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Lin D, Liang D, Huang M, Xu X, Bai Y, Meng D. The dyadic effects of family resilience and social support on quality of life among older adults with chronic illness and their primary caregivers in multigenerational families in China: A cross-sectional study. Heliyon 2024; 10:e27351. [PMID: 38463805 PMCID: PMC10923707 DOI: 10.1016/j.heliyon.2024.e27351] [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: 04/27/2022] [Revised: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
Older adults with chronic illness, as well as their primary caregivers in multigenerational families, may experience a complex interplay of factors that affect their quality of life (QOL). However, this interplay is not yet well-characterized for Chinese multigenerational families in particular. In this study, we analyzed how family resilience and social support affect the QOL of both older adults and caregivers in multigenerational Chinese families specifically. We enrolled 258 pairs of older adults with chronic illness and their primary caregivers in a multicenter cross-sectional study conducted in southern China in December 2021. Using the Actor-Partner Interdependence Model (APIM), we then examined the correlation between family resilience, social support, and QOL in dyadic analysis and found that QOL, family resilience, and social support for primary caregivers were better than those of older adults with chronic illness (t = 3.66-16.3, p<0.01). These factors were found to be positively correlated (r = 0.22-0.60, p<0.05), except for the family resilience of primary caregivers and the QOL of older adults with chronic illness (r = -0.14, p = 0.04). Additionally, actor effect results showed that when a dyadic member has high family resilience and objective social support, they tend to have a better QOL (β = 0.5-1.48, P < 0.01). However, partner effect results showed that when the primary caregiver has high family resilience, this is associated with a worse QOL for the older adult (β = -1.06, P < 0.01). Furthermore, we found that objective social support of dyads does not significantly influence their partner's QOL (β = 0.88/0.31, P>0.05) for any pair. This suggests that medical staff should pay attention to the impact of family resilience on the QOL of older adult and caregiver dyads and explore health management plans that focus on binary coping in multigenerational families.
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Affiliation(s)
- Dan Lin
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
| | - Dong Liang
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Minqing Huang
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Xinxin Xu
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Yamei Bai
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
| | - Dijuan Meng
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
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Shankar R, Luo N, Lim YW, Khatri P, Leong L, Teo GYX, Mukhopadhyay A, Choo J, Chua HR, Teng GG, Phua J, Hong WZ. Assessing caregiver burden in advanced kidney disease: protocol for a systematic review of the measurement properties of instruments and tools. BMJ Open 2024; 14:e078767. [PMID: 38413158 PMCID: PMC10900375 DOI: 10.1136/bmjopen-2023-078767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Caregiver burden is a significant issue in the care of patients with advanced kidney disease. Its assessment is crucial for evaluating the needs of caregivers and for the development of interventions to support them. Several instruments have been developed to measure caregiver burden in these patients. However, the measurement properties of these instruments have not been systematically reviewed. METHODS AND ANALYSIS This systematic review will include a comprehensive search of databases including PubMed, CINAHL, Embase, Cochrane Library, SCOPUS and Web of Science by using keywords and MeSH terms to identify relevant studies starting from each database inception to 1 January 2024 and covering papers in English. The search strategy will combine relevant keywords and database-specific subject headings related to the following concepts: (1) caregivers, (2) burden, stress, distress, (3) chronic kidney disease, end-stage kidney disease, dialysis. Reference lists of eligible articles will also be hand searched. We will include quantitative and qualitative studies evaluating measurement properties of instruments assessing caregiver burden in caregivers of adult patients (aged ≥18 years). Data will be extracted from the selected studies and analysed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist as the study quality assessment tool. Subsequently, the van der Vleuten utility index will be used to critique and categorise the instruments. A narrative that synthesises the utility of all instruments will be presented along with recommendations for the selection of instruments depending on specific clinical contexts. This systematic review will provide an overview of the measurement properties of available instruments, including discussion on reliability, validity and responsiveness. Results from the review may give rise to the subsequent development of most appropriate instrument that could be applied to the assessment of caregiver burden in advanced kidney disease. ETHICS AND DISSEMINATION Ethics approval is not required as this study will merely synthesise data from published studies. The results will be disseminated through peer-reviewed publications as well as conference presentations. PROSPERO REGISTRATION NUMBER CRD42023433906.
