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Fernàndez Labadía E, Masot O, Tejero Vidal LL, Botigué T, Bielsa-Gracia S. Educational interventions and identification of risk factors to prevent and reduce peritonitis in peritoneal dialysis: A scoping review. J Ren Care 2024; 50:307-318. [PMID: 38378190 DOI: 10.1111/jorc.12490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Peritonitis is a common and serious complication of peritoneal dialysis and is one of the main causes of peritoneal dialysis technique failure and long-term hemodialysis conversion. OBJECTIVES The aim of the review was to identify and clarify peritonitis risk factors and learn about strategies employed at international level to prevent and reduce the occurrence of peritoneal dialysis associated infections and their complications. DESIGN A scoping review. PARTICIPANTS Adults in pertitoneal dialysis. MEASUREMENTS The methodology framework of Arksey and O'Malley and PRISMA for Scoping Reviews guidelines were applied. A search was conducted of PubMed, Scopus and CINAHL using terms to identify peritoneal dialysis -associated risk factors and interventions carried out for the prevention and reduction of peritonitis in adult persons living at home. RESULTS The 17 studies selected were based on work carried out in nine different countries. Eleven articles analysed modifiable risk factors (low educational level, being a foreigner and low adherence to aseptic technique) and non-modifiable risk factors (age and comorbidities) that predispose to peritonitis in peritoneal dialysis. The other six studies applied an intervention to improve the prevalence of peritonitis considering educational practices adapted to patient characteristics and the application of retraining. CONCLUSIONS Personalised patient training and the identification of risk factors for peritonitis are key to reducing complications and enhancing the survival of peritoneal dialysis patients and the effectiveness of the technique.
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Affiliation(s)
- Elena Fernàndez Labadía
- Dyvision of Nephrology, Arnau de Vilanova University Hospital, Lleida, Spain
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Olga Masot
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain
- Health Education, Nursing, Sustainability and Innovation Research Group, University of Lleida, Lleida, Spain
| | | | - Teresa Botigué
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain
- Health Education, Nursing, Sustainability and Innovation Research Group, University of Lleida, Lleida, Spain
| | - Sara Bielsa-Gracia
- Dyvision of Nephrology, Arnau de Vilanova University Hospital, Lleida, Spain
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Jaelani TR, Ibrahim K, Jonny J, Pratiwi SH, Haroen H, Nursiswati N, Ramadhani BP. Peritoneal Dialysis Patient Training Program to Enhance independence and Prevent Complications: A Scoping Review. Int J Nephrol Renovasc Dis 2023; 16:207-222. [PMID: 37720493 PMCID: PMC10505035 DOI: 10.2147/ijnrd.s414447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/04/2023] [Indexed: 09/19/2023] Open
Abstract
Background Peritoneal dialysis (PD) training is essential to ensure patient independence and prevent life-threatening complications, such as peritonitis. The International Society for Peritoneal Dialysis (ISPD) recommends that every PD unit worldwide implement local PD training programs with the goal of improving self-care capabilities. This scoping review aims to give an overview of recent literature and recommendations on PD training programs aiming to improve the quality of care and outcomes for PD patients. Methods The literature search was conducted using the PC (Population, Concept) approach. The population of interest in this study is PD patients, and the study concept is the PD training program. Several databases were used to conduct the literature search, including PubMed, Science Direct, and CINAHL. The search process began from July 2022 until January 2023. The inclusion criteria for the search included research articles and recommendations. Results The search yielded 22 articles recommending training programs lasting from 5-8 days, with 1-3-hour sessions and a nurse-to-patient ratio of 1:1. A cumulative training time of 15 hours or more is recommended to enhance patient independence and reduce peritonitis rates. Home-based or in-unit PD training, conducted by experienced nurses using adult learning strategies, has shown significant value in improving self-care and preventing peritonitis. Evaluating training outcomes should encompass knowledge, skills, and attitudes, and the impact on peritonitis rates. Training programs should be flexible and consider physiological and psychosocial barriers to achieving the best results. Conclusion There are a variety of strategies for dialysis training concerning duration, session length, patient-to-trainer ratio, timing, methods, location, compliance, and the need for retraining. More evidence is needed to assess the impact of PD patient training programs on self-care capabilities and peritonitis incidence. Future studies should investigate the effects of training programs on compliance, self-efficacy, and patient and nurse perspectives.
