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Rostami M, Farahani P, Esmaelian S, Bahman Z, Fadel Hussein A, A Alrikabi H, Hosseini Hooshiar M, Yasamineh S. The Role of Dental-derived Stem Cell-based Therapy and Their Derived Extracellular Vesicles in Post-COVID-19 Syndrome-induced Tissue Damage. Stem Cell Rev Rep 2024:10.1007/s12015-024-10770-y. [PMID: 39150646 DOI: 10.1007/s12015-024-10770-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2024] [Indexed: 08/17/2024]
Abstract
Long coronavirus disease 2019 (COVID-19) is linked to an increased risk of post-acute sequelae affecting the pulmonary and extrapulmonary organ systems. Up to 20% of COVID-19 patients may proceed to a more serious form, such as severe pneumonia, acute respiratory distress syndrome (ARDS), or pulmonary fibrosis. Still, the majority of patients may only have mild, self-limiting sickness. Of particular concern is the possibility of parenchymal fibrosis and lung dysfunction in long-term COVID-19 patients. Furthermore, it has been observed that up to 43% of individuals hospitalized with COVID-19 also had acute renal injury (AKI). Care for kidney, brain, lung, cardiovascular, liver, ocular, and tissue injuries should be included in post-acute COVID-19 treatment. As a powerful immunomodulatory tool in regenerative medicine, dental stem cells (DSCs) have drawn much interest. Numerous immune cells and cytokines are involved in the excessive inflammatory response, which also has a significant effect on tissue regeneration. A unique reservoir of stem cells (SCs) for treating acute lung injury (ALI), liver damage, neurological diseases, cardiovascular issues, and renal damage may be found in tooth tissue, according to much research. Moreover, a growing corpus of in vivo research is connecting DSC-derived extracellular vesicles (DSC-EVs), which are essential paracrine effectors, to the beneficial effects of DSCs. DSC-EVs, which contain bioactive components and therapeutic potential in certain disorders, have been shown as potentially effective therapies for tissue damage after COVID-19. Consequently, we explore the properties of DSCs in this work. Next, we'll look at how SARS-CoV-2 affects tissue damage. Lastly, we have looked at the use of DSCs and DSC-EVs in managing COVID-19 and chronic tissue damage, such as injury to the heart, brain, lung, and other tissues.
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Affiliation(s)
- Mitra Rostami
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouria Farahani
- Doctor of Dental Surgery, Faculty of Dentistry, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Samar Esmaelian
- Faculty of Dentistry, Islamic Azad University, Tehran Branch, Tehran, Iran
| | - Zahra Bahman
- Faculty of dentistry, Belarusian state medical university, Minsk, Belarus
| | | | - Hareth A Alrikabi
- Collage of Dentist, National University of Science and Technology, Dhi Qar, 64001, Iraq
| | | | - Saman Yasamineh
- Young Researchers and Elite Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
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Ensari E, Akyol Onder EN, Bilac O, Ertan P. The Quality of Life in Patients with Familial Mediterranean Fever and Their Parents Perception. KLINISCHE PADIATRIE 2024. [PMID: 39106880 DOI: 10.1055/a-2339-3742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is a chronic disease characterized by recurrent episodes of fever and polyserositis. This study aimed to assess children's quality of life (QoL), as reported by children and their parents, and to compare the results according to clinical variables. MATERIAL AND METHODS The study examined 107 children with FMF, evaluating their demographic and genetic data, utilizing the Pediatric Quality of Life Inventory (PedsQL) to assess QoL, and comparing scores based on disease severity. RESULTS The severity of FMF is inversely correlated with QoL scores, with mild cases having the highest scores (97±4), followed by moderate (76±11) and severe cases (52±10.3) (p<0,001). Disease severity, treatment adherence, healthcare utilization, genetic mutations, family income, and maternal age at birth all significantly impact perceived quality of life in FMF patients (p<0,001). Additionally, parents reported lower QoL for children with FMF who experienced various adverse factors such as low family income, household smoking, frequent attacks, hospitalizations, irregular medication use, and low maternal education levels (p<0,001). CONCLUSION Children's daily activities, academic performance, and family functioning are all significantly impacted by FMF. Physicians caring for patients with FMF should be aware of the QoL changes in the management of these patients. As a result, medical therapy, patient education, and indicators of psychological and social support can all be offered more effectively.
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Affiliation(s)
- Esra Ensari
- Department of Pediatric Nephrology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Esra Nagehan Akyol Onder
- Pediatric Nephrology, Aksaray Training and Research Hospital, Department of Paediatric Nephrology, Aksaray, Turkey
| | - Oznur Bilac
- Department of Child and Adolescent Psychiatry, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Pelin Ertan
- Department of Pediatric Nephrology, Celal Bayar University School of Medicine, Manisa, Turkey
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Zorba E, Fasoi G, Grapsa E, Zartaloudi A, Polikandrioti M, Alikari V, Stavropoulou A, Dafogianni C, Impis O, Gerogianni G. Investigation of Social Constraints, Psychosocial Adjustment and Optimism among Dialysis Patients. Clin Pract 2024; 14:1430-1439. [PMID: 39051309 PMCID: PMC11270319 DOI: 10.3390/clinpract14040115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/12/2024] [Accepted: 07/12/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Social constraints are perceived as unsupportive behaviors, leading to inadequate psychosocial adjustment, while optimism can help people recover from distress and reduce any negative effects of chronic disease. The aim of this study was to investigate social constraints, psychosocial adjustment and optimism among patients on dialysis. METHODS In this study, 402 patients undergoing dialysis in Greece completed the following questionnaires: (i) the Social Constraints Scale (SCS) for the assessment of social constrains, (ii) the Psychosocial adjustment to illness scale (PAIS-SR) for the assessment of psychosocial adjustment, and (iii) the LOT-R scale for the assessment of optimism. A Mann-Whitney test was used for the comparison of continuous variables between two groups. Spearman correlation coefficients (rho) were used to explore the association of two continuous variables. Multiple linear regression analysis was used with the SCS scale. RESULTS Greater difficulty in psychosocial adjustment in the domestic, vocational, extended family and social environments, sexual relationships, and health care as well as greater psychological distress were significantly associated with a greater occurrence of social constraints (p < 0.001). Additionally, greater optimism was significantly associated with fewer social constraints and lower difficulty in adjusting to their disease (p < 0.001). CONCLUSIONS Greater difficulty in all dimensions of psychosocial adjustment is associated with more social constraints, while optimism is associated with fewer social constraints and better disease adjustment.
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Affiliation(s)
- Eirini Zorba
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Georgia Fasoi
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Eirini Grapsa
- Department of Nephrology, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Afroditi Zartaloudi
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Maria Polikandrioti
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Victoria Alikari
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Areti Stavropoulou
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Chrysoula Dafogianni
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Orchan Impis
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
| | - Georgia Gerogianni
- Department of Nursing, University of West Attica, 12243 Athens, Greece; (E.Z.); (G.F.); (A.Z.); (M.P.); (V.A.); (A.S.); (C.D.); (O.I.)
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Chan GCK, Kalantar-Zadeh K, Ng JKC, Tian N, Burns A, Chow KM, Szeto CC, Li PKT. Frailty in patients on dialysis. Kidney Int 2024; 106:35-49. [PMID: 38705274 DOI: 10.1016/j.kint.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 05/07/2024]
Abstract
Frailty is a condition that is frequently observed among patients undergoing dialysis. Frailty is characterized by a decline in both physiological state and cognitive state, leading to a combination of symptoms, such as weight loss, exhaustion, low physical activity level, weakness, and slow walking speed. Frail patients not only experience a poor quality of life, but also are at higher risk of hospitalization, infection, cardiovascular events, dialysis-associated complications, and death. Frailty occurs as a result of a combination and interaction of various medical issues in patients who are on dialysis. Unfortunately, frailty has no cure. To address frailty, a multifaceted approach is necessary, involving coordinated efforts from nephrologists, geriatricians, nurses, allied health practitioners, and family members. Strategies such as optimizing nutrition and chronic kidney disease-related complications, reducing polypharmacy by deprescription, personalizing dialysis prescription, and considering home-based or assisted dialysis may help slow the decline of physical function over time in subjects with frailty. This review discusses the underlying causes of frailty in patients on dialysis and examines the methods and difficulties involved in managing frailty among this group.
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Affiliation(s)
- Gordon Chun-Kau Chan
- Carol & Richard Yu Peritoneal Dialysis Research Centre, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension, Harbor-University of California, Los Angeles Medical Center, Torrance, California, USA
| | - Jack Kit-Chung Ng
- Carol & Richard Yu Peritoneal Dialysis Research Centre, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - Na Tian
- Department of Nephrology, General Hospital of Ning Xia Medical University, Yin Chuan, China
| | - Aine Burns
- Division of Nephrology, University College London, Royal Free Hospital, London, UK
| | - Kai-Ming Chow
- Carol & Richard Yu Peritoneal Dialysis Research Centre, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - Cheuk-Chun Szeto
- Carol & Richard Yu Peritoneal Dialysis Research Centre, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China; Li Ka Shing Institute of Health Sciences (LiHS), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Philip Kam-Tao Li
- Carol & Richard Yu Peritoneal Dialysis Research Centre, The Chinese University of Hong Kong, Hong Kong, China; Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, China.
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Safi F, Areshtanab HN, Ghafourifard M, Ebrahimi H. The association between self-efficacy, perceived social support, and family resilience in patients undergoing hemodialysis: a cross-sectional study. BMC Nephrol 2024; 25:207. [PMID: 38918709 PMCID: PMC11202372 DOI: 10.1186/s12882-024-03629-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Self-efficacy of patients on hemodialysis is considered a main component of the successful management of chronic kidney diseases. The self-efficacy of these patients may be influenced by many individual and social factors. This study aimed to assess the association between perceived self-efficacy and social support by patients on hemodialysis treatment and the resilience of their families. METHODS This cross-sectional study was conducted on 183 patients and 183 families of hemodialysis patients in the largest hemodialysis center in northwest of Iran. Data was collected from July to December 2021 using chronic kidney disease self-efficacy, multidimensional perceived social support (MSPSS), and the Walsh family resilience questionnaire (WFRQ). The collected data were analyzed by SPSS software using descriptive and inferential statistical tests. RESULTS The findings showed that the mean score of patients' self-efficacy was 171.63 ± 38.19 in a possible range of 25 to 250. Moreover, the mean score of perceived social support was 62.12 ± 16.12 in a possible range of 7 to 84. The mean total score of family resilience was 119.08 ± 26.20 in a possible range of 32 to 84. Also, the results of the study showed a positive and significant relationship between the self-efficacy of patients with their perceived social support and the resilience of their families (p < 0.01). CONCLUSION The results of the study showed that there is a significant relationship between patient self-efficacy and family resilience and social support received in chronic kidney patients undergoing hemodialysis. Therefore, it is suggested to consider practical strategies in the field of family resilience and social support to improve patients' self-efficacy.