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Affiliation(s)
- Ravi Shankar
- Medical Affairs - Research, Innovation and Enterprise, Alexandra Hospital, National University Health System, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | - Yee Wei Lim
- Medical Affairs - Research, Innovation and Enterprise, Alexandra Hospital, National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Priyanka Khatri
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Nephrology, Department of Medicine, National University Hospital, National University Health System, Singapore
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore
- Fast Programme, Alexandra Hospital, National University Health System, Singapore
| | - Leanne Leong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Nephrology, Department of Medicine, National University Hospital, National University Health System, Singapore
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore
- Fast Programme, Alexandra Hospital, National University Health System, Singapore
| | - Geraldine Yu-Xuan Teo
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore
- Fast Programme, Alexandra Hospital, National University Health System, Singapore
| | - Amartya Mukhopadhyay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore
- Fast Programme, Alexandra Hospital, National University Health System, Singapore
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore
| | - Jason Choo
- Department of Renal Medicine, Singapore General Hospital, Singapore
| | - Horng Ruey Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Nephrology, Department of Medicine, National University Hospital, National University Health System, Singapore
| | - Gim-Gee Teng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore
- Fast Programme, Alexandra Hospital, National University Health System, Singapore
- Division of Rheumatology, Department of Medicine, National University Hospital, National University Health System, Singapore
| | - Jason Phua
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore
- Fast Programme, Alexandra Hospital, National University Health System, Singapore
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore
| | - Wei Zhen Hong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Nephrology, Department of Medicine, National University Hospital, National University Health System, Singapore
- Chronic Programme, Alexandra Hospital, National University Health System, Singapore
- Fast Programme, Alexandra Hospital, National University Health System, Singapore
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Alaryni AA, Alrowaie F, Alghamdi A, Alabdullah R, Alnutaifi RA, Alajlan R, Alnutaifi RA, Aldakheelallah A, Alshabanat A, Bin Shulhub AS, Moazin OM, Qutob R, Alsolami E, Hakami OA. Assessment of Burden in Caregivers of Patients Undergoing Hemodialysis and Peritoneal Dialysis: A Cross-Sectional Study in Riyadh, Saudi Arabia. Cureus 2024; 16:e52513. [PMID: 38371074 PMCID: PMC10874250 DOI: 10.7759/cureus.52513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/20/2024] Open
Abstract
A caregiver attends to the needs or concerns of someone limited by disease, injury, or disability to enhance the patient's quality of life, which can be assessed in three areas: social, physical, and psychological. This cross-sectional study assessed the extent of burden experienced by the caregivers of patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) therapy in King Fahad Medical City in Riyadh, Saudi Arabia. The Zarit Burden Interview Arabic Abridged version (ZBI-A) was used to assess the level of burden experienced by caregivers. The data was collected and examined by professionals using the SPSS version 23. Based on the data of 50 participants, a mean ZBI-12 score of 12.22 ± 7.2 was reported. According to the ZBI scale, "No to mild burden," "Mild to moderate burden," and "High burden" were reported as 46% (n = 23), 38% (n = 19), and 16% (n = 8) of participants, respectively. The internal consistency of the ZBI-12 scale, assessed using Cronbach's alpha, was 0.664, indicating a satisfactory level of internal consistency. It was determined that caregivers of individuals undergoing PD and HD encounter different degrees of burden, with a significant proportion of caregivers experiencing a substantial burden.
