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Cai H, Wu Z, Xu J, Wang T, Li Y, Jiang Y, Xu M. Mitigating Social Isolation Among Peritoneal Dialysis Patients: The Impact of Educational Level, Physical Activity, and Familial Support. Risk Manag Healthc Policy 2024; 17:2271-2280. [PMID: 39355058 PMCID: PMC11444756 DOI: 10.2147/rmhp.s479130] [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: 07/23/2024] [Accepted: 09/05/2024] [Indexed: 10/03/2024] Open
Abstract
Objective This study investigates the prevalence and determinants of social isolation in peritoneal dialysis (PD) patients, focusing on the influence of environmental systems and individual behaviors on their social well-being. Methods We conducted a cross-sectional study from December 2023 to February 2024 at Shenzhen Traditional Chinese Medicine Hospital. A total of 259 PD patients were enrolled using a consecutive sampling method. Data were collected via validated tools including the Pittsburgh Sleep Quality Index (PSQI), Lubben Social Network Scale-6 (LSNS-6), Family APGAR Questionnaire, and Social Anxiety Subscale of Self-Consciousness Scale (SASS-CS). Statistical analyses utilized Spearman correlation and multiple linear regression to identify factors associated with social isolation. Results The average score for social isolation was 11 (range 7-15). Significant predictors of social isolation included education level, physical inactivity, and normal hemoglobin concentrations. Social isolation was negatively correlated with family functionality and positively correlated with social anxiety. Regression analysis confirmed education, family functionality, and social anxiety as significant independent predictors of social isolation. Conclusion Social isolation is common among PD patients, driven by factors such as education level, physical inactivity, and unexpectedly, normal hemoglobin levels linked to greater family isolation. Targeted interventions like education, physical activity promotion, and innovative therapies such as animal-assisted activities and social gardening can help reduce isolation and improve patient well-being.
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Affiliation(s)
- Huifang Cai
- Guangzhou University of Chinese Medicine Fourth Clinical Medical College, Shenzhen, People's Republic of China
| | - Zongbi Wu
- Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People's Republic of China
| | - Jieling Xu
- Guangzhou University of Chinese Medicine Fourth Clinical Medical College, Shenzhen, People's Republic of China
| | - Taifen Wang
- Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People's Republic of China
| | - Yanfeng Li
- Department of Neurology, People's Hospital of Longhua, Shenzhen, People's Republic of China
| | - Youli Jiang
- Department of Neurology, People's Hospital of Longhua, Shenzhen, People's Republic of China
| | - Mingming Xu
- Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People's Republic of China
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Seephom S, Balthip K, Jittanoon P. Experiences of Muslim patients living with peritoneal dialysis: A qualitative study in Southern Thailand. BELITUNG NURSING JOURNAL 2024; 10:430-437. [PMID: 39211461 PMCID: PMC11350350 DOI: 10.33546/bnj.3390] [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: 04/14/2024] [Revised: 05/10/2024] [Accepted: 07/01/2024] [Indexed: 09/04/2024] Open
Abstract
Background Living with peritoneal dialysis affects the patient's life. The experiences of peritoneal dialysis patients, especially Muslim patients, are incomprehensible. There is a need to explore this area further to foster nursing practice improvement through enhanced understanding. Objective The purpose of this study was to understand the experiences of Muslim patients who are undergoing peritoneal dialysis. Methods A qualitative descriptive design was employed to gain a deeper understanding of the experiences of Muslim patients undergoing peritoneal dialysis in a peritoneal dialysis unit in Southern Thailand. Participants were initially recruited through purposive sampling and then selected based on the inclusion criteria. Data saturation was reached from October 2019 to January 2020. Ten Muslim patients who had been receiving peritoneal dialysis for a minimum of one month participated in personalized, in-depth, face-to-face interviews, which were supplemented by field notes. Inductive content analysis was performed using open coding, categories, and abstractions. Results The experiences of Muslim patients undergoing peritoneal dialysis were grouped into two main categories: 1) Overwhelmed by change and 2) Learned to survive. Conclusion Peritoneal dialysis has a significant impact on Muslim patients, especially during the first months of treatment. Recognizing religious teachings and strengthening religious commitment through participation in religious practices are central to living on peritoneal dialysis. The findings offer a more profound insight into the experiences of Muslim patients receiving peritoneal dialysis. These results can be foundational knowledge for establishing and improving culturally appropriate nursing practices for Muslim patients.
