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Shanmugapriya K, Yuvaraj S, Vishnupriya D, Vinitha K, Vijayanila G, Zamrun Begam T, Veeralakshmi M, Thilagavathi V, Vejaiyan R, Thanasekar R. Assessment of Knowledge on Dietary Management of Chronic Kidney Disease Among Patients Undergoing Hemodialysis at a Tertiary Care Hospital in South India: A Cross-Sectional Analytical Study. Cureus 2024; 16:e55342. [PMID: 38559520 PMCID: PMC10981922 DOI: 10.7759/cureus.55342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Background This cross-sectional analytical study aimed to assess the level of knowledge on dietary management of chronic kidney disease (CKD) among patients undergoing hemodialysis in a tertiary care hospital in Puducherry, South India. Methodology The study was conducted among 86 inpatients diagnosed with CKD and undergoing hemodialysis in the dialysis unit. They were selected by simple random sampling. The self-administered, validated, self-structured questionnaire was used to collect the data. The study was conducted from May to September 2019. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (chi-square) were used to find out the relationship between the level of knowledge and background variables using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, New York, United States). Results The findings indicated that the majority of patients were in the 20-30 age range (36, 41.9%), male (58, 67.4%), from nuclear families (58, 66.3%), with mixed dietary habits (60, 69.8%), and undergoing thrice-weekly hemodialysis (34, 53.5%). Additionally, 59 (68.6%) were hypertensive and 14 (16.3%) were diabetic. Most patients exhibited a moderate level of knowledge (74, 86%), while a small percentage had inadequate (6, 7%) and adequate (6, 7%) knowledge, with a mean (SD) value of 2.00 (0.376). The study identified statistically significant associations between knowledge levels and age, occupation, food habits, duration of dialysis, pre-existing co-morbid illnesses, and treatment of hemodialysis with a p-value <0.05. Conclusions In conclusion, this study highlights that the majority of the CKD patients undergoing hemodialysis exhibit moderately adequate knowledge of dietary management. However, a notable need remains for further education and support in this area. Addressing these knowledge gaps is crucial, as it can empower nursing students and healthcare professionals to educate these patients on their dietary needs effectively. By providing comprehensive education and support, we can enhance the quality of care and improve outcomes for hemodialysis patients.
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Affiliation(s)
- Kannan Shanmugapriya
- Medical-Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - S Yuvaraj
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - D Vishnupriya
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - K Vinitha
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - G Vijayanila
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - T Zamrun Begam
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - M Veeralakshmi
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - V Thilagavathi
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - R Vejaiyan
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
| | - R Thanasekar
- College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, IND
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简 桂, 周 剑, 王 之, 杨 褀, 宦 红, 刘 媛, 竺 琼, 程 东, 唐 兢, 陈 碧, 汪 年. [Discussions Concerning the Generalist-Specialist Combination Management Model of Chronic Kidney Disease]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:1128-1132. [PMID: 38162064 PMCID: PMC10752768 DOI: 10.12182/20231160507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Indexed: 01/03/2024]
Abstract
In recent years, the effective management of patients with chronic kidney disease (CKD) is gaining growing attention. In 2014, our hospital established the CKD generalist-specialist combination management model, which incorporates a set of CKD management processes. The generalist component incorporates the following, general practitioners from 6 community health centers in the surrounding areas (with about 650 000 permanent residents in the region) joining hands, setting up a management team composed of doctors and nurses, and formulating management protocols for patient follow-up, patient record management, screening, risk assessment, examination and treatment, nutrition and exercise, and two-way referrals. The specialist component of the model incorporates the following, providing trainings for general practitioners in the in the community in the form of lectures on special topics and case discussion sessions, and organizing 7 national-level workshops for continuing medical education in the past decade, covering about 1 400 participants. In addition, regular meetings of the support groups of patients with renal diseases were organized to carry out information and education activities for patients. We have set up 4 community-based training centers and 6 specialized disease management centers, including one for diabetic nephropathy. We have retrospectively analyzed the risk factors of elderly CKD patients by establishing the elderly physical examination database (which has a current enrollment of 26 000 people), the elderly community CKD cross-sectional survey database, and the elderly CKD information management system. After 10 years of management practice, the level of institutionalization and standardization of CKD specialty management in our hospital has been improved. Moreover, we have expanded the management team and extended the management base from the hospital to community. We have improved the level of CKD management in community health centers and improved the specialty competence of the general practitioners in the communities. The generalist-specialist combination management model makes it possible for CKD patients to receive early screening and treatment, obtain effective and convenient follow-up and referral services, and improve their quality of life. Patients with complications such as diabetes, hypertension, and sarcopenia could access treatments with better precision. It is necessary to carry out the generalist-specialist integrated management of CKD, which is worthy of further development and improvement.