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Affiliation(s)
| | - Kusman Ibrahim
- Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia
| | - Jonny Jonny
- Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia
| | | | - Hartiah Haroen
- Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia
| | | | - Bunga Pinandhita Ramadhani
- Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia
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Fujii Y, Matsumura H, Shirasu A, Nakakura H, Yamazaki S, Kanazawa T, Saito N, Hirano H, Azuma H, Nozu K, Ashida A. Unexpected cause of repeated peritoneal dialysis-related complications: a case study of autism spectrum disorder with normal intelligence quotient in an adolescent. RENAL REPLACEMENT THERAPY 2023. [DOI: 10.1186/s41100-023-00470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Abstract
Background
Autism spectrum disorder (ASD) is a common communication disorder, with an incidence rate of 3%. In most cases, clinicians can diagnose ASD in a single outpatient visit. However, in the case of ASD patients without intellectual disability, clinicians are sometimes unaware for a prolonged period that a patient has ASD. In such cases, delayed diagnosis can lead to serious complications.
Case presentation
An 18-year-old boy had repeated severe complications of peritoneal dialysis. At the age of 9, the patient presented with proteinuria, and 5 years later, he developed end-stage kidney disease. Percutaneous renal biopsy and the clinical symptoms revealed focal segmental glomerulosclerosis with Charcot-Marie-Tooth disease due to a gene mutation in INF2. Peritoneal dialysis was initiated at the age of 14, but led to many related complications, including peritonitis, hypertensive retinopathy and encephalopathy, and acute heart failure. Initially, we were unaware of his developmental characteristics and autism spectrum disorder without intellectual disability, but through lengthy observations by various healthcare professionals, his unique characteristics were noticed. Because the patient often displayed a discrepancy between behavior and speech, we cautiously studied his thoughts and behaviors, and developed a special approach to ensure safe peritoneal dialysis.
Conclusions
When many peritoneal dialysis-related complications occur in a patient with normal intelligence quotient, autism spectrum disorder should be considered as a possible cause.
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Rodríguez-Zamora MC, Moreno-Serrano AP, Cabrera-Delgado AM, Regalado-Ruiz LA, Amato-Martínez JD. Vivencias del paciente ante el diagnóstico de enfermedad renal crónica y su ingreso a diálisis peritoneal. ENFERMERÍA NEFROLÓGICA 2022. [DOI: 10.37551/s2254-28842022007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción: Un número importante de pacientes que ingresan al programa de diálisis peritoneal reciben simultaneamente la noticia de que tienen enfermedad renal crónica en etapa terminal y requieren diálisis peritoneal. Para muchos de ellos la noticia es inesperada y desconsoladora, ya que tienen que acceder a la diálisis para poder seguir viviendo. Material y Método: Estudio cualitativo, descriptivo con enfoque fenomenológico. De 106 pacientes incidentes del programa de diálisis peritoneal ambulatoria a quienes se les solicitó consentimiento informado para contestar el instrumento (Coping Inventory Strategies), se seleccionaron 14 pacientes que relataron sus vivencias respecto a su diagnóstico de enfermedad renal crónica y la necesidad urgente de diálisis peritoneal. Se les pidió que escribieran en una cuartilla cómo enfrentaron la noticia de insuficiencia renal crónica y requerir diálisis peritoneal. Resultados: Se incluyeron en el estudio a 14 pacientes, con edad comprendida entre 41 y 61 años, y el 66% fueron mujeres. Se identificaron tres categorías y siete subcategorías: sociolaboral (estigma social e incertidumbre por el trabajo); actitud ante la muerte (resignación y sentimiento de culpa) y acompañamiento familiar (toma de decisiones, motivación y apoyo). El mayor número de pacientes se ubicó en la categoría de actitud ante la muerte y en la subcategoría de resignación como estrategia de afrontamiento. Conclusiones: Los pacientes describieron la fase en la que se enteraron de su diagnóstico y el ingreso a diálisis peritoneal como el momento más difícil y traumático, manifestaron sentimientos de angustia, limitaciones personales o sociales y reconocieron la dependencia del apoyo familiar.