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Affiliation(s)
- Abdullah A Alaryni
- Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Abdullah Alghamdi
- Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Razan Alabdullah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Raneem A Alnutaifi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Renad Alajlan
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Raed A Alnutaifi
- College of Medicine, King Saud University Medical City, Riyadh, SAU
| | | | - Alanoud Alshabanat
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Othillah M Moazin
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Rayan Qutob
- Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Enad Alsolami
- Internal Medicine, University of Jeddah, Jeddah, SAU
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Sayin Kasar K, Yildirim Y, Bulut U. Comfort Level in Caregivers of Palliative Care Patients and Affecting Factors: What Should We Know? OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:1461-1472. [PMID: 33990159 DOI: 10.1177/00302228211014779] [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: 02/01/2023]
Abstract
Caregivers are an important source of support for patients in palliative care. Comfort is an important concept in nursing care for both patients and their families, and nurses aim to increase comfort. The aim of the study was to determine the comfort level and influencing factors in caregivers of palliative care patients. The research sample consisted of 102 caregivers related to palliative care patients. The data were obtained with an Individual Information Form, the Edmonton Symptom Assessment Scale (ESAS) and the End of Life Comfort Scale (Caregiver/Family). The study was conducted in the palliative care clinic of Aksaray University Training and Research Hospital between October 2018 and April 2019. There was a significant relationship between the total comfort score of the caregivers and the patient's performance status, the caregivers' age, their economic situation, the length of the caregiving period and receiving help in care (social support) (p < 0.05). Providing comfort is an important function and challenge for holistic nursing care, as comfort is a lifelong need in health and disease. Caregivers in the risk group should be aware of this issue and necessary precautions should be taken.
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Affiliation(s)
- Kadriye Sayin Kasar
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey
| | | | - Ulku Bulut
- Family Medicine Department, Faculty of Medicine, Aksaray University, Aksaray, Turkey
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Seephom S, Jittanoon P, Balthip K. Muslim caregivers' experiences in caring for patients receiving peritoneal dialysis. J Ren Care 2023; 49:6-14. [PMID: 34971469 DOI: 10.1111/jorc.12408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 12/18/2021] [Accepted: 12/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fulfilling the role of a family caregiver has a substantial effect on the lives of those involved. However, existing information on family caregivers of patients receiving peritoneal dialysis is insufficient-especially Muslim caregivers, whose practice is unique. OBJECTIVES The aim of this study was to understand the experiences of Muslim family caregivers looking after patients receiving peritoneal dialysis in an Islamic context. DESIGN A descriptive qualitative approach was employed. PARTICIPANTS Thirteen Muslim family caregivers who have cared for patients undergoing peritoneal dialysis for at least 1 month. APPROACH Data were collected through face-to-face in-depth interviews and a focus group discussion. Content analysis was used to analyse the data with initial codes grouped into sub-categories, generic categories, and main categories. FINDINGS The experiences of Muslim family caregivers looking after patients receiving peritoneal dialysis generated two main categories: overwhelmed with suffering and learning to live as a caregiver. CONCLUSIONS Caregiving has a substantial impact on Muslim family caregivers. They need to be cared for holistically. The recognition of Islamic beliefs, doctrine of Allah, and religious practices are clear spiritual anchors for caregiving. The findings provide a deeper understanding of the experiences of Muslim family caregivers looking after patients receiving peritoneal dialysis. These findings could serve as the basis for developing a specific nursing intervention for such caregivers.
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Affiliation(s)
- Sunisa Seephom
- Division of Adult and Gerontological Nursing, The Srisavarindhira Thai Red Cross Institute of Nursing, Pathumwan, ฺBangkok, Thailand
| | - Piyanuch Jittanoon
- Division of Community Nurse Practitioner, Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand
| | - Karnsunaphat Balthip
- Division of Community Nurse Practitioner, Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand
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Difficulties in Caring for the Older Adults: Perspective of Brazilian and Portuguese Caregivers. NURSING REPORTS 2023; 13:284-296. [PMID: 36810278 PMCID: PMC9944437 DOI: 10.3390/nursrep13010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
This study aims to understand the difficulties in caring for the older adults with functional dependence from the perspective of Brazilian and Portuguese caregivers. This is a study based on the Theory of Social Representations, based on the Thematic Content Analysis proposed by Bardin, carried out with 21 informal caregivers of older adults in Brazil and 11 informal caregivers of older adults in Portugal. The instrument consisted of a questionnaire with sociodemographic data and data on health conditions along with an open interview with guiding questions on the theme of care. Data were analyzed using the Content Analysis technique proposed by Bardin, with the help of the QRS NVivo® Version 11 software (QSR International, Burlington, MA, USA). Three categories emerged from the speeches: "Caregiver burden", "Caregiver support network" and "Older adults resistance". The main difficulties mentioned by caregivers were associated with family articulation in meeting the needs of their older adults, whether due to the excessive demand of tasks, which results in overloading the caregiver, or the behaviors of the older adults themselves, or even the availability of a truly supportive and effective network.