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Affiliation(s)
- Farzaneh Safi
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, RN, Iran
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, RN, Iran.
| | - Mansour Ghafourifard
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Ebrahimi
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, RN, Iran
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Joseph L, Krishnan A, Lekha TR, Sasidharan N, Thulaseedharan JV, Valamparampil MJ, Harikrishnan S, Greenfield S, Gill P, Davies J, Manaseki-Holland S, Jeemon P. Experiences and challenges of people living with multiple long-term conditions in managing their care in primary care settings in Kerala, India: A qualitative study. PLoS One 2024; 19:e0305430. [PMID: 38870110 PMCID: PMC11175503 DOI: 10.1371/journal.pone.0305430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/29/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Multimorbidity or multiple long-term conditions (MLTCs), the coexistence of two or more chronic conditions within an individual, presents a growing concern for healthcare systems and individuals' well-being. However, we know little about the experiences of those living with MLTCs in low- and middle-income countries (LMICs) such as India. We explore how people living with MLTCs describe their illness, their engagements with healthcare services, and challenges they face within primary care settings in Kerala, India. METHODS We designed a qualitative descriptive study and conducted in-depth, semi-structured interviews with 31 people (16 males and 15 females) from family health centres (FHCs) in Kerala. Interview data were recorded, transcribed, and thematic analysis using the Framework Method was undertaken. FINDINGS Two main themes and three sub-themes each were identified; (1) Illness impacts on life (a)physical issues (b) psychological difficulties (c) challenges of self-management and (2) Care-coordination maze (a)fragmentation and poor continuity of care (b) medication management; an uphill battle and (c) primary care falling short. All participants reported physical and psychological challenges associated with their MLTCs. Younger participants reported difficulties in their professional lives, while older participants found household activities challenging. Emotional struggles encompassed feelings of hopelessness and fear rooted in concerns about chronic illness and physical limitations. Older participants, adhering to Kerala's familial support norms, often found themselves emotionally distressed by the notion of burdening their children. Challenges in self-management, such as dietary restrictions, medication adherence, and physical activity engagement, were common. The study highlighted difficulties in coordinating care, primarily related to traveling to multiple healthcare facilities, and patients' perceptions of FHCs as fit for diabetes and hypertension management rather than their multiple conditions. Additionally, participants struggled to manage the task of remembering and consistently taking multiple medications, which was compounded by confusion and memory-related issues. CONCLUSION This study offers an in-depth view of the experiences of individuals living with MLTCs from Kerala, India. It emphasizes the need for tailored and patient-centred approaches that enhance continuity and coordination of care to manage complex MLTCs in India and similar LMICs.
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Affiliation(s)
- Linju Joseph
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Athira Krishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | - Neethu Sasidharan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | | | | | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Paramjit Gill
- Academic Unit of Primary Care (AUPC) Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Justine Davies
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Semira Manaseki-Holland
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Panniyammakal Jeemon
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Özdemir Eler Ç, Kav S. Validity and reliability of the Turkish version of the patient on hemodialysis resilience scale. Ther Apher Dial 2024. [PMID: 38698762 DOI: 10.1111/1744-9987.14138] [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: 01/18/2024] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION The study aims to evaluate the validity and reliability of the hemodialysis resilience scale (PHRS) in the Turkish population. METHODS A cross-sectional methodologic study involved 136 hemodialysis patients at two dialysis centers affiliated with a foundation university in Turkey. The updated guidelines for the Intercultural Scale Adaptation Stages, Language, and Culture Adaptation were followed. RESULTS Cronbach's α of the PHRS-Tr was 0.94. A three-factor structure was extracted, namely "the pursuit of positive meaning in the present," "building the will to live through close human relationships," and "acceptance of hemodialysis as a part of daily life" explaining 66.82% of the total variance. Test-retest reliability was conducted with 50 patients within the sample 2 weeks after the first application. The correlation coefficient for test-retest reliability was r = 0.680. CONCLUSION The study results indicate that the PHRS-Tr is a valid and reliable tool for assessing resilience status in Turkish hemodialysis patients.
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Affiliation(s)
- Çiğdem Özdemir Eler
- Vocational Health School, Dialysis Program, Baskent University, Ankara, Türkiye
| | - Sultan Kav
- Department of Nursing, Faculty of Health Sciences, Baskent University, Ankara, Türkiye
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Alilu L, Pazirofteh S, Habibzadeh H, Rasouli J. The impact of teach-back training method (TBTM) on treatment adherence in hemodialysis patients: a randomized controlled trial. Ann Med Surg (Lond) 2024; 86:2723-2728. [PMID: 38694284 PMCID: PMC11060250 DOI: 10.1097/ms9.0000000000001906] [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: 11/24/2023] [Accepted: 02/25/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Ensuring adherence to treatment is vital for individuals undergoing haemodialysis. The demanding treatment frequency and duration often present challenges for patients in maintaining a consistent routine. Non-adherence can result in adverse health effects and an increased risk of hospitalization. This study aimed to evaluate the impact of teach-back training on treatment adherence among haemodialysis patients. Method A randomized controlled trial involved 60 end-stage kidney disease patients undergoing haemodialysis. Participants were randomly assigned to either the control or intervention group. Data were collected using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), assessing adherence in four dimensions: HD incidence, medication use, fluid restriction, and diet recommendations. The intervention group received feedback-based training on diet and fluid restriction during four 45-60-min sessions, while the control group received regular indoor training. Result Following the intervention, significant differences in mean scores for HD frequency, medication use, and fluid restriction were observed between the two groups (P<0.001). However, there was no significant difference in the mean score for food recommendations (P=0.108). Conclusion The teach-back training method (TBTM) is an effective communication strategy that enhances treatment adherence in haemodialysis patients. This intervention has the potential to improve patient outcomes and overall quality of life by simplifying medical information and encouraging patient engagement.
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Affiliation(s)
| | - Sonia Pazirofteh
- Department of medical-surgical nursing, School of Nursing and Midwifery
| | | | - Javad Rasouli
- Biostatistics. Urmia University of Medical Sciences, Urmia, Iran
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Marshall MR, Curd S, Kennedy J, Khatri D, Lee S, Pireva K, Taule’alo O, Tiavale-Moore P, Wolley MJ, Ma TM, Kam AL, Suh JS, Aspden TJ. Structural Equation Modelling to Identify Psychometric Determinants of Medication Adherence in a Survey of Kidney Dialysis Patients. Patient Prefer Adherence 2024; 18:855-878. [PMID: 38645697 PMCID: PMC11032681 DOI: 10.2147/ppa.s454248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Purpose Medication non-adherence in dialysis patients is associated with increased mortality and higher healthcare costs. We assessed whether medication adherence is influenced by specific psychometric constructs measuring beliefs about the necessity for medication and concerns about them. We also tested whether medication knowledge, health literacy, and illness perceptions influenced this relationship. Patients and Methods This study is based on data from a cross-sectional in-person questionnaire, administered to a random sample of all adult dialysis patients at a teaching hospital. The main outcome was self-assessed medication adherence (8-Item Morisky Medication Adherence Scale). The predictors were: concerns about medications and necessity for medication (Beliefs About Medication Questionnaire); health literacy; medication knowledge (Medication Knowledge Evaluation Tool); cognitive, emotional, and comprehensibility Illness perceptions (Brief Illness Perception Questionnaire). Path analysis was performed using structural equations in both covariance and variance-based models. Results Necessity for medication increased (standardized path coefficient [β] 0.30 [95% CI 0.05, 0.54]) and concerns about medication decreased (standardized β -0.33 [-0.57, -0.09]) medication adherence, explaining most of the variance in outcome (r2=0.95). Medication knowledge and cognitive illness perceptions had no effects on medication adherence, either directly or indirectly. Higher health literacy, greater illness comprehension, and a more positive emotional view of their illness had medium-to-large sized effects in increasing medication adherence. These were indirect rather and direct effects mediated by decreases in concerns about medications (standardized β respectively -0.40 [-0.63,-0.16], -0.60 [-0.85, -0.34], -0.33 [-0.52, -0.13]). Conclusion Interventions that reduce patients' concerns about their medications are likely to improve adherence, rather than interventions that increase patients' perceived necessity for medication. Improving patients' general health literacy and facilitating a better understanding and more positive perception of the illness can probably achieve this. Our study is potentially limited by a lack of generalizability outside of the population and setting in which it was conducted.
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Affiliation(s)
- Mark R Marshall
- School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Department of Medicine, Tauranga Hospital, Hauora a Toi Bay of Plenty, Tauranga, New Zealand
- Department of Renal Medicine, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
| | - Samantha Curd
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Julia Kennedy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Dharni Khatri
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sophia Lee
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Krenare Pireva
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Olita Taule’alo
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Porsche Tiavale-Moore
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Martin J Wolley
- Department of Renal Medicine, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
- Endocrine Hypertension Research Centre, University of Queensland Frazer Institute, Greenslopes and Princess Alexandra Hospitals, Brisbane, Queensland, Australia
- Department of Nephrology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
| | - Tian M Ma
- Department of Renal Medicine, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
- Institute for Innovation + Improvement, North Shore Hospital, Auckland, New Zealand
| | - Angela L Kam
- Department of Renal Medicine, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
- Barts Health NHS Trust, London, UK
| | - Jun S Suh
- Department of Renal Medicine, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
| | - Trudi J Aspden
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Yasin F, Khraim F, Santos M, Forgrave D, Hamad A. Factors influencing self-care management in adult hemodialysis patients: An integrative review. Qatar Med J 2024; 2024:12. [PMID: 38654818 PMCID: PMC11037095 DOI: 10.5339/qmj.2024.12] [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: 08/24/2023] [Accepted: 02/04/2024] [Indexed: 04/26/2024] Open
Abstract
Background: End-stage renal disease (ESRD) poses a significant health challenge, with hemodialysis (HD) being the most prevalent therapy. Patients undergoing HD must comply with a strict therapeutic regimen, including dietary control, fluid restriction, and medication adherence. Successful disease management and improved outcomes rely on patients' involvement and participation in their care. Aim: To identify the factors that hinder or facilitate self-care management (SCM) in HD patients. Methodology: This review followed Whittemore and Knafl's integrative review framework. A comprehensive literature search of articles published between 2017 and 2022 was conducted in CINAHL, Medline, and PubMed using the keywords end-stage renal disease, hemodialysis, self-care management, self-care, and self-management. This search yielded 21 suitable articles for review. Results: SCM is influenced by three main factors: facilitators, barriers, and outcomes. Facilitators of SCM include self-care management interventions, patient knowledge, socio-demographic factors, family support, healthcare professionals, peer support, and psychological factors. Barriers encompass psychological and physical conditions. Outcomes include both physiological and psychological aspects. Conclusion: Understanding the factors influencing SCM in HD patients is vital for developing reliable and effective self-care strategies and interventions to enhance both physical and psychological outcomes.