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Cantillo-Medina CP, Castro-Morea BV, Mosquera YH. Estudio de la competencia para el autocuidado de las personas en tratamiento renal sustitutivo con diálisis. ENFERMERÍA NEFROLÓGICA 2021. [DOI: 10.37551/s2254-28842021034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción: Las personas con enfermedad renal crónica dializadas demandan mayor cuidado por el manejo complejo de su condición, las múltiples complicaciones asociadas al tratamiento y la necesidad de asumir estilos de vida saludables, para garantizar la efectividad y seguridad de las terapias.Objetivos: Determinar la competencia para el autocuidado de las personas en diálisis, así como su relación con las características sociodemográficas y clínicas.Metodología: Se realizó un estudio observacional descriptivo de corte transversal, en una unidad renal del sur de Colombia. Instrumentos utilizados: Encuesta de caracterización para el cuidado de la persona con enfermedad crónica, Formulario de características clínicas y Cuestionario de Competencia para el cuidado versión-paciente.Resultados: Se incluyeron un total de 200 personas dializadas, con una edad media de 59±13,89 años, el 50,5% mujeres, con pareja estable, apoyo para su cuidado, grado educativo primario, dedicados a labores del hogar, y nivel socioeconómico bajo. El 47,5% evidenció alta competencia para su autocuidado, el 42% una competencia media y el 10,5% baja. Se identificaron asociaciones estadísticamente significativas de la competencia para el autocuidado con las variables asistencia puntual a terapia (p=0,024) y adherencia farmacológica (p=0,001).Conclusiones: La población abordada se caracterizó por vivir en condiciones socioeconómicas que aumentan la vulnerabilidad de la persona dializada, en su mayoría contó con soporte para el cuidado, presentó nivel de competencia para el autocuidado entre alto y medio, relacionado con asistencia puntual a terapia y cumplimiento en adherencia farmacológica.
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Jones LA, Gordon EJ, Hogan TP, Fiandaca CA, Smith BM, Stroupe KT, Fischer MJ. Challenges, Facilitators, and Recommendations for Implementation of Home Dialysis in the Veterans Health Administration: Patient, Caregiver, and Clinician Perceptions. KIDNEY360 2021; 2:1928-1944. [PMID: 35419547 PMCID: PMC8986044 DOI: 10.34067/kid.0000642021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 09/21/2021] [Indexed: 02/04/2023]
Abstract
Background Home dialysis confers similar survival and greater quality of life than in-center hemodialysis for adults with ESKD but remains underutilized. We examined challenges and facilitators to implementation of home dialysis and identified stakeholder-centered strategies for improving it. Methods We conducted a qualitative, cross-sectional, multisite evaluation that included five geographically dispersed Veterans Health Administration (VHA) home dialysis programs. Participants included patients with ESKD receiving home dialysis, their informal caregivers, and home dialysis staff. Semistructured telephone interviews were conducted and audio-recorded from 2017 through 2018, to assess perceived barriers and facilitators to patient home dialysis use in VHA. Transcribed interviews were analyzed thematically by each participant group. Results Participants included 22 patients receiving home dialysis (18 on peritoneal dialysis [PD] and four hemodialysis [HD]); 20 informal caregivers, and 19 home dialysis program staff. Ten themes emerged as challenges to implementing home dialysis, of which six (60%) spanned all groups: need for sterility, burden of home dialysis tasks, lack of suitable home environment, physical side effects of home dialysis, negative psychosocial effects of home dialysis, and loss of freedom. Four themes (40%), identified only by staff, were insufficient self-efficacy, diminished peer socialization, geographic barriers, and challenging health status. Twelve themes emerged as facilitators to implementing home dialysis, of which seven (58%) spanned all groups: convenience, freedom, avoidance of in-center HD, preservation of autonomy, adequate support, favorable disposition, and perceptions of improved health. Two themes (17%) common among patients and staff were adequate training and resources, and physical and cognitive skills for home dialysis. Recommendations to promote implementation of home dialysis common to all participant groups entailed incorporating mental health care services, offering peer-to-peer coaching, increasing home visits, providing health data feedback, and reducing patient burden. Conclusions Stakeholder-centered challenges were rigorously identified. Facilitators and recommendations can inform efforts to support home dialysis implementation.
