The interaction analysis between advanced age and longer dialysis vintage on the survival of patients receiving maintenance hemodialysis

The Effect of Spiritual Well-Being on Hope Among Hemodialysis Patients: A Latent Profile Analysis

INTRODUCTION

Spiritual well-being was a critical component of quality of life for hemodialysis patients. However, existing research primarily concentrates on the overall level of spiritual well-being and associated factors, often neglecting the heterogeneity within the hemodialysis patients regarding their patterns of spiritual well-being. In addition, the effect of spiritual well-being on hope levels in hemodialysis patients remains unclear. This study aimed to examine the latent profiles of spiritual well-being among hemodialysis patients and to explore their effect on hope.

METHODS

A convenience sampling method was employed between July 2023 and March 2024 to recruit hemodialysis patients from three teaching hospitals in Sichuan Province as study participants. All participants complied with a demographic questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, and the Herth Hope Index. A latent profile analysis was adopted to identify the latent profiles of spiritual well-being among hemodialysis patients, and hierarchical linear regression was conducted to examine their role in hope.

FINDINGS

Two latent profiles of spiritual well-being were identified based on the participants' responses, designated as "Spiritual burnout group"(n = 246, 74.4%) and "Spiritual fulfillment group" (n = 51, 25.6%). Different latent profiles of spiritual well-being among hemodialysis patients have a significant positive effect on the level of hope (ΔR 2 = 0.224, p < 0.001).

DISCUSSION

The spiritual well-being of hemodialysis patients was identified as suboptimal and demonstrated a significant positive association with their level of hope. Healthcare providers could identify the different profiles of spiritual well-being in HD patients and deliver targeted interventions to guide them to positively live in harmony with themselves, others, and the environment to improve their level of hope.

Clinical manifestations and outcomes of COVID-19 in maintenance hemodialysis patients of a high infectious epidemic country: a prospective cross-sectional study

Introduction

The outbreak of COVID-19 poses great challenges for patients on maintenance haemodialysis. Here, we reported the clinical characteristics and laboratory features of maintenance haemodialysis (MHD) patients with COVID-19 in Bangladesh.

Methods

Altogether, 67 MHD patients were enroled in the study from two dedicated tertiary-level hospitals for COVID-19 after the prospective cross-sectional execution of selection criteria. Data were collected from medical records and interviews. Different statistical analysis was carried out in the data analysis.

Results

The mean age was 55.0±9.9 years, with 40 males (59.7%). The mean dialysis duration was 23.4±11.5 months. The most common symptoms were fever (82.1%), cough (53.7%), and shortness of breath (55.2%), while the common comorbid condition was hypertension (98.5%), followed by diabetes (56.7%). Among MHD patients, 52.2% to 79.1% suffered from severe to critical COVID-19, 48 patients (71.6%) had 26-75% lung involvement on high resolution computed tomography of the chest, 23 patients (34.3%) did not survive, 20 patients (29.9%) were admitted to ICU, and nine patients (13.4%) needed mechanical ventilation. Patients who did not survive were significantly older (mean age: 63.0 vs. 50.86 years, P=0.0001), had significantly higher cardiovascular risk factors (69.6% vs. 43.2%, P=0.04), severe shortness of breath (82.6% vs. 40.9%, P=0.0001), and longer hospital stays (mean days: 17.9 vs. 13.0, P=0,0001) compared to the survivor group. The white blood cell count, C-reactive protein, lactate dehydrogenase, pro-calcitonin, and thrombocytopenia were significantly (P<0.0001) higher, while the albumin level was significantly lower (P=0.0001) in non-survivor compared to patients who survived.

Conclusion

Maintenance haemodialysis patients had severe to critical COVID-19 and had a higher risk of non-survival if they were older and had comorbidities such as hypertension and diabetes. Therefore, MHD patients with COVID-19 need close monitoring to improve their outcomes.