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Affiliation(s)
| | - Fadi Khraim
- Faculty of Nursing, Qatar University, Doha, Qatar
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Tesfaye W, Parrish N, Sud K, Grandinetti A, Castelino R. Medication Adherence Among Patients With Kidney Disease: An Umbrella Review. ADVANCES IN KIDNEY DISEASE AND HEALTH 2024; 31:68-83. [PMID: 38403396 DOI: 10.1053/j.akdh.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 02/27/2024]
Abstract
Chronic kidney disease (CKD) imposes a significant medication burden on patients due to the necessity of multiple treatments to slow disease progression, manage coexisting conditions, and address complications. The complex medication regimen, in turn, has implications for clinical and patient-centered outcomes. This umbrella review provides comprehensive evidence on extent of medication nonadherence among adults with CKD, as well as associated risk factors, outcomes, and the effectiveness of interventions by synthesizing evidence from published systematic reviews and/or meta-analyses. We identified 37 works that met our inclusion criteria. These reviews covered various aspects of treatment adherence in people with CKD, which can be categorized into four main themes: (i) prevalence of treatment nonadherence; (ii) factors associated with (non)adherent behaviors; (iii) outcomes associated with treatment (non)adherence; and (iv) interventions to improve treatment adherence or overall self-management practices. Approximately half of the included studies (15/34) focused on interventions aimed at improving medication adherence or overall CKD management, while outcomes associated with medication (non)adherence were relatively underexplored in the literature. The reported prevalence rates of medication nonadherence varied widely among reviews and stages of CKD. The determinants of adherence identified included socioeconomic variables, disease or clinical conditions, and psychosocial factors. Common interventions to improve adherence included nurse-led interventions, pharmaceutical services, and eHealth technologies, which had varying effects on medication adherence or dialysis sessions.
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Affiliation(s)
- Wubshet Tesfaye
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia.
| | | | - Kamal Sud
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Nepean Kidney Research Centre, Department of Renal Medicine, Nepean Hospital, Kingswood, New South Wales, Australia
| | - Amanda Grandinetti
- Population Health Partnership, National Kidney Foundation of Illinois, IL
| | - Ronald Castelino
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia; Pharmacy Department, Blacktown Hospital, Sydney, New South Wales, Australia
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Levin SR, Alonso A, Salazar ED, Farber A, Chitalia VC, King EG, Cheng TW, Siracuse JJ. Recent evaluation by nephrologists is associated with decreased incidence of tunneled dialysis catheter being used at the time of first arteriovenous access creation. J Vasc Surg 2024; 79:128-135. [PMID: 37742733 DOI: 10.1016/j.jvs.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/14/2023] [Accepted: 09/17/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE Late primary care provider (PCP) or nephrologist evaluation of patients with progressive kidney disease may be associated with increased morbidity and mortality. Among patients undergoing initial arteriovenous (AV) access creation, we aimed to study the relationship of recent PCP and nephrologist evaluations with perioperative morbidity and mortality. METHODS We performed a retrospective review of patients from 2014 to 2022 who underwent initial AV access creation at an urban, safety-net hospital. Univariable and multivariable analyses identified associations of PCP and nephrologist evaluations <1 year and <3 months before surgery, respectively, with hemodialysis initiation via tunneled dialysis catheters (TDCs), 90-day readmission, and 90-day mortality. RESULTS Among 558 patients receiving initial AV access, mean age was 59.7 ± 14 years, 59% were female gender, and 60.6% were Black race. Recent PCP and nephrology evaluations occurred in 386 (69%) and 362 (65%) patients, respectively. On multivariable analysis, unemployed and uninsured statuses were associated with decreased likelihood of PCP evaluation (unemployment: odds ratio [OR], 0.51; 95% confidence interval [CI], 0.34-0.77; uninsured status: OR, 0.05; 95% CI, 0.01-0.45) and nephrologist evaluation (unemployment: OR, 0.63; 95% CI, 0.43-0.91; uninsured status: OR, 0.22; 95% CI, 0.06-0.83) (all P < .05). Social support was associated with increased likelihood of PCP evaluation (OR, 1.81; 95% CI, 1.07-3.08) (all P < .05). Hemodialysis was initiated with TDCs in 304 patients (55%). Older age (OR, 0.98; 95% CI, 0.96-0.99), obesity (OR, 0.38; 95% CI, 0.25-0.58), and nephrologist evaluation (OR, 0.12; 95% CI, 0.08-0.19) were independently associated with decreased hemodialysis initiation with TDCs in patients receiving an initial AV access (all P < .05). Ninety-day readmission occurred in 270 cases (48%). Cirrhosis (OR, 2.5; 95% CI, 1.03-6.03; P = .04), coronary artery disease (OR, 2.31; 95% CI, 1.5-3.57), prosthetic AV access (OR, 1.84; 95% CI, 1.04-3.26), and impaired ambulation (OR, 1.75; 95% CI, 1.15-2.66) were independently associated with increased readmission (all P < .05). Older age (OR, 0.98; 95% CI, 0.97-0.99), prior TDC (OR, 0.65; 95% CI, 0.45-0.94), and unemployment (OR, 0.58; 95% CI, 0.39-0.86) were associated with decreased readmission (all P < .05). Ninety-day mortality occurred in 1.6% of patients. Neither PCP nor nephrologist evaluation was associated with readmission or mortality. CONCLUSIONS Recent nephrology evaluation was associated with reduced hemodialysis initiation with TDCs among patients undergoing initial AV access creation. Unemployed and uninsured statuses posed barriers to accessing nephrology care.
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Affiliation(s)
- Scott R Levin
- Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Andrea Alonso
- Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Eduardo D Salazar
- Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Alik Farber
- Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Vipul C Chitalia
- Renal Section, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA; Veterans Affairs Boston Healthcare System, Boston, MA; Institute of Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA
| | - Elizabeth G King
- Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Thomas W Cheng
- Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
| | - Jeffrey J Siracuse
- Division of Vascular and Endovascular Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
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Bradley N, Dowrick C, Lloyd-Williams M. Explaining how and why social support groups in hospice day services benefit palliative care patients, for whom, and in what circumstances. Palliat Care Soc Pract 2023; 17:26323524231214549. [PMID: 38044931 PMCID: PMC10693225 DOI: 10.1177/26323524231214549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023] Open
Abstract
Background Palliative care aims to provide holistic support for people with life-limiting illness, responding to psychological, social and spiritual needs, as well as to clinical and physical. In the United Kingdom, hospice day services (including day care, group interventions, group activities, and social events for palliative care outpatients) aim to provide opportunities for patients to gain social support, which is thought to improve their quality of life. Objectives This research explored social support within hospice day services, to explain in detail how and why social support obtained within a hospice day service could be beneficial to palliative care patients. Design Qualitative research using observations of hospice day services and interviews with service providers. Methods Data collection involved nineteen interviews with hospice service providers (n = 19) and researcher observations of hospice day services. The findings detail how patient and hospice context interact to produce mechanisms that lead to outcomes beyond the hospice day service. Results Practical, clinical and social aspects of the hospice day service are important for patients feeling welcome and safe in the setting. The opportunity to connect with other people and work towards personal goals can boost self-confidence for patients who have lost access to meaningful activity. New friendships between patients encourages reciprocal support and feelings of belonging. It is beneficial to have permission to speak freely about topics deemed inappropriate elsewhere, because honest communication is helpful in accepting and adapting to their circumstances. Conclusion Hospice day services facilitate group settings for reciprocal social support. This research proposes an initial programme theory that can be further developed and tested. It explains how and why, in some contexts, social support increases personal and practical resources to cope with illness and death, leading to changes outside of the hospice (to mood, interpersonal interactions and behaviour) that could improve quality of life.
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Affiliation(s)
- Natasha Bradley
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, BT7 1NN, UK
- Centre for Health & Clinical Research, University of the West of England (UWE), Bristol BS16 1DD, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Mari Lloyd-Williams
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
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Dinh TTH, Bonner A. Exploring the relationships between health literacy, social support, self-efficacy and self-management in adults with multiple chronic diseases. BMC Health Serv Res 2023; 23:923. [PMID: 37649013 PMCID: PMC10466814 DOI: 10.1186/s12913-023-09907-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/12/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Self-management in chronic diseases is essential to slowing disease progression and preventing complications. However, empirical research on the associations of critical factors, such as health literacy, social support, and self-efficacy with self-management in the context of multiple chronic diseases is scarce. This study aimed to investigate these associations and provides insights for healthcare providers to develop effective educational strategies for people with multiple chronic diseases. METHODS Using a cross-sectional survey design, adults (n = 600) diagnosed with at least two chronic diseases were conveniently recruited. To measure health literacy, social support, self-efficacy, and chronic disease self-management behaviours, the Health Literacy Questionnaire (HLQ), Medical Outcome Study - Social Support Survey, Self-efficacy in Managing Chronic Disease, and Self-management in Chronic Diseases instruments were utilized respectively. Comorbidity status was assessed using Age-adjusted Charlson Comorbidity Index (ACCI). A generalised linear regression model was used with a backward technique to identify variables associated with self-management. RESULTS Participants' mean age was 61 years (SD = 15.3), 46% were female, and most had up to 12 years of education (82.3%). Mean scores for HLQ domains 1-5 varied from 2.61 to 3.24 (possible score 1-4); domains 6-9 from 3.29 to 3.65 (possible score 1-5). The mean scores were 52.7 (SD = 10.4, possible score 0-95), 5.46 (SD = 1.9, possible score 0-10) and 82.1 (SD = 12.4, possible score 30-120) for social support, self-efficacy, and self-management, respectively. Mean ACCI was 6.7 (SD = 2.1). Eight factors (age > 65 years, being female, 4 health literacy domains, greater social support, and higher self-efficacy levels) were significantly associated with greater self-management behaviours while comorbidity status was not. The factors that showed the strongest associations with self-management were critical health literacy domains: appraisal of health information, social support for health, and healthcare provider support. CONCLUSIONS Developing critical health literacy abilities is a more effective way to enhance self-management behaviours than relying solely on self-confidence or social support, especially for people with multiple chronic diseases. By facilitating communication and patient education, healthcare providers can help patients improve their critical health literacy, which in turn can enhance their self-management behaviours.
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Affiliation(s)
- Thi Thuy Ha Dinh
- School of Nursing, University of Tasmania, Launceston, TAS, Australia.
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia.