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Alshammari B, Noble H, McAneney H, Alshammari F, O’Halloran P. Caregiver Burden in Informal Caregivers of Patients in Saudi Arabia Receiving Hemodialysis: A Mixed-Methods Study. Healthcare (Basel) 2023; 11:healthcare11030366. [PMID: 36766941 PMCID: PMC9914672 DOI: 10.3390/healthcare11030366] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Long-term caregiving for patients receiving hemodialysis (HD), is associated with physical and psychological stress, which may impact on the well-being and quality of life of caregivers. Due to a lack of understanding of the experiences of informal caregivers of patients receiving HD, especially in Saudi Arabia, this study aimed to measure burden in informal caregivers of patients receiving HD, examine the factors that predict caregiver burden (CB), and explore the experience of burden in caregivers of patients receiving HD. (2) Methods: This study used a mixed-methods, sequential, explanatory design, which consisted of two phases. Phase 1 involved a cross-sectional study design, with a convenience sample of 61 caregivers of patients on maintenance HD for at least 3 months. All caregivers in the study completed the Arabic version of the Zarit Burden Interview to identify caregiver burden. Phase 2 of the study involved a qualitative descriptive design involving semi-structured interviews with nine caregivers. (3) Results: Study findings indicate that caregivers did not experience severe burden. Being older, a female caregiver and having comorbidities was positively associated with increased levels of caregiver burden. In the qualitative phase of the study, a number of important factors emerged that may contribute to a reduction in caregiver burden, including social support, cultural acceptance, and religious influences. (4) Conclusion and impact: CB was found to be low when a comparison was made with other studies using similar populations. Understanding the factors that influence caregiver burden will contribute to the accurate assessment of caregiver burden and help reduce burden in informal caregivers, patients with renal failure, and others with chronic illnesses worldwide.
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Affiliation(s)
- Bushra Alshammari
- Medical and Surgical Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia
- Correspondence: (B.A.); (P.O.)
| | - Helen Noble
- School of Nursing and Midwifery, Medical Biology Center, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK
| | - Helen McAneney
- UCD Center for Interdisciplinary Research, Education and Innovation in Health Systems, University College Dublin, Belfield, 4 Dublin, Ireland
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 2440, Saudi Arabia
| | - Peter O’Halloran
- School of Nursing and Midwifery, Medical Biology Center, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK
- Correspondence: (B.A.); (P.O.)
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Karimollahi M, Abazari M, Tazakori Z, Ramazanzadeh N. Caregiving burden and social support in family caregivers of patients with cancer: A cross-sectional study. INTERNATIONAL JOURNAL OF CARE COORDINATION 2022. [DOI: 10.1177/20534345221121067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Providing care for patients by family caregivers causes in several consequences known as “Caregiving Burden”, which affects the caregiver's health and the whole family process, considered in holistic healthcare/nursing. This study aimed to evaluate the caregiving burden and social support in family caregivers of patients with cancer and their influencing factors in a local area in Iran. Methods In this cross-sectional study, 190 family members of patients with cancer were studied through convenient sampling method. Data were collected using demographic data sheet enriched with Karnofsky Performance Status Scale and Katz Index of Independence in Activities of Daily Living (ADL), and Zarit Burden Inventory and Medical Outcomes Social Support Survey questionnaires. Results The results indicated intermediate performance status and moderate independence in ADL in patients. The mean score of caregiving burden was 43.95 ± 17.48 which indicates moderate to severe burden. The average social support in the caregivers was 60.25 ± 23.81% which shows above the average social support. Both performance status and dependence in ADL of patient had statistically significant effect on the caregiving burden in caregivers. Also a statistically significant negative relationship was observed between caregiving burden and social support in primary family caregivers of patients with cancer. Discussion Considering the increasing importance of primary care provided by families, developing strategies for providing caregiver's needs through family care in cancer nursing is essential. So supporting caregivers through family nursing in holistic healthcare by providing social support, can play a significant role in reducing caregiving burden in healthcare services considering the qualified holistic healthcare/nursing.