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Affiliation(s)
- Lindsey A. Jones
- Veterans Affairs Information Resource Center, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois
| | - Elisa J. Gordon
- Department of Surgery-Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois,Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois
| | - Timothy P. Hogan
- Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial Hospital, Bedford Veterans Affairs Medical Center, Bedford, Massachusetts,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Cindi A. Fiandaca
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois
| | - Bridget M. Smith
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois
| | - Kevin T. Stroupe
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois
| | - Michael J. Fischer
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. Veterans Affairs Hospital, Hines, Illinois,Medical Service, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois,Medicine/Nephrology, University of Illinois at Chicago, Chicago, Illinois
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Lillebuen L, Schick-Makaroff K, Thompson S, Molzahn A. Facilitators and Barriers to Care in Rural Emergency Departments in Alberta for Patients on Peritoneal Dialysis (PD): An Interpretive Descriptive Study. Can J Kidney Health Dis 2020; 7:2054358120970098. [PMID: 33224512 PMCID: PMC7649850 DOI: 10.1177/2054358120970098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 09/24/2020] [Indexed: 12/04/2022] Open
Abstract
Background: Home dialysis offers many advantages to patients, but they require support to manage a home-based therapy such as peritoneal dialysis (PD). A rural emergency department provides an important safety net for patients requiring medical care, including managing complications of PD, such as peritonitis. Patients living in northern Alberta are spread out geographically and can be far from a PD training center, yet anecdotally, many rural sites do not provide care for these patients. Objective: Our aim was to identify the facilitators and barriers to nursing care in rural emergency departments in northern Alberta for patients receiving PD. Design: A qualitative interpretive descriptive approach was used. Setting: Rural emergency departments across northern Alberta. Participants: Purposeful sampling was used to seek participants from 1 of 4 rural acute care hospital emergency departments in northern Alberta. Six registered nurses and 1 licensed practical nurse agreed to participate in the study. They ranged in experience from 2 to 18 years. Two of the participants were unit managers, 2 were clinical nurse educators (CNEs), and the other 3 were staff nurses with 1 of them in a leadership position. Methods: Individual semistructured interview were conducted over the telephone. The interview guide was developed based on a review of the literature. Interviews continued until no new information was obtained, that is, data were saturated. Interviews were audio recorded and transcribed verbatim. Field notes were recorded. A constant comparative approach was used for analysis. The coding process was both deductive (drawing from the literature) and inductive. Results: Seven participants were interviewed, and there were 4 main themes and 1 subtheme that emerged from the analysis: education (along with the subtheme of resources) was seen as both facilitators and barriers; patient/family ability to perform PD; infrequent exposure; and physician supports. Continuing education about PD was a facilitator, and the lack of education was a barrier to provision of PD care. Similarly, availability of resource materials about PD and access to a CNE were facilitators, while lack of these resources was a barrier to offering PD care. As PD was not always seen regularly, infrequent exposure was a barrier to offering PD care. Lack of physician supports, both from the locum physicians who were sometimes reluctant to care for these patients and the delays in reaching nephrologists were barriers. Limitations: The findings represent the perceptions of the emergency department nurses who participated. These perceptions may differ from those of nurses who work in other regions of the country. Furthermore, most participants were in a leadership role, and it may be that their perspectives differ from those of front-line nurses. Conclusions: The findings from our study highlight the need for availability of education and resource materials/persons to care for these patients. There is also a need for greater physician support from both local physicians as well as nephrologists to offer high-quality PD care. Trial registration: Not applicable. This study is not a clinical trial. It did not involve prospective assignment of participants to a treatment group.