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia
- Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia
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15
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Zhang X, Luo X, Xiao F, Xu W, Ma L, Yan J. The relationship between illness perceptions and fluid-control adherence among Chinese hemodialysis patients: a cross-sectional study. PSYCHOL HEALTH MED 2023; 28:1682-1697. [PMID: 37227800 DOI: 10.1080/13548506.2023.2216467] [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: 06/24/2022] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
Fluid-control adherence was important for hemodialysis (HD) patients, and while significant correlations between treatment adherence and illness perceptions have been found, there is limited research that explored the relationship between illness perceptions and fluid-control adherence. We sought to assess illness perceptions and fluid-control adherence and to explore the relationship between them among Chinese hemodialysis patients. A cross-sectional study of 253 Chinese HD patients was conducted. We recorded sociodemographic and disease characteristics, Revised Illness Perception Questionnaire (IPQ-R) responses, Fluid Control in Hemodialysis Patients Scale (FCHPS) scores and the interdialytic weight gain (IDWG). The total FCHPS score of hemodialysis patients was of a moderate level, and 45.85% hemodialysis patients' IDWG exceeded 3.0 kg. Regression analysis revealed that sex, academic level, marital status, treatment control dimension and causal (physical) factors of illness perceptions explained 12.7% variance in the total FCHPS score. Age, normalized whole-body urea clearance (Kt/V), dry weight (DW) residual urine volume (mL/24 h) and consequence dimension of illness perceptions explained 29.0% variance in IDWG. About mediating effect analysis, positive indirect effects on IDWG were found for identity, consequences and emotional representations through the attitude dimension of FCHPS, and negative indirect effects on IDWG were found for treatment control and illness coherence through the attitude dimension of FCHPS. The results demonstrated that some sociodemographic and clinical characteristics and illness perceptions were associated with fluid-control adherence, and the patient's attitude toward fluid control is an important mediator between illness perceptions and IDWG, implying that attitude can be a focus of intervention programs based on illness perceptions to improve Chinese HD patients' fluid-control adherence.
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Affiliation(s)
- Xiaomin Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xingying Luo
- Department of Multidisciplinary Team, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Feina Xiao
- Department of Health Management Center, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wenhua Xu
- Department of Nuclear Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Ling Ma
- Department of Multidisciplinary Team, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jun Yan
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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16
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Predictors of Self-Management Behaviors After Discharge Among Unplanned Dialysis Patients. THE JOURNAL OF NURSING RESEARCH : JNR 2023; 31:e267. [PMID: 36648373 DOI: 10.1097/jnr.0000000000000523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patients with unplanned dialysis must perform self-management behaviors to maintain their health in the community after discharge. Understanding the factors that predict the postdischarge self-management behaviors of patients with unplanned dialysis can assist nurses to implement appropriate discharge plans for this population. PURPOSE This study was designed to predict the effects of uncertainty in illness, self-care knowledge, and social-support-related needs during hospitalization on the self-management behaviors of patients with unplanned dialysis during their first 3 months after discharge from the hospital. METHODS One hundred sixty-nine patients with unplanned dialysis from the nephrology department of a medical center in Taiwan were enrolled in this prospective study using convenience sampling. At hospital admission, demographic, uncertainty in illness, self-care knowledge, and social support information was collected using a structured questionnaire. Information on self-management behavior was collected at 3 months postdischarge when the patients visited outpatient clinics. RESULTS Hierarchical multiple regression analyses showed that self-care knowledge, uncertainty in illness, and social support were important predictors of self-management behaviors at 3 months postdischarge, explaining 65.6% of the total variance in self-management behaviors. Social support increased the variance in self-management behaviors by 27.9%. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Comprehensive discharge planning to improve the postdischarge self-management behaviors of patients with unplanned dialysis should involve interventions to improve self-care knowledge, reduce uncertainty in illness, and increase social support. Building social support should be given priority attention.
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17
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Sousa H, Ribeiro O, Christensen AJ, Figueiredo D. Mapping Patients' Perceived Facilitators and Barriers to In-Center Hemodialysis Attendance to the Health Belief Model: Insights from a Qualitative Study. Int J Behav Med 2023; 30:97-107. [PMID: 35275346 DOI: 10.1007/s12529-022-10075-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous research has shown that deliberate withdrawal, skipping, and/or shortening hemodialysis sessions has become a major health problem associated with poor clinical outcomes and early mortality in patients with end-stage renal disease (ESRD). However, patients' experiences with this treatment remain largely unexplored. This study aimed to explore patients' perceived facilitators and barriers to in-center hemodialysis attendance and map these findings to the Health Belief Model. METHODS A qualitative exploratory study was conducted with a purposive sample. Semi-structured interviews were conducted and submitted to thematic analysis. RESULTS Twenty-four patients (66.2 ± 12.3 years old; length of time on hemodialysis: 35.2 ± 51.5 months) were interviewed. Five major facilitators (social support, perceived benefits, self-efficacy, time on dialysis, and risk/susceptibility perception) and two barriers (lack of knowledge about ESRD and hemodialysis, and psychosocial costs) were identified. CONCLUSION Adherence to the prescribed regimen of hemodialysis attendance is a complex and multidimensional phenomenon that involves an interaction between modifying factors (social support, disease and treatment knowledge, time on dialysis) and patients' perceived benefits, perceived risks, self-efficacy, and treatment costs. This study findings expand knowledge by suggesting that perceiving health benefits from the beginning of treatment, self-efficacy to deal with dialysis demands, and purpose in life are important facilitators of adherence to in-center hemodialysis sessions. Furthermore, it suggests that the impact of the hemodialysis regimen on the emotional well-being of family members is an important barrier. Future interventions should focus on skills training to promote self-efficacy and family coping with the demands of in-center hemodialysis, improve disease and treatment knowledge, and help balance perceived benefits with dialysis costs.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, Aveiro, 3810-193, Portugal.
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, Aveiro, 3810-193, Portugal
| | - Alan J Christensen
- Department of Psychology, East Carolina University, North Carolina, 27858, USA
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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18
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Dilas D, Flores R, Morales-García WC, Calizaya-Milla YE, Morales-García M, Sairitupa-Sanchez L, Saintila J. Social Support, Quality of Care, and Patient Adherence to Tuberculosis Treatment in Peru: The Mediating Role of Nurse Health Education. Patient Prefer Adherence 2023; 17:175-186. [PMID: 36704124 PMCID: PMC9871033 DOI: 10.2147/ppa.s391930] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Peru is one of the countries with the highest burden of tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) in the Latin American region and globally. Health education provided by nurses reinforces social support and the quality of patient care allows a greater impact on adherence to TB treatment. PURPOSE This study evaluated the mediating effect of treatment education between social support, quality of care, and treatment adherence in TB patients. METHODS A cross-sectional study was carried out considering 162 adult TB patients from four health centers of the public sector located in the center of the city of Lima, Peru. Data were collected on variables, such as social support, quality of care, health education, and adherence to TB treatment. SmartPLS was used for data analysis. RESULTS The results showed that social support and quality of care significantly influence health education. Likewise, health education mediates social support and quality of care for better adherence to treatment. CONCLUSION It is recommended that hospitals take initiatives to provide better health education on TB treatment to ensure better adherence to treatment.
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Affiliation(s)
- Delker Dilas
- Unit of Public Health, Postgraduate School, Peruvian Union University, Lima, Perú
| | - Rosarias Flores
- Unit of Public Health, Postgraduate School, Peruvian Union University, Lima, Perú
| | - Wilter C Morales-García
- Unit of Public Health, Postgraduate School, Peruvian Union University, Lima, Perú
- Correspondence: Wilter C Morales-García, Unit of Public Health, Postgraduate School, Peruvian Union University, Km 19, Carretera Central, Lima, 15033, Perú, Email
| | | | | | | | - Jacksaint Saintila
- School of Medicine, Señor de Sipán University, Chiclayo, Perú
- Jacksaint Saintila, School of Medicine, Señor de Sipán University, Km 5, Carretera a Pimentel, Chiclayo, 14001, Lambayeque, Perú, Email
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Mbeje PN. Factors affecting the quality of life for patients with end-stage renal disease on dialysis in KwaZulu-Natal province, South Africa: A descriptive survey. Health SA 2022; 27:1932. [PMID: 36570086 PMCID: PMC9772709 DOI: 10.4102/hsag.v27i0.1932] [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: 02/02/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background End-stage renal disease (ESRD) is a world-wide public health problem that requires renal replacement therapy in the form of dialysis. Although dialysis prolongs the patients' lifespan, it is not necessarily associated with an improved quality of life (QoL). Aim To determine the factors affecting the QoL of patients with ESRD on dialysis. Setting The study was conducted in three public sector hospitals in the province of KwaZulu-Natal. Methods A convenience sample of 316 participants was used. The World Health Organization - QoL Biomedical Research and Education Foundation (WHOQOL-BREF) instrument was used and adapted to include economic factors. Data were analysed using descriptive and inferential statistics. Results Majority had poor QoL through economic (98.1%), psychological (94.6%), physical (70.3%), and social factors (55.1%). Factors affecting their QoL were influenced by the type of dialysis, and statistical significances were noted in psychological and social factors (p < 0.0001), with those on peritoneal dialysis being affected the most. Overall, majority of patients (91.7%, n = 288) had a score of less than 50, which indicated poor QoL. Conclusion Poor QoL is associated with increased risk of mortality and hospitalisation in patients with ESRD and is mainly influenced by a broad range of dimensions of life. Contribution In addressing challenges encountered by patients, study findings may influence the policymakers to intervene in view of all the dimensions of QoL, to prolong life.
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Affiliation(s)
- Pretty N. Mbeje
- School of Nursing and Public Health, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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20
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Mirzadeh SI, Arefeen A, Ardo J, Fallahzadeh R, Minor B, Lee JA, Hildebrand JA, Cook D, Ghasemzadeh H, Evangelista LS. Use of machine learning to predict medication adherence in individuals at risk for atherosclerotic cardiovascular disease. SMART HEALTH (AMSTERDAM, NETHERLANDS) 2022; 26:100328. [PMID: 37169026 PMCID: PMC10168531 DOI: 10.1016/j.smhl.2022.100328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background Medication nonadherence is a critical problem with severe implications in individuals at risk for atherosclerotic cardiovascular disease. Many studies have attempted to predict medication adherence in this population, but few, if any, have been effective in prediction, sug-gesting that essential risk factors remain unidentified. Objective This study's objective was to (1) establish an accurate prediction model of medi-cation adherence in individuals at risk for atherosclerotic cardiovascular disease and (2) identify significant contributing factors to the predictive accuracy of medication adherence. In particular, we aimed to use only the baseline questionnaire data to assess medication adherence prediction feasibility. Methods A sample of 40 individuals at risk for atherosclerotic cardiovascular disease was recruited for an eight-week feasibility study. After collecting baseline data, we recorded data from a pillbox that sent events to a cloud-based server. Health measures and medication use events were analyzed using machine learning algorithms to identify variables that best predict medication adherence. Results Our adherence prediction model, based on only the ten most relevant variables, achieved an average error rate of 12.9%. Medication adherence was closely correlated with being encouraged to play an active role in their treatment, having confidence about what to do in an emergency, knowledge about their medications, and having a special person in their life. Conclusions Our results showed the significance of clinical and psychosocial factors for predicting medication adherence in people at risk for atherosclerotic cardiovascular diseases. Clini-cians and researchers can use these factors to stratify individuals to make evidence-based decisions to reduce the risks.