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Brown EA, Ekstrand A, Gallieni M, Gorrín MR, Gudmundsdottir H, Guedes AM, Heidempergher M, Kitsche B, Lobbedez T, Lundström UH, McCarthy K, Mellotte GJ, Moranne O, Petras D, Povlsen JV, Punzalan S, Wiesholzer M. Availability of assisted peritoneal dialysis in Europe: call for increased and equal access. Nephrol Dial Transplant 2022; 37:2080-2089. [PMID: 35671088 DOI: 10.1093/ndt/gfac193] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Availability of assisted PD (asPD) increases access to dialysis at home, particularly for the increasing numbers of older and frail people with advanced kidney disease. Although asPD has been widely used in some European countries for many years, it remains unavailable or poorly utilised in others. A group of leading European nephrologists have therefore formed a group to drive increased availability of asPD in Europe and in their own countries. METHODS Members of the group filled in a proforma with the following headings: personal experience, country experience, who are the assistants, funding of asPD, barriers to growth, what is needed to grow, and their top 3 priorities. RESULTS Only 5 of the 13 countries surveyed provided publicly funded reimbursement for asPD. The use of asPD depends on overall attitudes to PD with all respondents mentioning need for nephrology team education and/or patient education and involvement in dialysis modality decision making. CONCLUSION AND CALL TO ACTION Many people with advanced kidney disease would prefer to have their dialysis at home, yet if the frail patient chooses PD most healthcare systems cannot provide their choice. AsPD should be available in all countries in Europe and for all renal centres. The top priorities to make this happen are education of renal healthcare teams about the advantages of PD, education of and discussion with patients and their families as they approach the need for dialysis, and engagement with policy makers and healthcare providers to develop and support assistance for PD.
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Affiliation(s)
- Edwina A Brown
- Imperial College Healthcare NHS Trust, Imperial College Renal and Transplant Centre, London, UK
| | - Agneta Ekstrand
- Helsinki University Hospital, Abdomen Center, Nephrology, Helsinki, Finland
| | - Maurizio Gallieni
- Department of Biomedical and Clinical Sciences, Università di Milano, Italy.,Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Maite Rivera Gorrín
- Hospital Ramón y Cajal, Servicio de Nefrología. UAH. IRyCis. Carretera de Colmenar km 9, 100 28034 Madrid, Spain
| | | | - Anabela Malho Guedes
- Serviço de Nefrologia, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | | | - Benno Kitsche
- Kuratorium für Dialyse und Nierentransplantation e.V., Cologne.,NADia - Netzwerk assistierte Dialyse, Berlin, Germany
| | - Thierry Lobbedez
- Néphrologie, CHU CAEN, Avenue de la Côte de Nacre, CAEN CEDEX 9, France
| | - Ulrika Hahn Lundström
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Kate McCarthy
- Baxter Healthcare Ltd, Wallingford, Compton, Newbury, UK
| | - George J Mellotte
- Trinity Health Kidney Centre, Tallaght University Hospital, Tallaght, Dublin NROA
| | - Olivier Moranne
- Department Nephrology-Dialysis-Apheresis, CHU Caremeau Nimes, France
| | - Dimitrios Petras
- Department of Nephrology, General Hospital 'Hippokration', Athens, Greece
| | - Johan V Povlsen
- Dept. Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Sally Punzalan
- Imperial College Healthcare NHS Trust, Imperial College Renal and Transplant Centre, London, UK
| | - Martin Wiesholzer
- Clinical Department for Internal Medicine1, University Hospital St.Poelten, Austria, Karl Landsteiner University of Health Sciences
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Ibrahim N, Chu SY, Siau CS, Amit N, Ismail R, Abdul Gafor AH. The effects of psychosocial and economic factors on the quality of life of patients with end-stage renal disease and their caregivers in Klang Valley, Malaysia: protocol for a mixed-methods study. BMJ Open 2022; 12:e059305. [PMID: 36691236 PMCID: PMC9171257 DOI: 10.1136/bmjopen-2021-059305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/12/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The number of patients in Malaysia requiring dialysis is expected to rise substantially in the future due to the ageing population and increasing prevalence of diabetes mellitus and hypertension. Hence, more individuals will be expected to adopt the role of caregivers in the future. The upward trend of end-stage renal disease (ESRD) and caregiving for dialysis patients has detrimental consequences for both patients and caregivers in terms of their psychological well-being and quality of life. Despite the current circumstances, there are very few studies in Malaysia that have explored the psychosocial factors, specifically on the economic impact of the management of ESRD. METHODS AND ANALYSIS This two-phase sequential explanatory mixed-methods design, incorporating a quantitative design (phase I) and a qualitative study (phase II), is to be conducted in 4 government hospitals and 10 other non-governmental organisations or private dialysis centres within Klang Valley, Malaysia. A cross-sectional survey (phase I) will include 236 patient-caregiver dyads, while focus group discussions (phase II) will include 30 participants. The participants for both phases will be recruited purposively. Descriptive statistics, independent sample t-tests and multiple regression analysis will be used for analyses in phase I, and thematic analysis will be used in phase II. ETHICS AND DISSEMINATION Approval for the study has been obtained from the National Medical Research and Ethics Committee (MREC) (NMRR-21-1012-59714) and the Research Ethics Committee of Hospital Canselor Tuanku Muhriz UKM (UKM PPI/111/8/JEP-2021-078) and University of Malaya Medical Centre (MREC ID NO: 2 02 178-10346). Informed consent of the participants will be obtained beforehand, and no personal identifiers will be obtained from the participants to protect their anonymity. The findings will be published in peer-reviewed scientific journals and presented at national or international conferences with minimal anonymised data.