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Affiliation(s)
- Lisa Lillebuen
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | | | - Stephanie Thompson
- Division of Nephrology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Anita Molzahn
- Faculty of Nursing, University of Alberta, Edmonton, Canada
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Xing Z, Wang Y, Li H, Li Y, Wan Z, Sun D, Sun J. Theory-Based Interventions to Promote Fluid Intake Adherence Among Dialysis Patients: A Systematic Review. Res Theory Nurs Pract 2020; 33:357-391. [PMID: 31666394 DOI: 10.1891/1541-6577.33.4.357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Dialysis involves a complex regimen including diet, fluid, medication, and treatment. Therapeutic regimen adherence determines the therapeutic success, quality of life, and survival of patients on dialysis. Complying with fluid management is the most difficult among the therapeutic regimen. Several theory-based interventions have been designed to promote fluid intake compliance in patients receiving dialysis. This review has two aims. One is to explore the effectiveness of theory-based interventions. The other is to examine the extent of the combination of theory and interventions in improving adherence to fluid intake among dialysis patients. METHODS A literature review was performed using PubMed, PsycINFO, Embase, Web of Science, and the Cochrane Library to acquire associated studies. Data were extracted independently by two researchers. The degree of theory application was accessed using a theory coding scheme (TCS). RESULTS Eight studies were identified as eligible for inclusion, and five theories were cited as basis (health belief model, social cognitive theory, self-regulation model, transtheoretical model). According to the TCS, adherence outcomes and the extent of theory use were not optimal. IMPLICATIONS FOR PRACTICE Combining theory with patient health education might be beneficial in improving fluid intake adherence of dialysis patients. The framework and TCS could be considered to guide theory utilization and promote nursing education in improving the quality of renal nursing care.
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Affiliation(s)
- Zhuangjie Xing
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China.,Department of Intensive Care Unit, Linyi City People Hospital, Linyi, China
| | - Yonghong Wang
- Department of Neurology, the First Hospital of Jilin University, Changchun, Jilin, China
| | - Huanhuan Li
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Yuan Li
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Zhenzhen Wan
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Dan Sun
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
| | - Jiao Sun
- Basic Nursing Department, School of Nursing, Jilin University, Changchun, China
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Ramírez-Perdomo CA, Perdomo-Romero AY, Rodriguez-Vélez ME. El sistema de salud: barreras para los usuarios con insuficiencia renal crónica. AVANCES EN ENFERMERÍA 2020. [DOI: 10.15446/av.enferm.v38n2.83555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: comprender la experiencia vivida por un grupo de personas con insuficiencia renal crónica que recibieron un trasplante de órgano frente a los servicios de salud y lossignificados del cuidado de la salud realizados por enfermeras y familiares.Materiales y métodos: estudio cualitativo con enfoque fenomenológico-hermenéutico. La muestra se compone de 11 personas con insuficiencia renal crónica trasplantadas, cincocuidadores y cinco enfermeras. Entrevistas recolectadas y grabadas entre diciembre de 2015 y enero de 2017. Para el análisis se empleó el método propuesto por Van Manen.Resultados: uno de los temas que emerge es la experiencia de encontrarse y vivir con insuficiencia renal crónica, del cual se extrae el subtema relacionado con la vivencia en elsistema de salud por parte de las personas enfermas, sus cuidadores y los profesionales de enfermería.Conclusiones: la insuficiencia renal crónica asume un significado complejo y multidimensional para la persona con la enfermedad, sus cuidadores familiares y las enfermeras que asumen el cuidado de este grupo de personas, que los lleva a experimentar el sistema de salud con un efecto adverso que deshumaniza el cuidado de las personas.
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Abstract
Objetivo: Explorar de manera comprensiva la experiencia vivida en el tratamiento de la Enfermedad Renal Crónica y los significados del cuidado elaborados por enfermeras y familiares que interactúan con estas personas. Método: Estudio cualitativo, enfoque fenomenológico-hermenéutico, empleando el referente teórico de Van Manen, 11 personas con la enfermedad, 5 cuidadores y 5 enfermeros participaron en el estudio, en la ciudad de Neiva; información recolectada a través de entrevistas en profundidad. Resultados: emergió el dilema entre la libertad y la vida al construir el sentido de afrontar el tratamiento de la Enfermedad Renal Crónica, los subtemas se enmarcaron en la dureza de la hemodiálisis, el significado de la máquina de diálisis, la apariencia de la fístula arterio venosa, el impacto del catéter peritoneal y la dieta. Conclusiones: el tratamiento de la enfermedad irrumpe en la vida de las personas produciendo cambios abruptos en su vida que los lleva a reconocer la finitud de su existencia, las alternativas para sobrevivir, los cambios en su corporeidad. De los cuales no son ajenos sus cuidadores y enfermeras, llamados a brindarles apoyo para lograr enfrentar el tratamiento.