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Affiliation(s)
- Seyed Iman Mirzadeh
- School of Electrical Engineering & Computer Science, Washington State University, Pullman, WA, 99163, USA
| | - Asiful Arefeen
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
- Corresponding author: (A. Arefeen)
| | - Jessica Ardo
- Sue & Bill Gross School of Nursing University of California Irvine, Irvine, CA, 92697, USA
| | - Ramin Fallahzadeh
- Department of Biomedical Data Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Bryan Minor
- School of Electrical Engineering & Computer Science, Washington State University, Pullman, WA, 99163, USA
| | - Jung-Ah Lee
- Sue & Bill Gross School of Nursing University of California Irvine, Irvine, CA, 92697, USA
| | - Janett A. Hildebrand
- Department of Nursing at the School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA
| | - Diane Cook
- School of Electrical Engineering & Computer Science, Washington State University, Pullman, WA, 99163, USA
| | - Hassan Ghasemzadeh
- College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
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21
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O'Hara DV, Yi TW, Lee VW, Jardine M, Dawson J. Digital health technologies to support medication adherence in chronic kidney disease. Nephrology (Carlton) 2022; 27:917-924. [PMID: 36176176 PMCID: PMC9828762 DOI: 10.1111/nep.14113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/24/2022] [Accepted: 09/17/2022] [Indexed: 01/12/2023]
Abstract
Non-adherence to medications is a critical challenge in the management of people with chronic kidney disease (CKD). This review explores the complexities of adherence in this population, the unique barriers and enablers of good adherence behaviours, and the role of emerging digital health technologies in bridging the gap between evidence-based treatment plans and the real-world standard of care. We present the current evidence supporting the use of digital health interventions among CKD populations, identifying the key research questions that remain unanswered, and providing practical strategies for clinicians to support medication adherence in a digital age.
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Affiliation(s)
- Daniel V. O'Hara
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Renal MedicineRoyal North Shore HospitalSydneyNew South WalesAustralia
| | - Tae Won Yi
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia,Department of Medicine, Clinician Investigator ProgramUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Vincent W. Lee
- Department of Renal MedicineWestmead HospitalSydneyNew South WalesAustralia,Westmead Applied Research Centre, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Meg Jardine
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Renal MedicineConcord Repatriation General HospitalSydneyNew South WalesAustralia
| | - Jessica Dawson
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Nutrition and DieteticsSt George HospitalSydneyNew South WalesAustralia
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Senteio CR, Ackerman MK. Count Me Out: Perceptions of Black Patients Who are on Dialysis but Who are Not on a Transplant Waitlist. HEALTH COMMUNICATION 2022; 37:1167-1179. [PMID: 34320893 DOI: 10.1080/10410236.2021.1940017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
End-stage renal disease (ESRD) is characterized by racial inequity; Blacks are 3 times more likely to develop ESRD than Whites. Transplant is the preferred treatment option since transplanted patients experience better clinical outcomes. Racial inequities persist at each of the steps required for transplantation. Despite the vast literature describing these racial inequities, it does not include dialysis patients' awareness and understanding of treatment options, specifically for transplant. To address this gap, we purposely sampled Blacks in Detroit who were receiving dialysis and who were not active on any transplant waitlist to investigate their understanding and perceptions of transplants. We used uncertainty management theory (UMT) to better understand perceived barriers to getting and remaining on a transplant waitlist. We aimed to address a critical gap in the literature to inform approaches addressing this enduring inequity. For this qualitative study, we conducted individual, semi-structured interviews with 24 Black ESRD patients, aged 34-73 years: 9 male and 15 female. Participants shared their experiences of being on dialysis, perceptions, and understanding of transplants. We describe two key findings: 1) uncertainty for these patients is prevalent and multi-layered and 2) social support can both dissuade an individual from pursuing transplant (i.e., reluctance to ask family members to be donors) and it can result in decreasing uncertainty (e.g., participants wanting to pursue transplant to be with family). We highlight the specific need to improve patient education regarding treatment options and enhancing how relevant health information can be communicated.
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Idilbi N, Grimberg Z, Drach-Zahavy A. Haemodialysis patient's adherence to treatment: Relationships among nurse-patient-initiated participation and nurse's attitude towards patient participation. J Clin Nurs 2022. [PMID: 35854651 DOI: 10.1111/jocn.16449] [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: 02/07/2022] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the relationship between nurse-patient-initiated participation, nurses' attitudes towards patient's participation, and patients' adherence to treatment. Specifically, to (1) explore nurse-patient participation during haemodialysis and quantify the information into measurable indices; (2) determine the haemodialysis patient's adherence to treatment; (3) describe nurses' attitudes towards patient participation; and (4) establish the relationships between nurse-patient-initiated participation, nurses' attitudes towards patient participation and patients' adherence to treatment. BACKGROUND To improve haemodialysis patients' health, it is crucial to identify nurses' and patients' factors facilitating adherence to treatment. DESIGN An exploratory-sequential mixed-methods (quantitative and qualitative) design. METHODS All nurses working at a dialysis ward (n = 30) and their randomly selected patients (n = 102) participated. Qualitative data on nurse-patient-initiated participation were derived from transcribed nurse-patient conversations and quantified for further analyses. Nurses' attitudes towards patient participation were collected via questionnaire, and adherence to treatment via observed reduction in prescribed haemodialysis time. [CONSORT-SPI guidelines]. RESULTS Content analysis of the conversations indicated that nurse-initiated participation focused on patient's medical condition, treatment plan and education; while patients initiated more small talk. Non-adherence to treatment was significant (Mean = 0.19 h; SD = 0.33). Regression analyses indicated that nurses' attitude towards participation was negatively linked to patient adherence, while patient-nurse-initiated participation was unrelated. Nurses' attitudes towards patient participation moderated the relationship between nurse-patient-initiated participation and patient adherence: the more positive the attitude towards inclusion the more negative the link between patient or nurse-initiated participation and patient adherence. CONCLUSIONS The findings provided paradoxical insights: Nurses' positive attitudes towards participation lead them to accept the patient's position for shortening haemodialysis treatment, so that adherence to care decreases. RELEVANCE TO CLINICAL PRACTICE Nurses require education on negotiating methods to help achieve patient adherence while respecting the patient's opinion. Patients should be educated how to approach nurses, seeking the information they need.
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Affiliation(s)
- Nasra Idilbi
- Department of Nursing, Max Stern Yezreel Valley College, Emek Yezreel, Israel.,Galilee Medical Center, Nahariya, Israel
| | - Zoya Grimberg
- Galilee Medical Center, Nahariya, Israel.,University of Haifa, Haifa, Israel
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24
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Lee AR. Review article: Dietary management of coeliac disease. Aliment Pharmacol Ther 2022; 56 Suppl 1:S38-S48. [PMID: 35815831 DOI: 10.1111/apt.16974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/23/2021] [Accepted: 05/03/2022] [Indexed: 12/09/2022]
Abstract
As the gluten-free diet is currently the only treatment for coeliac disease and one that needs to applied in the long term, this review aims to explore the various issues confronting an individual and discuss the importance of ongoing dietary management. The process of dietary counselling has shifted from one that focuses on just foods to avoid to one that evaluates the multiple life factors (social, cultural, environmental, biological) that affect the individual's food choices and dietary behaviour. The nutritional quality of a gluten-free diet continues to affect vitamin, mineral and weight status of individuals with coeliac disease. There are many barriers to dietary adherence including increased cost and limited availability of gluten-free products, as well as the negative impact on an individual's social domain of quality of life. Therefore, assessment, education and counselling by a coeliac specialist dietitian should be the cornerstone of dietary management.
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Affiliation(s)
- Anne R Lee
- Celiac Disease Center, Columbia University Irving Medical Center, New York City, New York, USA
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Yin H, Jiang C, Shi X, Chen Y, Yu X, Wang Y, Li W, Ma H, Geng Q. Job Burnout Is Associated With Prehospital Decision Delay: An Internet-Based Survey in China. Front Psychol 2022; 13:762406. [PMID: 35496161 PMCID: PMC9045849 DOI: 10.3389/fpsyg.2022.762406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background Prehospital delay is associated with non-modifiable factors such as age, residential region, and disease severity. However, the impact of psychosocial factors especially for job burnout on prehospital decision delay is still little understood. Method This internet-based survey was conducted between 14 February 2021 and 5 March 2021 in China through the Wechat platform and web page. Self-designed questionnaires about the expected and actual length of prehospital decision time and the Chinese version of Maslach Burnout Inventory-General Survey, Type D Personality Scale-14, and Social Support Rating Scale were applied. A total of 1,039 general participants with a history of perceptible but tolerable body discomfort were included. Results The top six reasons for prehospital decision delay were: (1) endure until self-healing (50.7%), (2) too busy to ask for leave (40.3%), (3) process for seeing a doctor too complicated (35.8%), (4) too tired after work (26.2%), (5) worry about the expenditure (16.6%), and (6) fear of being identified as with serious problem (14.5%). The univariate analyses revealed that older age (p = 0.001), type D personality (p = 0.025), job burnout (p = 0.055), and worrying about expenditure (p = 0.004) were associated with prolonged prehospital decision time, while engaged in medical-related job (p = 0.028) and with more social support (p = 0.066) would shorten the delay. The multivariate analysis using logistic regression model with forward selecting method showed that age [per 10 years, odds ratio (OR) 1.19 (1.09–1.31), p < 0.001], job burnout [per 10 points in Maslach Burnout Inventory-General Survey (MBI-GS), OR 1.17 (1.04–1.31), p = 0.007], and worrying about expenditure [OR 1.75 (1.25–2.47), p = 0.001] were the three determinants for prehospital decision delay (>7 days). Mediating effects were analyzed by using bias-corrected percentile bootstrap methods (N = 10,000). Social support was found partially mediated the relationship between the determinants and prehospital decision time. The partial mediating effect of social support accounted for 24.0% of the total effect for job burnout and 11.6% for worrying about expenditure. Conclusion Psychosocial factors have a non-negligible impact on prehospital decision delay. The crucial part of prehospital decision delay may be the lack of motivation inside. Job burnout and lack of social support, as two commonly seen features in the modern world, should be given enough consideration in disease prevention and treatment.