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Affiliation(s)
- Norhayati Ibrahim
- Centre for Health Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Sin Yee Chu
- Centre for Health Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Rozmi Ismail
- Centre for Research in Psychology and Human Well-being (PsiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Hospital Canselor Tuanku Muhriz UKM, Cheras, Federal Territory of Kuala Lumpur, Malaysia
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Alshammari B, Noble H, McAneney H, Alshammari F, O’Halloran P. Factors Associated with Burden in Caregivers of Patients with End-Stage Kidney Disease (A Systematic Review). Healthcare (Basel) 2021; 9:healthcare9091212. [PMID: 34574986 PMCID: PMC8468425 DOI: 10.3390/healthcare9091212] [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: 08/22/2021] [Revised: 09/07/2021] [Accepted: 09/07/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Caring for a patient with end-stage kidney disease (ESKD) is highly stressful and can impact negatively on the physical and psychological well-being of caregivers. To accurately assess caregiver burden (CB), health care providers (HCPs) need to identify characteristics associated with an increase in CB. AIM The aim of this review is to explore CB in caregivers of adult patients with ESKD and to identify characteristics associated with any increase in CB. METHOD A comprehensive literature search was completed using five electronic databases. Medline, Embase, CINHAL, PsycINFO, and Scopus. The Joanna Briggs Institute checklist (JBI) was used to quality appraise full text papers included in the review. No time limit for the date of publication of studies was employed, to enable the inclusion of more extensive literature. RESULTS A total of 38 relevant studies from 18 countries were identified and included in the review. A variety of patient and caregiver factors can impact positively or negatively on CB, including socio-demographic factors of patients and caregivers, disease-related factors, situational and relational factors, environmental factors, and psychological factors. CONCLUSION This review provides awareness to HCPs of the important factors associated with CB, when assessing or targeting interventions for caregivers experiencing burden.
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Affiliation(s)
- Bushra Alshammari
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK; (H.N.); (P.O.)
- College of Nursing, University of Hail, Hail 2440, Saudi Arabia
- Correspondence: or
| | - Helen Noble
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK; (H.N.); (P.O.)
| | - Helen McAneney
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland;
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 2440, Saudi Arabia;
| | - Peter O’Halloran
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK; (H.N.); (P.O.)