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11
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Maley MAL, Patel RS, Lafferty NT, Steiner GZ, Chow JSF, Johnson DW, Boudville NC. A Theory-Driven, Evidence-Based Approach to Implementing the ISPD Syllabus-Patients as Learners. Perit Dial Int 2019; 39:409-413. [PMID: 31501291 DOI: 10.3747/pdi.2019.00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Moira A L Maley
- Medical School, The University of Western Australia, Perth, Western Australia, Australia .,Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
| | - Rakesh S Patel
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Natalie T Lafferty
- Centre for Technology and Innovation in Learning, University of Dundee, Dundee, Scotland, United Kingdom
| | - Genevieve Z Steiner
- NICM Health Research Institute and Translational Health Research Institute (THRI), Western Sydney University, Penrith, New South Wales, Australia
| | - Josephine S F Chow
- Clinical Innovation & Business Unit, South Western Sydney Local Health District, NSW, Australia.,School of Nursing, University of Sydney, Sydney, New South Wales, Australia.,School of Health Science, University of Tasmania, Tasmania, Australia
| | - David W Johnson
- Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Translational Research Institute, Brisbane, Queensland, Australia
| | - Neil C Boudville
- Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Australasian Kidney Trials Network, Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
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12
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Ji M, Wang AH, Ye J, Shen YH, Chen CM, Yu C, Li LF. Effects of the health belief model following acute exacerbation of chronic obstructive pulmonary disease in a hospital in China. J Thorac Dis 2019; 11:3593-3598. [PMID: 31559066 DOI: 10.21037/jtd.2019.07.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background This study aims to investigate the effects of education with health belief model (HBM) on anxiety and fatigue among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients with AECOPD admitted into Taizhou People's Hospital, Jiangsu, China between December 2012 and October 2013 were randomly selected for the present study according to random number table. A total of 99 cases with anxiety were included. These patients were divided into two groups: experimental group educated by HBM (n=47), and control group educated by conventional method (n=52). The scores for anxiety and fatigue were evaluated using the self-rating anxiety scale (SAS) and multidimensional fatigue inventory (MFI-20). Results After educational intervention by HBM, patients achieved a significant decrease in anxiety and fatigue scores, when compared to patients in the control group, who were educated by the conventional method at the time of admission, discharge, and 6 weeks after discharge (P<0.05). Conclusions HBM program effectively may alleviate anxiety and fatigue, providing necessary information for symptom management among patients with AECOPD.
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Affiliation(s)
- Mei Ji
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou 225300, China
| | - Ai-Hong Wang
- Department of Basic Nursing, Nanjing University of Chinese Medicine, School of Nursing, Nanjing 210023, China
| | - Jun Ye
- Department of Laboratory Medicine, Taizhou People's Hospital, Taizhou 225300, China
| | - Ya-Hui Shen
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou 225300, China
| | - Chun-Mei Chen
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou 225300, China
| | - Chen Yu
- Department of Respiratory Medicine, Taizhou People's Hospital, Taizhou 225300, China
| | - Li-Fang Li
- Department of Nursing, Taizhou People's Hospital, Taizhou 225300, China
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13
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Radmore NM, Hyrkäs K. Teaching–learning partnership between nurses and long‐term patients undergoing peritoneal dialysis: A qualitative study. J Ren Care 2019; 45:159-170. [DOI: 10.1111/jorc.12291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 02/28/2019] [Accepted: 04/05/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Kristiina Hyrkäs
- Director, Center for Nursing Research and Quality OutcomesMaine Medical CenterPortland Maine 04102 USA