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Affiliation(s)
- Han Yin
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Cheng Jiang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaohe Shi
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yilin Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
| | - Xueju Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu Wang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Weiya Li
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Huan Ma
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Cardiac Rehabilitation, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Qingshan Geng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,School of Medicine, South China University of Technology, Guangzhou, China
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Liu Y, Mao A. Exploring the Meaning in Life and the Influencing Factors among Patients Undergoing Hemodialysis in Macau. SAGE Open Nurs 2022; 8:23779608221092170. [PMID: 35434306 PMCID: PMC9008827 DOI: 10.1177/23779608221092170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/28/2022] [Accepted: 03/11/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction The meaning in life (ML) is a significant predictor of the physical and
mental health of patients with chronic diseases, and its construct is
culturally specific.As a group between normal people and the patients with
advanced cancer, patients with End-Stage Kidney Disease (ESKD) who are
undergoing hemodialysis (HD) are often outside of research focus on ML. Objectives This study was to investigate the status of ML of patients on HD in Macau of
China and to analyze the influence of social-demographic characteristics and
disease-related factors on their ML. The study findings would inform the
development of evidence-based interventions in nursing care for this patient
population. Methods This study employed a cross-sectional survey design. Eligible participants
were recruited by convenient sampling from the largest HD center in Macau in
January 2020. The participants’ social-demographic and disease-related
characteristics were collected, and their ML status was assessed by the
Meaning in Life Scale for Hemodialysis Patients (MLSHP). SPSS 22.0 software
was used to analyze the data. Results Questionnaires were distributed to 249 potential participants who were
patients on HD, and 238 patients replied to the questionnaires effectively.
The effective response rate was 95.58% (238/249). The average score of ML
for the patients was 93.75 ± 10.00, which was 72% of the total score of 130
on the ML scale. Gender, religious belief, duration of dialysis treatment,
and symptom-related distress had impacts on ML levels
(p < .05), with religious belief being a particularly
strong predictor (p < .001). Conclusion The level of ML for patients on HD in Macau is relatively high. Different
demographic or disease-related factors impact participants’ ML, supporting
or contradicting previous studies. While the study findings are meaningful
under the local cultural contexts, they have implications for nurses in
other places to develop evidence-based interventions for patients on HD.
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Affiliation(s)
- Yuanyi Liu
- Kiang Wu Nursing College of Macau, Macau, China
- Kiang Wu Hospital, Macau, China
| | - Aimei Mao
- Kiang Wu Nursing College of Macau, Macau, China
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Faisal S, Ivo J, Tennant R, Prior KA, Grindrod K, McMillan C, Patel T. Integration of a smart multidose blister package for medication intake: A mixed method ethnographic informed study of older adults with chronic diseases. PLoS One 2022; 17:e0262012. [PMID: 35061773 PMCID: PMC8782488 DOI: 10.1371/journal.pone.0262012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/15/2021] [Indexed: 11/18/2022] Open
Abstract
Smart adherence products are marketed to assist with medication management. However, little is known about their in-home integration by older adults. It is necessary to investigate the facilitators and barriers older adults face when integrating these products into their medication taking routines before effectiveness can be examined. The aim of this study was to (a) examine the integration of a smart multidose blister package and (b) understand medication intake behaviour of adults with chronic diseases using an integrated theoretical model comprised of the Technology Acceptance Model (TAM), Theory of Planned Behaviour (TPB) and Capacity, Opportunity, Motivation and Behaviour (COM-B) Model. An ethnographic-informed study was conducted with older adults using the smart multidose blister package to manage their medications for eight weeks. Data was collected quantitatively and qualitatively using in-home observations, photo-elicitation, field notes, semi-structured interviews, system usability scale (SUS) and net promoter scale (NPS). The interview guide was developed with constructs from the TAM, TPB and COM-B Model. Data were analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL) framework to generate themes and sub-themes which were mapped back to TAM, TBP and COM-B Model. Ten older adults with an average age of 76 years, of which 80% were female, participated in the study. On average, participants reported five medical conditions, while the average number of medications was 11.1. The mean SUS was 75.50 and overall NPS score was 0. Qualitative analysis identified three themes; (1) factors influencing medication intake behaviour (2) facilitators to the product use and, (3) barriers to the product use. The smart blister package was found to be easy to use and acceptable by older adults. Clinicians should assess an older adult’s medication intake behavior as well as barriers and facilitators to product use prior to recommending an adherence product for managing medications.
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Affiliation(s)
- Sadaf Faisal
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Jessica Ivo
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Ryan Tennant
- Faculty of Engineering, Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Kelsey-Ann Prior
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Colleen McMillan
- Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
- Renison University College, University of Waterloo, Waterloo, Ontario, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
- Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
- Schlegel–University of Waterloo Research Institute of Aging, Waterloo, Ontario, Canada
- * E-mail:
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28
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Rao Q, Zeng J, Wang S, Hao J, Jiang M. Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study. J Pain Res 2022; 15:147-157. [PMID: 35082527 PMCID: PMC8784256 DOI: 10.2147/jpr.s345610] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/23/2021] [Indexed: 01/02/2023] Open
Abstract
Purpose Patients undergoing maintenance hemodialysis (MHD) frequently experience chronic pain, which can severely affect their quality of life (QOL). The objective of this study was to evaluate the prevalence of chronic pain in MHD patients and examine the factors associated with QOL. Patients and Methods A cross-sectional questionnaire-based survey was conducted between October 2020 and April 2021, 1204 MHD patients from nine hemodialysis units were screened for chronic pain in Chengdu, China, and 296 MHD patients with chronic pain were enrolled in this study. We analyzed data on clinicodemographic characteristics, pain interference and severity (Brief Pain Inventory), QOL (Medical Outcomes Study 36-item Short Form Health Survey - mental component summary [MCS] and physical component summary [PCS]), pain self-efficacy (Pain Self-Efficacy Questionnaire), and social support (Social Support Rating Scale). Results The prevalence of chronic pain in MHD patients was 26.74% in this study. The most common areas of pain were lower back (63.5%), lower limbs (55.0%), and head (33.5%), 36.5% did not implement any measures to relieve it. Of the patients who did receive pain treatment or medication, 56.9% reported that the measures they took had less than half of the pain relief. MHD patients with chronic pain had poor QOL based on scores on the MCS (53 ± 16.76) and PCS (40.56 ± 13.81). Stepwise multiple regression identified age, financial strain, pain interference, social support, and pain self-efficacy as independent predictors of QOL. Pain self-efficacy was significantly associated with social support (r = 0.5, p < 0.01), MCS (r = 0.69, p < 0.01), and PCS (r = 0.8, p < 0.01). The mediating effects of pain self-efficacy were 70.31% on the relationship between social support and MCS, and 75.62% on the relationship between social support and PCS. Conclusion Chronic pain is prevalent and undermanaged in Chinese MHD patients, resulting in worse QOL. Healthcare providers should focus on pain management and the impact of psychosocial factors on patient QOL. Further research should deepen our understanding of how pain self-efficacy mediates the relationship between social support and QOL.
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Affiliation(s)
- Qian Rao
- School of Nursing, Chengdu Medical College, Chengdu, People’s Republic of China
| | - Jing Zeng
- School of Nursing, Chengdu Medical College, Chengdu, People’s Republic of China
- Correspondence: Jing Zeng School of Nursing, Chengdu Medical College, No. 601 Tianhui Road, Rongdu Avenue, Chengdu, 610083, People’s Republic of ChinaTel +0086-28-62308666 Email
| | - Shaoqing Wang
- Department of Nephrology, The Second Affiliated Hospital of Chengdu Medical College, Chengdu, People’s Republic of China
| | - Jue Hao
- School of Nursing, Chengdu Medical College, Chengdu, People’s Republic of China
| | - Menglin Jiang
- School of Nursing, Chengdu Medical College, Chengdu, People’s Republic of China
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29
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Marinho CLA, Gomes OV, da Silva GB, Schwingel PA. Smartphone and application use in self-management of chronic kidney disease: a cross-sectional feasibility study. SAO PAULO MED J 2022; 141:e202278. [PMID: 36197350 PMCID: PMC10065095 DOI: 10.1590/1516-3180.2022.0078.r2.09082022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Smartphone and application use can improve communication and monitoring of chronic diseases, including chronic kidney disease, through self-management and increased adherence to treatment. OBJECTIVE To assess smartphone use in patients with chronic kidney disease on dialysis and their willingness to use mobile applications as a disease self-management strategy. DESIGN AND SETTING This was a cross-sectional study of chronic kidney disease patients on hemodialysis in the São Francisco Valley in the Northeast Region, Brazil. METHODS The questionnaire developed by the authors was administered between April and June 2021. Cronbach's alpha coefficient for the construct was 0.69. Associations between the dependent and independent variables were determined using univariate analysis. Multivariate analysis with logistic regression analysis was also performed. RESULTS A total of 381 patients were included, of whom 64% had a smartphone, although only 3.1% knew of a kidney disease-related application. However, 59.3% believed that using an application could help them manage their disease. Having a smartphone was associated with treatment adherence, higher educational attainment, and higher per capita income. Educational attainment remained an independent factor in multivariate analysis. CONCLUSION More than 64% of patients had a smartphone, although few knew of applications developed for kidney disease. More than half of the population believed that technology use could benefit chronic kidney disease treatment. Smartphone ownership was more common among the younger population, with higher educational attainment and income, and was associated with greater adherence to hemodialysis sessions.