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Affiliation(s)
- Sunisa Seephom
- Division of Adult and Gerontological Nursing, The Srisavarindhira Thai Red Cross Institute of Nursing, Pathumwan, Bangkok, Thailand
| | - Karnsunaphat Balthip
- Division of Community Health Nursing, Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkla, Thailand
| | - Piyanuch Jittanoon
- Division of Community Health Nursing, Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkla, Thailand
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Fissell RB, Wysocki M, Bonnet K, Abifaraj F, Cavanaugh KL, Nair D, Umeukeje EM, Wild MG, Liddell P, Spangler M, Schlundt D. Patient perspectives on peritoneal dialysis (PD) and the PD catheter: Strategies and Solutions. Perit Dial Int 2023; 43:231-240. [PMID: 36855928 PMCID: PMC10329216 DOI: 10.1177/08968608231152063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION Peritoneal dialysis (PD) catheter complications reduce quality of life and increase risks for hospitalizations, for unplanned transitions to haemodialysis and for death. Patient PD catheter management is crucial for safe, sustained PD. Patient perspectives on strategies for living with PD and using a PD catheter may inform efforts to reduce PD catheter complications, increase individual patient PD modality persistence, and thus increase overall home dialysis prevalence. METHODS We interviewed 32 adult PD patients in Nashville, Tennessee. Qualitative analyses included (1) isolation of themes, (2) development of a coding system and (3) creation of a conceptual framework using an inductive-deductive approach. RESULTS Challenges identified by patients as important included drain pain, difficulty eating and sleeping, and fear of peritonitis. Coping strategies included repositioning while draining, adjusting eating patterns, and development of PD patient and helper knowledge and confidence, especially at home after initial training. Patients described a trial-and-error iterative process of trying multiple strategies with input from multiple sources, which led to individualised solutions. CONCLUSIONS The trial-and-error process may be crucial for maintaining PD. Individual patient success with PD may be promoted by creating expectations during training that a solution may require multiple attempts, and by a reimbursement policy that supports robust nursing support for safe progression through the trial-and-error process, particularly in the first few months for incident patients. Interventions to support patient motivation and optimal coping behaviour may also support an increase in PD modality duration for individual patients, and thus increase overall PD prevalence.
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Affiliation(s)
- Rachel B Fissell
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew Wysocki
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | | | - Kerri L Cavanaugh
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Devika Nair
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ebele M Umeukeje
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marcus G Wild
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Peter Liddell
- University of Mississippi Medical Center, Jackson, MS, USA
| | | | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
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Li P, Cao X, Liu W, Zhao D, Pan S, Sun X, Cai G, Zhou J, Chen X. Evolving peritoneal dialysis care in Chinese mainland from 2010 to 2020: Comparison data from two surveys. Semin Dial 2022; 36:214-220. [PMID: 36450343 DOI: 10.1111/sdi.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/28/2022] [Accepted: 08/13/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Along with the peritoneal dialysis (PD)-favored policy in China and the implementation of more comprehensive PD management, PD has evolved in Chinese mainland over the last decade. Despite the existence of national registries and several provincial epidemiological descriptive studies, there was almost no national research on the changing trajectory in PD population. A comparison study, based on two national surveys that were 10 years apart, was conducted to reveal the evolvement of PD care in Chinese mainland. METHODS Two national surveys have been done respectively in 2010 and 2020 to capture the epidemiological status, application of different modalities, management of perioperative infection, and long-term complications among PD patients. RESULTS In the study with 730 participating hospitals (n = 14,912 PD patients) in 2010 and 746 hospitals (n = 101,537) in 2020, prevalent PD patients have increased in the past 10 years with increased numbers of PD patients in both secondary (average 5 ± 16 vs. 43 ± 41, p < 0.01) and tertiary hospitals (32 ± 53 vs. 153 ± 215, p < 0.01). Automated PD has been accessible in 0.4% of all hospitals, only in tertiary centers in 2010 and its application increased to 51% in 2020. PD centers have become more engaged in PD catheter placement, treated properly for the PD-related infection, and carried out the follow-up in compliance with the national protocols. CONCLUSIONS Our study indicates that over the past decade, the prevalent PD population has quickly expanded with increased APD availability in Chinese mainland. The management of PD patients has become better conforming to the guidelines and long-term follow-up of patients have remained stable. Further studies are warranted to evaluate whether the rapidly changing paradigm of PD could translate into the socio-economic benefits in the society.