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Portolés J, Vega A, Lacoba E, López-Sánchez P, Botella M, Yuste C, Martín Cleary C, Sanz Ballesteros S, González Sanchidrian S, Sánchez García L, Carreño A, Bajo MA, Janeiro D. Is peritoneal dialysis suitable technique CKD patients over 65 years? A prospective multicenter study. Nefrologia 2021; 41:529-538. [PMID: 36165135 DOI: 10.1016/j.nefroe.2021.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/18/2020] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is increasing in patients older than 65 years and is related to morbidity, frailty, and dependence. Peritoneal dialysis (PD) has classically been associated with young patients with an active life. HYPOTHESIS PD should be offered to patients over 65 years. We search for any unfavorable results that may advice not to recommend PD therapy for this group. OBJECTIVE To describe PD treatment and outcomes in patients > 65 years, to compare their results with patients < 65 years and to identify areas with room for improvement in a real-life study. STUDY Prospective, observational, and multicenter study performed in incident PD patients, from January 2003 until January 2018. RESULTS We included 2,435 PD patients, 31.9% were older than 65 years; there was a difference of 25 years between both groups. Median follow up was 2.1 years. Older than 65 years group had more comorbidity: Diabetes (29.5% vs 17.2%; p < 0.001), previous CV events 34.5% vs 14.0%; p < 0.001), Charlson index (3.8 vs 3.0; p < 0.001). We did not find differences in efficacy and PD adequacy objectives fulfillment, anaemia management or blood pressure during follow-up. Peritonitis rate was higher in older 65 years group (0.65 vs 0.45 episodes/patient/year; p < 0.001), but there was not differences in germs, admission rate and follow up. Mortality was higher in older 65 years group (28.4% vs 9.4%) as expected. PD permanence probability was similar (2.1 years). The main cause of PD withdrawal was transplant in group < 65 years (48.3%) and transfer to HD in group > 65 years. The main reason was caregiver or patient fatigue (20.2%), and not technique failure (7.3%). Multivariate Cox regression analysis showed a relation (HR [95%CI]) between mortality and age > 65 years 2.4 [1.9-3.0]; DM 1.6 [1.3-2.1]; CV events 2.1 [1.7-2.7]. Multivariate Cox regression analysis identify a relation between technique failure and age > 65 years 1.5 [1.3-1.9]; DM 1.6 [1.3-1.9] and previous transplant 1.5 [1.2-2.0]. CONCLUSION Patients older than 65 years fulfilled PD adequacy criteria during the follow up. We believe PD is a valid option for patients older 65 years. It is necessary to try to prevent infections and patient/caregiver fatigue, to avoid HD transfer for reasons not related to technique failure.
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Affiliation(s)
- Jose Portolés
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, Spain; REDInREN RETIC ISCIII 016/009, Spain.
| | - Almudena Vega
- Servicio de Nefrología, H. Universitario Gregorio Marañón, Madrid, Spain; REDInREN RETIC ISCIII 016/009, Spain
| | - Enrique Lacoba
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, Spain; REDInREN RETIC ISCIII 016/009, Spain
| | | | - Mario Botella
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, Spain
| | - Claudia Yuste
- REDInREN RETIC ISCIII 016/009, Spain; Servicio de Nefrología, H. Universitario Doce de Octubre, Madrid, Spain
| | - Catalina Martín Cleary
- REDInREN RETIC ISCIII 016/009, Spain; Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, Spain
| | | | | | | | - Agustín Carreño
- Servicio de Nefrología, H. Universitario Ciudad Real, Ciudad Real, Spain
| | - M Auxiliadora Bajo
- REDInREN RETIC ISCIII 016/009, Spain; Servicio de Nefrología, H. Universitario La Paz, Madrid, Spain
| | - Darío Janeiro
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, Spain; REDInREN RETIC ISCIII 016/009, Spain
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Portolés J, Vega A, Lacoba E, López-Sánchez P, Botella M, Yuste C, Martín Cleary C, Sanz Ballesteros S, González Sanchidrian S, Sánchez García L, Carreño A, Bajo MA, Janeiro D. Is peritoneal dialysis suitable technique CKD patients over 65 years? A prospective multicenter study. Nefrologia 2021. [PMID: 33610372 DOI: 10.1016/j.nefro.2020.10.010] [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: 11/28/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is increasing in patients older than 65years and is related to morbidity, frailty, and dependence. Peritoneal dialysis (PD) has classically been associated with young patients with an active life. HYPOTHESIS PD should be offered to patients over 65years. We search for any unfavorable results that may advice not to recommend PD therapy for this group. OBJECTIVE To describe PD treatment and outcomes in patients >65years, to compare their results with patients <65years and to identify areas with room