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Affiliation(s)
| | - Orlando Vieira Gomes
- MD, MSc. Nephrologist and Assistant Professor, School of
Medicine, Universidade Federal do Vale do São Francisco (UNIVASF), Petrolina
(PE), Brazil
| | - Geraldo Bezerra da Silva
- MD, PhD. Physician and Professor, Department of Internal
Medicine, School of Medicine, Universidade Federal do Ceará (UFC), and School of
Medicine, Public Health and Medical Sciences Graduate Programs, Universidade de
Fortaleza (UNIFOR), Fortaleza (CE), Brazil
| | - Paulo Adriano Schwingel
- PhD. Sports Physiologist and Associate Professor, Human
Performance Research Laboratory, Universidade de Pernambuco (UPE), Petrolina
(PE), Brazil
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30
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Hwang W, Lee JH, Nam J, Oh J, Park I, Cho MS. Self-care Through Dynamic Appetite Alteration: A Grounded Theory Study of Patient Experience on Maintenance Hemodialysis. Clin Nutr Res 2022; 11:264-276. [DOI: 10.7762/cnr.2022.11.4.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Wonsun Hwang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Ji-hyun Lee
- Food Services & Clinical Nutrition Team, Ajou University, Suwon 16499, Korea
| | - Juha Nam
- Dietary Department, Union Plaza Care Center, New York, NY 11354, USA
| | - Jieun Oh
- College of Science and Industry Convergence, Ewha Womans University, Seoul 03760, Korea
| | - Inwhee Park
- Department of Nephrology, Ajou University School of Medicine, Suwon 16499, Korea
| | - Mi Sook Cho
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
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Vijay VR, Kang HK. The worldwide prevalence of non-adherence to diet and fluid restrictions among hemodialysis patients: A systematic review and meta-analysis. J Ren Nutr 2021; 32:658-669. [PMID: 34923113 DOI: 10.1053/j.jrn.2021.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/16/2021] [Accepted: 11/28/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Non-adherence to diet and fluid restrictions in hemodialysis (HD) patients can lead to undesired health outcomes. This systematic review and meta-analysis aim to estimate the pooled prevalence of non-adherence to diet and fluid restrictions in HD patients. METHODS Research papers from PubMed, CINAHL, and Google Scholar on non-adherence to diet and fluid restrictions in HD patients published between 2000 and 2020 were selected for this study. The methodological quality of each study was graded, and the estimates were pooled using the random-effects model of meta-analysis. Analyses of subgroups and meta-regression were carried out. Egger's test and visual analysis of the symmetry of funnel plots were used to assess the publication bias. RESULTS Eight hundred sixty-eight potential records were identified during the search. Twenty-three studies that met inclusion criteria were considered for meta-analysis and comprised 11,209 HD patients (mean age 55.85 years± SD 6.86, males 57.74%). The estimated worldwide prevalence of non-adherence to diet and fluid restrictions was 60.2% (95% CI: 47.3- 72.5) and 60.6% (95% CI: 50- 70.7), respectively. The meta-regression found that the income category was negatively, and the risk of bias score was positively associated with the prevalence of non-adherence to fluid restrictions (p<0.05). The funnel plot of studies included pooling the prevalence of non-adherence to fluid restrictions revealed asymmetry, and a significant publication bias was also noted as assessed by Egger's test (P = 0.004). However, the pooled estimate should be interpreted with caution because the prevalence of individual studies varies considerably due to methodological or measurement discrepancies. CONCLUSION The pooled prevalence of non-adherence to diet (47.3 - 72.5%) and fluid (50 - 70.7%) restrictions were substantially high. The health care team must recognize the factors and barriers influencing adherence behavior and develop holistic interventions to improve it.
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Affiliation(s)
- V R Vijay
- Tutor, College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Harmeet Kaur Kang
- Professor cum Principal, Chitkara School Of Health Sciences,Chitkara University, Punjab, India
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Sousa H, Ribeiro O, Paúl C, Costa E, Frontini R, Miranda V, Oliveira J, Ribeiro F, Figueiredo D. "Together We Stand": A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers. Healthcare (Basel) 2021; 9:healthcare9111585. [PMID: 34828630 PMCID: PMC8624118 DOI: 10.3390/healthcare9111585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 12/03/2022] Open
Abstract
This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre–post pilot study, delivered in a multifamily group format. Feasibility was based on screening, eligibility, content, retention, completion, and intervention adherence rates. Acceptability was assessed at post-intervention through a focus group interview. Self-reported anxiety and depression and patients’ inter-dialytic weight gain (IDWG) were also measured. The screening (93.5%), retention (85.7%), and completion (100%) rates were satisfactory, whereas eligibility (22.8%), consent (18.4%), and intervention adherence (range: 16.7–50%) rates were the most critical. Findings showed that participants appreciated the intervention and perceived several educational and emotional benefits. The results from the Wilcoxon Signed-Rank Test showed that a significant decrease in anxiety symptoms (p = 0.025, r = 0.646) was found, which was followed by medium to large within-group effect sizes for changes in depression symptoms (p = 0.261, r = 0.325) and patients’ IDWG (p = 0.248, r = 0.472), respectively. Overall, the results indicated that this family-based psychoeducational intervention is likely to be feasible, acceptable, and effective for patients undergoing HD and their family caregivers; nonetheless, further considerations are needed on how to make the intervention more practical and easily implemented in routine dialysis care before proceeding to large-scale trials.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal; (H.S.); (O.R.); (J.O.)
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal; (H.S.); (O.R.); (J.O.)
| | - Constança Paúl
- Center for Health Technology and Services Research (CINTESIS.UA), Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal;
| | - Elísio Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO—REQUIMTE), Faculty of Pharmacy, University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal;
| | - Roberta Frontini
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria, 2410-541 Leiria, Portugal;
| | | | - Jaime Oliveira
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal; (H.S.); (O.R.); (J.O.)
| | - Fernando Ribeiro
- Campus Universitário de Santiago, Institute for Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), Campus Universitário de Santiago, School of Health Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence:
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Bielopolski D, Wenziger C, Steinmetz T, Rozen Zvi B, Kalantar-Zadeh K, Streja E. Novel Protein to Phosphorous Ratio Score Predicts Mortality in Hemodialysis Patients. J Ren Nutr 2021; 32:450-457. [PMID: 34740537 DOI: 10.1053/j.jrn.2021.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/19/2021] [Accepted: 08/10/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Lowering serum phosphorus in people on hemodialysis may improve their survival. However, prior studies have shown that restricting dietary protein intake, a major source of phosphorus, is associated with higher mortality. We hypothesized that a novel metric that incorporates both these values commensurately can improve survival prediction. METHODS We used serum phosphorous and normalized protein catabolic rate (nPCR), a surrogate of dietary protein intake, to form a new metric R that was used to examine the associations with mortality in 63,016 people on hemodialysis (HD) of one year after treatment initiation. Survival models were adjusted for case-mix, malnutrition-inflammation cachexia syndrome (MICS), and residual kidney function (RKF). RESULTS Individuals treated with hemodialysis were divided into five groups in accordance with R value. Group 1 included sick individuals with high phosphorous and low nPCR. Group 5 included individuals with low phosphorous and high nPCR. After 1-year follow-up, survival difference between the groups reflected R value, where an increase in R was associated with improved survival. The association of R with mortality was strengthened by adjustment in demographic variables and attenuated after adjustment to MICS. Mortality associations in accordance with R were not influenced by residual kidney function (RKF). CONCLUSION The novel protein to phosphorus ratio score R predicts mortality in people on dialysis, probably reflecting both nutrition and inflammation state independent of RKF. The metric enables better phosphorus monitoring, although adequate dietary protein intake is ensured and may improve the prediction of outcomes in the clinical setting.
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Affiliation(s)
- Dana Bielopolski
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, School of Medicine, Irvine, CA; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Nephrology Institute, Rabin Medical Center, Petah Tiqva, Israel.
| | - Cachet Wenziger
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, School of Medicine, Irvine, CA
| | - Tali Steinmetz
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Nephrology Institute, Rabin Medical Center, Petah Tiqva, Israel
| | - Benaya Rozen Zvi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Nephrology Institute, Rabin Medical Center, Petah Tiqva, Israel
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, School of Medicine, Irvine, CA
| | - Elani Streja
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, School of Medicine, Irvine, CA
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The Association between Social Support and Cognitive Impairment among the Urban Elderly in Jinan, China. Healthcare (Basel) 2021; 9:healthcare9111443. [PMID: 34828488 PMCID: PMC8625136 DOI: 10.3390/healthcare9111443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/16/2022] Open
Abstract
China is currently facing a severe challenge of population ageing. However, no study has specifically explored the association between social support and cognitive impairment in Chinese urban elderly aged 60 and older. We explored the prevalence of cognitive impairment and its relationship with social support among the urban elderly aged above 60 years in Jinan, China. A total of 522 urban elderly individuals were recruited using multi-stage cluster random sampling, of which 35.55% were males and 64.45% were females. The average age of all participants was 69.66 ± 8.91 years old. Social support was assessed using the Social Support Rating Scale. Cognitive status was assessed using the Mini-Mental State Examination. Data were collected through face-to-face interviews using structured questionnaires. Descriptive analysis, chi-square tests, and logistic regression analyses were conducted. After analysing the data from 512 participants, 154 (30.1%), 352 (68.8%), and 6 (1.2%) participants had high, moderate, and low levels of social support, respectively. In addition, 125 participants (24.4%) had a cognitive impairment, while the other 387 participants (75.6%) had a normal cognitive status. Binary logistic regression analyses showed that age, educational level, occupation or pre-retirement occupation, and social support were statistically associated with cognitive impairment. A significant association between social support and cognitive impairment was found among the urban elderly in Jinan, China, which provided useful information for the intervention of cognitive impairment. More attention should be paid to the social support of the urban elderly to effectively reduce the occurrence of cognitive impairment.
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Psychological Backgrounds of Medically Compromised Patients and Its Implication in Dentistry: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168792. [PMID: 34444548 PMCID: PMC8392062 DOI: 10.3390/ijerph18168792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022]
Abstract
The number of medically compromised dental patients is increasing every year with the increase in the super-aged population. Many of these patients have underlying psychiatric problems and diseases, which need to be recognized by dental professionals for better treatment outcomes. The aim of this narrative review article is to summarize the psychological and psychiatric backgrounds of medically compromised patients who are frequently visited and taken care of by dentists using findings from recent systematic reviews and meta-analyses. Anxiety and symptoms of depression, post-traumatic stress disorders, panic disorders, poor cognitive functions, and poor quality of life were some of the common psychological backgrounds in medically compromised patients. Additionally, the consequences of these psychological problems and the considerations that need to be taken by the dentist while treating these patients have been discussed. Dental professionals should be aware of and recognize the different psychological backgrounds of medically compromised dental patients in order to provide appropriate dental treatment and to prevent oral conditions from worsening.
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Mejia C, Libby BA, Bracken ML, Shanley B, Holovatska MM, Wanik J, Shanley E, Waring ME. Interest in Digital Dietary Support Among Adults With Kidney Failure Receiving Hemodialysis. J Ren Nutr 2021; 31:327-332. [DOI: 10.1053/j.jrn.2020.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/24/2020] [Accepted: 06/05/2020] [Indexed: 01/09/2023] Open
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Chen C, Zheng J, Driessnack M, Liu X, Liu J, Liu K, Peng J, You L. Health literacy as predictors of fluid management in people receiving hemodialysis in China: A structural equation modeling analysis. PATIENT EDUCATION AND COUNSELING 2021; 104:1159-1167. [PMID: 33129627 DOI: 10.1016/j.pec.2020.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To explore the impact of health literacy (HL) on perceived benefits of fluid restriction (PBFR), self-reported fluid restriction (SRFR) and relative-interdialytic weight gain (R-IDWG) in people receiving hemodialysis (HD). METHODS We conducted a cross-sectional study in two nephrology departments from two hospitals in Guangzhou, China (n = 226). The HL questionnaire, PBFR Subscale of Health Belief Model Constructs and Fluid Adherence Subscale of the HD Patients Therapy Adherence Scale were used. R-IDWG was calculated by the mean IDWG (from 3 consecutive HD), divided by the dry weight. RESULTS In structural equation modeling, three domains of the HL questionnaire, namely Actively Managing My Health, Social Support and Actively Engaging with Healthcare Providers (HCPs), were directly and positively associated with PBFR. Higher Actively Managing My Health predicted higher SRFR both directly and indirectly. Sufficient Social Support and adequate Actively Engaging with HCPs predicted higher SRFR indirectly. All three HL domains predicted R-IDWG indirectly. CONCLUSION Improving patients' HL could increase their understanding of PBFR and be more apt to follow fluid restrictions and reduce R-IDWG. PRACTICE IMPLICATIONS A better understanding of the relationships among HL, PBFR, SRFR and R-IDWG will allow for tailored interventions to decrease R-IDWG in people receiving HD.