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Warsame F, Haugen CE, Ying H, Garonzik-Wang JM, Desai NM, Hall RK, Kambhampati R, Crews DC, Purnell TS, Segev DL, McAdams-DeMarco MA. Limited health literacy and adverse outcomes among kidney transplant candidates. Am J Transplant 2019; 19:457-465. [PMID: 29962069 PMCID: PMC6312744 DOI: 10.1111/ajt.14994] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/08/2018] [Accepted: 06/07/2018] [Indexed: 01/25/2023]
Abstract
More than one-third of US adults have limited health literacy, putting them at risk of adverse clinical outcomes. We evaluated the prevalence of limited health literacy among 1578 adult kidney transplant (KT) candidates (May 2014-November 2017) and examined its association with listing for transplant and waitlist mortality in this pilot study. Limited health literacy was assessed at KT evaluation by using a standard cutoff score ≤5 on the Brief Health Literacy Screen (score range 0-12, lower scores indicate worse health literacy). We used logistic regression and adjusted Cox proportional hazards models to identify risk factors for limited health literacy and to quantify its association with listing and waitlist mortality. We found that 8.9% of candidates had limited health literacy; risk factors included less than college education (adjusted odds ratio [aOR] = 2.87, 95% confidence interval [CI]:1.86-4.43), frailty (aOR = 1.85, 95% CI:1.22-2.80), comorbidity (Charlson comorbidity index [1-point increase] aOR = 1.12, 95% CI: 1.04-1.20), and cognitive impairment (aOR = 3.45, 95% CI: 2.20-5.41) after adjusting for age, sex, race, and income. Candidates with limited health literacy had a 30% (adjusted hazard ratio = 0.70, 95% CI: 0.54-0.91) decreased likelihood of listing and a 2.42-fold (95% CI: 1.16- to 5.05-fold) increased risk of waitlist mortality. Limited health literacy may be a salient mechanism in access to KT; programs to aid candidates with limited health literacy may improve outcomes and reduce disparities.
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Affiliation(s)
- Fatima Warsame
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christine E Haugen
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hao Ying
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Niraj M Desai
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rasheeda K Hall
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Rekha Kambhampati
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Deidra C Crews
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tanjala S Purnell
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mara A McAdams-DeMarco
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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15
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Morita PP, Huynh K, Zakir A, Cafazzo JA, McQuillan RF, Bargman JM, Chan CT. Supporting the Establishment of New Home Dialysis Programs Through the Explore Home Dialysis Program. Kidney Int Rep 2019; 4:293-300. [PMID: 30775626 PMCID: PMC6365366 DOI: 10.1016/j.ekir.2018.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/16/2018] [Accepted: 10/22/2018] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The globally increasing prevalence of chronic kidney disease has resulted in an ever-growing demand for renal replacement therapy. Although programs are present around the world, there is a paucity of immersive educational programs that train clinicians and administrators to develop new home dialysis programs. Explore Home Dialysis (EHD) is a program created to fill this gap. METHODS We present the results of the evaluation of the EHD program. Our team interviewed 23 clinicians and administrators who participated in the EHD program. We also assessed country-specific needs and challenges associated with home dialysis. RESULTS The 4 main findings include (i) the evaluation of the effectiveness of the EHD program; (ii) the need for an educational program to train individuals on how to deploy home dialysis programs; (iii) evidence that such an educational program is beneficial to participants and for the establishment of new home dialysis programs; and (iv) the identification of barriers to the development of home dialysis programs in countries represented in this study. The data show an increased demand, with strong patient and provider interest in establishing new programs, interest in accessing resources to train clinical and administrative staff in how to run a home dialysis program, and positive feedback about the EHD program in general. CONCLUSIONS The data from this study were used in the next iteration of the EHD program, to inform clinicians about challenges in the deployment of new home dialysis programs, and to present educational resources that need to be developed in the future.
