | - L. Mesiti
- School of Medicine, Faculty of Science, Medicine and Health; University of Wollongong; Wollongong NSW Australia
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13
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Havas K, Douglas C, Bonner A. Person-centred care in chronic kidney disease: a cross-sectional study of patients' desires for self-management support. BMC Nephrol 2017; 18:17. [PMID: 28086812 PMCID: PMC5237219 DOI: 10.1186/s12882-016-0416-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 12/09/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND People with chronic kidney disease (CKD) must self-manage their illness to assist with slowing disease-progression, but this is a complex task requiring support from healthcare professionals. Despite the established importance of person-centred care, people with CKD are rarely consulted regarding their desires for self-management support (SMS). METHODS A cross-sectional survey was conducted face-to-face in a Queensland primary care clinic and distributed Australia-wide via an online interface promoted by Kidney Health Australia during 2015. Participants were ≥18 years old and had a self-reported doctor's diagnosis of CKD (any stage; N = 97). The survey was based upon existent literature which identified 10 areas that those with CKD believe require additional support. Descriptive data were generated and Mann-Whitney U tests were performed to compare the desires of different groups of participants. RESULTS Of the 97 participants, 36 completed a hardcopy survey in clinic, and 61 completed the online version. Just over half (60.8%) were female, age ranged from 16-89 (M = 56.44), and time since diagnosis ranged from just diagnosed to 60 years (Mdn = 8.08 years). Strong interest in receiving additional support across all 10 areas was reported (Mdns = 8.00-10.00), with "keeping a positive attitude and taking care of mental and physical health" receiving the highest rating. Those who were: younger (p < .001); more highly educated (p < .001); working (p < .001); diagnosed longer ago (p = .015); and women (p = .050) expressed stronger overall desire for additional support. CONCLUSIONS In addition to information about CKD and medications, everyday strategies ought to be prioritised in patient education. Varying levels of engagement and eagerness to learn more about self-management highlight the need for a person-centred approach to SMS.
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Affiliation(s)
- Kathryn Havas
- School of Nursing, Queensland University of Technology, Victoria Park Rd, 4059, Kelvin Grove, Brisbane, QLD, Australia. .,Chronic Kidney Disease Centre for Research Excellence, University of Queensland, Brisbane, Australia.
| | - Clint Douglas
- School of Nursing, Queensland University of Technology, Victoria Park Rd, 4059, Kelvin Grove, Brisbane, QLD, Australia
| | - Ann Bonner
- School of Nursing, Queensland University of Technology, Victoria Park Rd, 4059, Kelvin Grove, Brisbane, QLD, Australia.,Chronic Kidney Disease Centre for Research Excellence, University of Queensland, Brisbane, Australia.,Visiting Research Fellow, Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Australia
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Lambert K, Mullan J, Mansfield K, Lonergan M. A Cross-Sectional Comparison of Health Literacy Deficits Among Patients With Chronic Kidney Disease. JOURNAL OF HEALTH COMMUNICATION 2015; 20 Suppl 2:16-23. [PMID: 26513027 DOI: 10.1080/10810730.2015.1080329] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Inadequate health literacy in people with chronic kidney disease (CKD) is associated with poorer disease management and greater complications. There are limited data on the health literacy deficits of people with CKD. The aim of this study was to investigate the types and extent of health literacy deficits in patients with CKD using the multidimensional Health Literacy Management Scale (HeLMS) and to identify associations between patient characteristics and the domains of health literacy measured by the HeLMS. Invitations to participate were sent to patients with CKD attending the renal unit of a regional Australian hospital. These patients included predialysis, dialysis (peritoneal and hemodialysis), and kidney transplant patients. This study identified that inadequate health literacy--especially in the domains relating to attending to one's health needs, understanding health information, social support, and socioeconomic factors--was common. Male gender and education level were significantly associated with inadequate health literacy. The type and extent of health literacy deficits varied among CKD groups, and transplant patients had more deficits than other CKD patient groups. This study provides useful information for health professionals treating patients with CKD, especially with regard to the design of self-management interventions and health information.