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Affiliation(s)
- Ping Li
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Xueying Cao
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Weicen Liu
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Delong Zhao
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Sai Pan
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Xuefeng Sun
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Guangyan Cai
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Jianhui Zhou
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
| | - Xiangmei Chen
- Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research Beijing P.R. China
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Yan T, Chan CWH, Chow KM, Li M. Experiences and perception of character strengths among patients with breast cancer in China: a qualitative study. BMJ Open 2022; 12:e061994. [PMID: 36307158 PMCID: PMC9621164 DOI: 10.1136/bmjopen-2022-061994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/06/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To explore the patients' experiences on character strengths that Chinese patients experience after the diagnosis of breast cancer. DESIGN A qualitative, exploratory study using semistructured interviews based on the patients' lived experience after being diagnosed with breast cancer. Ethics approval was granted. Interviews were audiorecorded and transcribed verbatim. Values in Action Classification of Strengths provided conceptual framework for analysing strengths. Directed content analysis based on the classification of strengths and framework analysis were used to analyse transcribed data. The Standards for Reporting Qualitative Research guideline was followed. SETTING The Second Affiliated Hospital of Zhengzhou University and Henan Provincial Cancer Hospital in China. PARTICIPANTS Adult patients over 18 years, diagnosed with breast cancer between October 2019 and December 2020 were recruited. We used purposive sample method to collected data from 24 participants diagnosed with breast cancer. RESULTS Six themes (virtues) emerged from our analysis. In addition, two new subthemes (character strengths) emerged in this study, selflessness and pragmatism, respectively. Patients with breast cancer described a large repertoire of character strengths they used or wished for during survivorship, including gratitude, hope, humility, kindness, humour, honesty and forgiveness. Cultural values (eg, collectivism, familyism, Confucianism and Buddhist beliefs) helped structure the experiences of Chinese patients' character strengths. Patients wanted their character strengths to be more noticed, appreciated and encouraged by others and reported their psychological trajectory of using personal strengths. CONCLUSION The findings indicated that patients with breast cancer believing character strengths are important to them. Medical staff should pay more attention to motivating and cultivating character strengths of patients with breast cancer. Attention to make strength-based practices workable in clinical health promotion programmes is necessary. The healthcare system should develop tailored individualised psychological services that specifically address patients' needs for the application of personalised character strengths. TRIAL REGISTRATION NUMBER NCT04219267, Pre-results.
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Affiliation(s)
- Tingting Yan
- School of Nursing, Peking University, Beijing, Beijing, China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, Beijing, China
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Fox DE, King-Shier KM, James MT, Venturato L, Clarke A, Ravani P, Oliver MJ, Quinn RR. The availability of support and peritoneal dialysis survival: A cohort study. ARCH ESP UROL 2022; 42:353-360. [PMID: 35353014 DOI: 10.1177/08968608221086752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Providing support is important to maintain a patient on peritoneal dialysis (PD), though its impact on outcomes has not been investigated thoroughly. We examined the association between having support and risk of a transfer to hemodialysis. METHODS In this retrospective observational cohort study, we used data captured in the Dialysis Measurement Analysis and Reporting system about patients who started PD in Alberta, Canada, between 1 January 2013 and 30 September 2018. Support was defined as the availability of a support person in the home who was able, willing and available to provide support for PD in the patient's residence. The outcome of interest was a transfer to hemodialysis for at least 90 days. We estimated the cumulative incidence of a transfer over time accounting for competing risks and hazard ratios to summarise the association between support and a transfer. We split follow-up time as hazard ratios varied over time. RESULTS Six hundred and eighty-three incident PD patients, median age 58 years (IQR: 47-68) and 35% female, were followed for a median of 15 months. The cumulative incidence of a transfer to hemodialysis at 24 months was 26%. Having support was associated with a reduced risk of a transfer between 3 and 12 months after the start of dialysis (HR3-12mo: 0.44; 95% CI: 0.25-0.78), but not earlier (hazard ratio (HR)<3mo: 0.96; 95% confidence interval (CI): 0.55-1.69) or later (HR>12mo: 1.19; 95% CI: 0.65-2.17). CONCLUSIONS A transfer to hemodialysis is common. Having a support person at home is associated with a short-term protective effect after the initiation of PD.
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Affiliation(s)
- Danielle E Fox
- Department of Community Health Sciences, The University of Calgary, Alberta, Canada
| | - Kathryn M King-Shier
- Faculty of Nursing and Department of Community Health Sciences, The University of Calgary, Alberta, Canada
| | - Matthew T James
- Departments of Medicine and Community Health Sciences, The University of Calgary, Alberta, Canada
| | | | - Alix Clarke
- Department of Medicine, The University of Calgary, Alberta, Canada
| | - Pietro Ravani
- Departments of Medicine and Community Health Sciences, The University of Calgary, Alberta, Canada
| | - Matthew J Oliver
- Division of Nephrology, Department of Medicine, The University of Toronto, Ontario, Canada
| | - Robert R Quinn
- Departments of Medicine and Community Health Sciences, The University of Calgary, Alberta, Canada
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