for improvement in a real-life study. STUDY Prospective, observational, and multicenter study performed in incident PD patients, from January 2003 until January 2018. RESULTS We included 2,435 PD patients, 31.9% were older than 65years; there was a difference of 25years between both groups. Median follow up was 2.1years. Older than 65years group had more comorbidity: Diabetes (29.5% vs 17.2%; p<0.001), previous CV events 34.5% vs 14.0%; p<0.001), Charlson index (3.8 vs 3.0; p<0.001). We did not find differences in efficacy and PD adequacy objectives fulfillment, anaemia management or blood pressure during follow-up. Peritonitis rate was higher in older 65years group (0.65 vs 0.45 episodes/patient/year; p<0.001), but there was not differences in germs, admission rate and follow up. Mortality was higher in older 65years group (28.4% vs 9.4%) as expected. PD permanence probability was similar (2.1years). The main cause of PD withdrawal was transplant in group <65years (48.3%) and transfer to HD in group >65years. The main reason was caregiver or patient fatigue (20.2%), and not technique failure (7.3%). Multivariate Cox regression analysis showed a relation (HR [95%CI]) between mortality and age>65years 2.4 [1.9-3.0]; DM 1.6 [1.3-2.1]; CV events 2.1 [1.7-2.7]. Multivariate Cox regression analysis identify a relation between technique failure and age>65years 1.5 [1.3-1.9]; DM 1.6 [1.3-1.9] and previous transplant 1.5 [1.2-2.0]. CONCLUSION Patients older than 65years fulfilled PD adequacy criteria during the follow up. We believe PD is a valid option for patients older 65years. It is necessary to try to prevent infections and patient/caregiver fatigue, to avoid HD transfer for reasons not related to technique failure.
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Affiliation(s)
- Jose Portolés
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, España; REDInREN RETIC ISCIII 016/009, España.
| | - Almudena Vega
- Servicio de Nefrología, H. Universitario Gregorio Marañón, Madrid, España; REDInREN RETIC ISCIII 016/009, España
| | - Enrique Lacoba
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, España; REDInREN RETIC ISCIII 016/009, España
| | | | - Mario Botella
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, España
| | - Claudia Yuste
- REDInREN RETIC ISCIII 016/009, España; Servicio de Nefrología, H. Universitario Doce de Octubre, Madrid, España
| | - Catalina Martín Cleary
- REDInREN RETIC ISCIII 016/009, España; Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, España
| | | | | | | | - Agustín Carreño
- Servicio de Nefrología, H. Universitario Ciudad Real, Ciudad Real, España
| | - M Auxiliadora Bajo
- REDInREN RETIC ISCIII 016/009, España; Servicio de Nefrología, H. Universitario La Paz, Madrid, España
| | - Darío Janeiro
- Servicio de Nefrología, H. Universitario Puerta de Hierro, Madrid, España; REDInREN RETIC ISCIII 016/009, España
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Physical performance and health-related quality of life among older adults on peritoneal dialysis: a cross-sectional study. Int Urol Nephrol 2021; 53:1033-1042. [PMID: 33392883 DOI: 10.1007/s11255-020-02737-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/02/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Identifying performance-based tests that meaningful for patients may facilitate the implementation of rehabilitation programs. The primary aim of this study was to determine the independent associations between different performance-based tests and health-related quality of life (HRQoL) among elderly peritoneal dialysis (PD) patients. METHODS This cross-sectional study was conducted in China. Patients on PD who were 60 years of age or above were included. HRQoL was assessed using the Medical Outcomes Study Short Form 36. Physical function was determined by handgrip strength, timed up and go (TUG) test, 5-repetition sit-to-stand test, and comfortable gait speed. Depressive symptoms were measured using the self-reported Geriatric Depression Scale (GDS-15). Multiple linear regression analyses were performed to examine the factors influencing HRQoL. RESULTS In total, 115 participants with a mean age of 69.7 were included (46 women and 69 men). TUG (β =- 0.460, p < 0.001), prealbumin (β = 0.223, p = 0.014), and education level (β = 0.183, p = 0.042) were associated with physical health. GDS score (β = - 0.475, p < 0.001), serum albumin level (β = 0.264, p = 0.003), and sex (β = 0.217, p = 0.012), were associated with mental HRQoL. CONCLUSION TUG could be a valuable test for use in clinical practice and research aiming at facilitating tailed exercise programs, as it was associated with self-perceived physical HRQoL and could be meaningful to elderly PD patients. Depressive symptoms and nutrition were another two important rehabilitation areas for optimizing the overall HRQoL of older adults on PD.
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