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Affiliation(s)
- Plinio P. Morita
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Kathy Huynh
- Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Areeba Zakir
- Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Joseph A. Cafazzo
- Healthcare Human Factors, Techna Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Rory F. McQuillan
- Division of Nephrology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Division of Nephrology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Joanne M. Bargman
- Division of Nephrology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Division of Nephrology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christopher T.M. Chan
- Division of Nephrology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Division of Nephrology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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16
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Peikani FA, Shahgholian N, Kazemi A. The Effect of Health-belief-model-Based Training on Behaviors Preventing Peritonitis in Patients on Peritoneal Dialysis. Int J Prev Med 2018; 9:72. [PMID: 30167102 PMCID: PMC6106128 DOI: 10.4103/ijpvm.ijpvm_566_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/01/2018] [Indexed: 01/03/2023] Open
Abstract
Background: Peritonitis is one of the important complications of peritoneal dialysis and one of the reasons for failure of this therapeutic technique. As one of the important reasons for development of peritonitis is disregard for health behaviors, this study aims to investigate the effect of education based on health belief model (HBM) on behaviors preventing peritonitis in peritoneal dialysis patients. Methods: This double-blind clinical trial study conducted on 60 patients with peritoneal dialysis in Isfahan, Iran. A researcher-made questionnaire was used to evaluate knowledge, HBM constructs, and peritonitis preventive behaviors in three stages (before, immediately after and 2-month after intervention). The intervention group received four HBM-based educational sessions and the control group received a lecture session. Data were analyzed using Chi-square, Mann–Whitney, Fisher's exact test, independent t-test, and repeated measures ANOVA. Results: There was no significant difference between the two groups’ background variables and level of knowledge, perceived, sensitivity, severity, benefits, arriers, self-efficacy, personal and environmental hygiene behaviors and fluid-replacement technique before the intervention. Immediately after the intervention, all of the variables, except perceived barriers, personal, and environmental hygiene, were significantly higher in the intervention group than the control group (P < 0.05); 2 months after the intervention, all of the variables, except personal hygiene and perceived barriers, were significantly higher in the intervention group (P < 0.05); in three stages, personal hygiene was not significantly different between the two groups; and 2 months after the intervention, the variable of perceived barriers decreased significantly in the intervention group (P < 0.05). Conclusions: Education based on HBM is effective on promoting behaviors preventing peritonitis. Education based on HBM is suggested in peritoneal dialysis patients to prevent peritonitis.
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Affiliation(s)
- Fatemeh Attari Peikani
- Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Shahgholian
- Department of Critical Care Nursing, Isfahan Kidney Diseases Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Nursing and Midwifry Care Resarch Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Stavropoulou A, Grammatikopoulou MG, Rovithis M, Kyriakidi K, Pylarinou A, Markaki AG. Through the Patients' Eyes: The Experience of End-Stage Renal Disease Patients Concerning the Provided Nursing Care. Healthcare (Basel) 2017; 5:healthcare5030036. [PMID: 28754014 PMCID: PMC5618164 DOI: 10.3390/healthcare5030036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/10/2017] [Accepted: 07/19/2017] [Indexed: 11/21/2022] Open
Abstract
Chronic kidney disease is a condition that affects both the physical and mental abilities of patients. Nursing care is of pivotal importance, in particular when end-stage renal disease (ESRD) patients are concerned, since the quality of the provided care may severely influence the patient’s quality of life. This is why it is important to explore patient experiences concerning the rendered care. However, limited up-to-date studies have addressed this issue. The aim of the present study was to stress the experiences of ESRD patients concerning the provided nursing care in the hemodialysis unit at the University Hospital in Heraklion, Crete. A qualitative methodological approach was used, based on the principles of phenomenological epistemology. Semi-structured interviews were conducted, and open-ended questions were applied to record how patients experienced the rendered care during dialysis. The recorded data were analyzed via qualitative content analysis, which revealed three main themes: ‘Physical Care’, ‘Psychological Support’ and ‘Education’. Patients’ views were conceptualized into sub-themes within each main theme. The interviews revealed the varied and distinct views of ESRD patients, indicating that the rendered care should be individualized.
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Affiliation(s)
- Areti Stavropoulou
- Department of Nursing, Technological Educational Institute of Crete, Estavromenos, Irakleio, 71004, Greece.
| | - Maria G Grammatikopoulou
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos 574 00, Greece.
| | - Michail Rovithis
- Department of Nursing, Technological Educational Institute of Crete, Estavromenos, Irakleio, 71004, Greece.
| | - Konstantina Kyriakidi
- Department of Nutrition & Dietetics, Technological Educational Institute of Crete, Estavromenos, Irakleio, 71004, Greece.
| | - Andriani Pylarinou
- Department of Nutrition & Dietetics, Technological Educational Institute of Crete, Estavromenos, Irakleio, 71004, Greece.
| | - Anastasia G Markaki
- Department of Nutrition & Dietetics, Technological Educational Institute of Crete, Estavromenos, Irakleio, 71004, Greece.
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