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Affiliation(s)
- Chen Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Jing Zheng
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, Portland, USA
| | - Xu Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiali Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ke Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Junsheng Peng
- School of Nursing, Sun Yat-sen University, Guangzhou, China; Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Liming You
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Sousa H, Ribeiro O, Figueiredo D. End-stage renal disease is not yours, is not mine, is OURS: Exploring couples lived experiences through dyadic interviews. Hemodial Int 2021; 25:361-371. [PMID: 33763973 DOI: 10.1111/hdi.12929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION As a psychosocial dyad, couples are greatly challenged by end-stage renal disease (ESRD). Renal replacement therapies are highly demanding and involve lifelong restrictions and readjustments that sometimes translate into profound changes in couples' routines. However, little is known about the experiences of these couples with this condition. This study examined the experiences of couples living with ESRD. METHODS A qualitative exploratory study was conducted with a purposive sample. Semistructured dyadic interviews were conducted with 12 patients (65.1 ± 12.8 years old; eight males) undergoing in-center hemodialysis for 18.6 (±13.3) months and their spouses (60.3 ± 11.2 years old; seven females). The interviews were digitally audio-recorded, transcribed verbatim, and submitted to thematic analysis by two independent researchers. FINDINGS The findings from the dyadic perspective were conceptualized into two major themes: negative impacts (emotional distress, constraints on leisure and daily activities, impacts on couples' dynamics, and difficulties in meal planning) and unmet needs (educational, relational, financial, instrumental, and supportive needs). DISCUSSION The findings suggested that ESRD has several negative impacts that are related to the reported unmet needs, which might difficult couples' psychosocial adjustment to the condition. Both partners may benefit from educational and supportive interventions that address their needs, targeting the couple as a unit. Recognizing ESRD as a family condition is crucial for the development of innovative family-based interventions that can promote couples' healthy adjustment to the disease.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
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Affiliation(s)
- Pierre Delanaye
- Department of Nephrology, Dialysis, and Transplantation, University of Liège (ULg CHU), Liège, Belgium
- Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nimes, France
| | - Christophe Mariat
- Department of Nephrology, Dialysis and Renal Transplantation, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Etienne, Jean Monnet University, Saint-Etienne, France
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Flythe JE, Hilliard TS, Ikeler K, Keller S, Gipson DS, Grandinetti AC, Nordyke RJ, Perrone RD, Roy-Chaudhury P, Unruh M, West M, Bocell F, Hurst FP. Toward Patient-Centered Innovation: A Conceptual Framework for Patient-Reported Outcome Measures for Transformative Kidney Replacement Devices. Clin J Am Soc Nephrol 2020; 15:1522-1530. [PMID: 32276947 PMCID: PMC7536748 DOI: 10.2215/cjn.00110120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Individuals with dialysis-dependent kidney failure experience considerable disease- and treatment-related decline in functional status and overall well-being. Despite these experiences, there have been few substantive technological advances in KRT in decades. As such, new federal initiatives seek to accelerate innovation. Historically, integration of patient perspectives into KRT product development has been limited. However, the US Food and Drug Administration recognizes the importance of incorporating patient perspectives into the total product life cycle (i.e., from product conception to postmarket surveillance) and encourages the consideration of patient-reported outcomes in regulatory-focused clinical trials when appropriate. Recognizing the significance of identifying patient-reported outcome measures (PROMs) that capture contemporary patient priorities, the Kidney Health Initiative, a public-private partnership between the American Society of Nephrology and US Food and Drug Administration, convened a workgroup to (1) develop a conceptual framework for a health-related quality of life PROM; (2) identify and map existing PROMs to the conceptual framework, prioritizing them on the basis of their supporting evidence for use in the regulatory environment; and (3) describe next steps for identifying PROMs for use in regulatory clinical trials of transformative KRT devices. This paper summarizes the proposed health-related quality-of-life PROM conceptual framework, maps and prioritizes PROMs, and identifies gaps and future needs to advance the development of rigorous, meaningful PROMS for use in clinical trials of transformative KRT devices.
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Affiliation(s)
- Jennifer E. Flythe
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina Kidney Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Kourtney Ikeler
- American Institutes for Research, Chapel Hill, North Carolina
| | - San Keller
- American Institutes for Research, Chapel Hill, North Carolina
| | - Debbie S. Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | | | | | | | - Prabir Roy-Chaudhury
- Division of Nephrology and Hypertension, Department of Medicine, University of North Carolina Kidney Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina
- W.G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
| | - Mark Unruh
- School of Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Melissa West
- Kidney Health Initiative and American Society of Nephrology, Washington, DC
| | - Fraser Bocell
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Frank P. Hurst
- Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
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An Underestimated Human Need After Renal Transplantation: Sexuality. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09647-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rambod M, Pasyar N, Mokhtarizadeh M. Psychosocial, Spiritual, and Biomedical Predictors of Hope in Hemodialysis Patients. Int J Nephrol Renovasc Dis 2020; 13:163-169. [PMID: 32617015 PMCID: PMC7326188 DOI: 10.2147/ijnrd.s255045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Hemodialysis patients deal with some psychological and social problems. These problems may be the predictors of hope. This study aimed to determine the psychosocial, spiritual, and biomedical predictors of hope in hemodialysis patients. METHODS This cross-sectional study was conducted on 350 hemodialysis patients in hemodialysis centers affiliated to Shiraz University of Medical Sciences. Adult Hope Scale, Depression Anxiety Stress Scales, Personal Resources Questionnaire-85, Spiritual Well-Being Scale, and biomedical markers were used for data collection. The data were entered into the SPSS 22 software and were analyzed using Pearson's correlation coefficient and linear regression analysis. RESULTS The mean score of hope was 28.54 (SD=5.27). The mean scores of depression, anxiety, and stress were 17.87 (SD=7.62), 13.12 (SD=3.47), and 12.99 (SD=3.88), respectively. The mean scores of social support and spiritual well-being were 126.35 (SD=17.53) and 74.02 (SD=5.84), respectively. The means of biomedical markers including interdialytic weight gain, urea nitrogen, creatinine, phosphate, sodium, and potassium were 2.10 (SD=1.04), 51.55 (SD=13.10), 6.98 (SD=2.48), 4.71 (SD=1.08), 139.32 (SD=4.91), and 4.87 (SD=0.93), respectively. The results revealed a significant association between hope and depression, anxiety, stress, social support, and spiritual well-being (p<0.05). In addition, stress (β=-0.14, p=0.01), anxiety (β=-0.20, p=0.002), and social support (β=0.49, p<0.001) were the predictors of hope. CONCLUSION The hemodialysis patients reported moderate levels of hope, social support, anxiety, and depression. In addition, most of them adhered to dietary and fluid restrictions. Considering the association between hope and social support, spiritual well-being, anxiety, depression, and stress, using some interventions regarding the mentioned variables might increase hope among hemodialysis patients.
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Affiliation(s)
- Masoume Rambod
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Mokhtarizadeh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Sitjar-Suñer M, Suñer-Soler R, Masià-Plana A, Chirveches-Pérez E, Bertran-Noguer C, Fuentes-Pumarola C. Quality of Life and Social Support of People on Peritoneal Dialysis: Mixed Methods Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4240. [PMID: 32545857 PMCID: PMC7345330 DOI: 10.3390/ijerph17124240] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
Although some study has been made into quality of life in patients with peritoneal dialysis, little is known about how this relates to social support. The aim of this paper was to study health-related quality of life, perceived social support and the experiences of people receiving peritoneal dialysis. A cross-sectional study was conducted using quantitative and qualitative methodologies, between June 2015 and March 2017. Fifty-five patients receiving peritoneal dialysis were studied. The most affected quality of life dimensions were the effects of the disease, the burden of the disease, occupational status, sleep and satisfaction. The physical component of the quality of life questionnaire was negatively associated with the number of hospital admissions over the previous year (p = 0.027) and positively associated with social support (p = 0.002). With regard to the mental component, age (p = 0.010) and social support (p = 0.041) were associated with a better quality of life. Peritoneal dialysis, while not a panacea, is experienced as being less aggressive than hemodialysis, allowing greater autonomy and improved perceived health. Greater symptomology corresponded to worse quality of life and to perceiving the disease as a burden. Patients had to adapt to the new situation despite their expectations. Social support was observed to be a key factor in perceived quality of life.
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Affiliation(s)
- Miquel Sitjar-Suñer
- University Hospital Dr. Josep Trueta, Nephrology Service, 17007 Girona, Spain;
- UVic-UCC, Barcelona, 08500 Vic, Spain
| | - Rosa Suñer-Soler
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
| | - Afra Masià-Plana
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
| | - Emilia Chirveches-Pérez
- Department of Nursing, UVic-UCC, 08500 Vic, Spain;
- Research Group on Methodology, Methods, Models of Health and Social Outcome, UVic-UCC, 08500 Vic, Spain
| | - Carme Bertran-Noguer
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
| | - Concepció Fuentes-Pumarola
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
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Pasyar N, Rambod M, Jowkar M. The Effect of Peer Support on Hope Among Patients Under Hemodialysis. Int J Nephrol Renovasc Dis 2020; 13:37-44. [PMID: 32214839 PMCID: PMC7078768 DOI: 10.2147/ijnrd.s240756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/25/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction Providing social support for patients under hemodialysis treatment can reduce their psychological, social, and physical problems. The present study aimed at determining the effect of peer support on hopefulness in patients under hemodialysis. Methods This clinical trial with a pre/posttest design was conducted on 128 patients who had referred to the hemodialysis centers of Shiraz University of Medical Sciences in 2019. The patients were randomly divided into an intervention and a control group. The patients in the intervention group were supported by their peers for eight weeks and were provided with the usual care, but the controls were only provided with the usual care. The data were collected using Snyder Hope Scale. Then, the data were entered into the SPSS software, version 18 and were analyzed using independent t-test and paired t-test. Results At baseline, the participants in both groups were similar with respect to the mean scores of hope and its subscales (p>0.05). However, there was a significant difference between the two groups in terms of hope and its subscales eight weeks after the intervention (p<0.001). Conclusion The results confirmed the effect of peer support on increasing hope among the patients under hemodialysis. Peer support in informational, emotional, instrumental, and spiritual forms could create a positive incentive and increase hope among the patients. Clinical Trial Number This clinical trial has been registered in the Iranian Registry of Clinical Trials (IRCT20190126042498N1).
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Affiliation(s)
- Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoume Rambod
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Nursing Department, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Jowkar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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