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Affiliation(s)
- Kelly Lambert
- a School of Medicine , University of Wollongong , Wollongong , New South Wales , Australia
- b Department of Clinical Nutrition , Illawarra Shoalhaven Local Health District , Wollongong , New South Wales , Australia
| | - Judy Mullan
- c Graduate School of Medicine , University of Wollongong , Wollongong , New South Wales , Australia
| | - Kylie Mansfield
- c Graduate School of Medicine , University of Wollongong , Wollongong , New South Wales , Australia
| | - Maureen Lonergan
- d Renal Medicine , Illawarra Shoalhaven Local Health District , Wollongong , New South Wales , Australia
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Davison I, Cooke S. HOW NURSES' ATTITUDES AND ACTIONS CAN INFLUENCE SHARED CARE. J Ren Care 2014; 41:96-103. [DOI: 10.1111/jorc.12105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ian Davison
- Centre for Research in Medical and Dental Education; School of Education; University of Birmingham; UK
| | - Sandra Cooke
- Jubilee Centre for Character and Virtues, School of Education; University of Birmingham; UK
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Wright Nunes J, Greene JH, Wallston K, Eden S, Shintani A, Elasy T, Rothman RL, Ikizler TA, Cavanaugh KL. Pilot study of a physician-delivered education tool to increase patient knowledge about CKD. Am J Kidney Dis 2013; 62:23-32. [PMID: 23540261 DOI: 10.1053/j.ajkd.2013.01.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 01/16/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Limited research exists on physician-delivered education interventions. We examined the feasibility and impact of an educational tool on facilitating physician-patient kidney disease communication. STUDY DESIGN Pilot feasibility clinical trial with a historical control to examine effect size on patient knowledge and structured questions to elicit physician and patient feedback. SETTING & PARTICIPANTS Adults with chronic kidney disease (CKD) stages 1-5, seen in nephrology clinic. INTERVENTION 1-page educational worksheet, reviewed by physicians with patients. OUTCOMES Kidney knowledge between patient groups and provider/patient feedback. MEASUREMENTS Patient kidney knowledge was measured using a previously validated questionnaire compared between patients receiving the intervention (April to October 2010) and a historical cohort (April to October 2009). Provider input was obtained using structured interviews. Patient input was obtained through survey questions. Patient characteristics were abstracted from the medical record. RESULTS 556 patients were included, with 401 patients in the historical cohort and 155 receiving the intervention. Mean age was 57 ± 16 (SD) years, with 53% men, 81% whites, and 78% with CKD stages 3-5. Compared with the historical cohort, patients receiving the intervention had higher adjusted odds of knowing they had CKD (adjusted OR, 2.20; 95% CI, 1.16-4.17; P = 0.02), knowing their kidney function (adjusted OR, 2.25; 95% CI, 1.27-3.97; P = 0.005), and knowing their stage of CKD (adjusted OR, 3.22; 95% CI, 1.49-6.92; P = 0.003). Physicians found the intervention tool easy and feasible to integrate into practice and 98% of patients who received the intervention recommended it for future use. LIMITATIONS Study design did not randomly assign patients for comparison and enrollment was performed in clinics at one center. CONCLUSIONS In this pilot study, a physician-delivered education intervention was feasible to use in practice and was associated with higher patient kidney disease knowledge. Further examination of physician-delivered education interventions for increasing patient disease understanding should be tested through randomized trials.
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Affiliation(s)
- Julie Wright Nunes
- Department of Internal Medicine, Division of Nephrology, University of Michigan Health System, Ann Arbor, MI, USA
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Johansson L. SHARED DECISION MAKING AND PATIENT INVOLVEMENT IN CHOOSING HOME THERAPIES. J Ren Care 2013; 39 Suppl 1:9-15. [DOI: 10.1111/j.1755-6686.2013.00337.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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