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Affiliation(s)
- 桂花 简
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 剑峰 周
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 之 王
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 褀 杨
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 红梅 宦
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 媛 刘
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 琼 竺
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 东生 程
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 兢 唐
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 碧华 陈
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - 年松 汪
- 上海交通大学医学院附属第六人民医院 肾病科 (上海 200233) Department of Nephrology, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
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Rotondi S, Tartaglione L, Pasquali M, Ceravolo MJ, Mitterhofer AP, Noce A, Tavilla M, Lai S, Tinti F, Muci ML, Farcomeni A, Mazzaferro S. Association between Cognitive Impairment and Malnutrition in Hemodialysis Patients: Two Sides of the Same Coin. Nutrients 2023; 15:nu15040813. [PMID: 36839171 PMCID: PMC9964006 DOI: 10.3390/nu15040813] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
Cognitive impairment and malnutrition are prevalent in patients on hemodialysis (HD), and they negatively affect the outcomes of HD patients. Evidence suggests that cognitive impairment and malnutrition may be associated, but clinical studies to assess this association in HD patients are lacking. The aim of this study was to evaluate the association between cognitive impairment evaluated by the Montreal Cognitive Assessment (MoCA) score and nutritional status evaluated by the malnutrition inflammation score (MIS) in HD patients. We enrolled 84 HD patients (44 males and 40 females; age: 75.8 years (63.5-82.7); HD vintage: 46.0 months (22.1-66.9)). The MISs identified 34 patients (40%) as malnourished; the MoCa scores identified 67 patients (80%) with mild cognitive impairment (MCI). Malnourished patients had a higher prevalence of MCI compared to well-nourished patients (85% vs. 70%; p = 0.014). MoCa score and MIS were negatively correlated (rho:-0.317; p < 0.01). Our data showed a high prevalence of MCI and malnutrition in HD patients. Low MoCA scores characterized patients with high MISs, and malnutrition was a risk factor for MCI. In conclusion, it is plausible that MCI and malnutrition are linked by common sociodemographic, clinical, and biochemical risk factors rather than by a pathophysiological mechanism.
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Affiliation(s)
- Silverio Rotondi
- Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, 04100 Rome, Italy
- Department of Translational and Precision Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Lida Tartaglione
- Department of Translational and Precision Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
- Nephrology Unit, Department of Internal Medicine and Medical Specialities, University Policlinico Umberto I Hospital, 00161 Rome, Italy
| | - Marzia Pasquali
- Nephrology Unit, Department of Internal Medicine and Medical Specialities, University Policlinico Umberto I Hospital, 00161 Rome, Italy
| | - Maria Josè Ceravolo
- Nephrology and Dialysis Unit, University Hospital Policlinico Tor Vergata, 00133 Rome, Italy
| | - Anna Paola Mitterhofer
- Nephrology and Dialysis Unit, University Hospital Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Systems Medicine, University Hospital Policlinico Tor Vergata, 00133 Rome, Italy
| | - Annalisa Noce
- Nephrology and Dialysis Unit, University Hospital Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Systems Medicine, University Hospital Policlinico Tor Vergata, 00133 Rome, Italy
| | - Monica Tavilla
- Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, 04100 Rome, Italy
| | - Silvia Lai
- Department of Translational and Precision Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Francesca Tinti
- Department of Translational and Precision Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
- Nephrology Unit, Department of Internal Medicine and Medical Specialities, University Policlinico Umberto I Hospital, 00161 Rome, Italy
| | - Maria Luisa Muci
- Nephrology an Dialysis Unit, Fatebenefratelli Isola Tiberina Fondazione Policlinico Universitario A. Gemelli-Isola, 00186 Rome, Italy
| | - Alessio Farcomeni
- Department of Economics & Finance, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Sandro Mazzaferro
- Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, 04100 Rome, Italy
- Department of Translational and Precision Medicine, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
- Correspondence: ; Tel.: +39-0649978393
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Cui Y, Li R, Yang T, Wang H, Jin S, Liu N, Liu H, Zhang Y. Influence of positive and negative affect on self-management among patients with early chronic kidney disease during the COVID-19 pandemic: The mediating and suppressing effect of ego depletion. Front Psychiatry 2022; 13:992404. [PMID: 36245863 PMCID: PMC9556950 DOI: 10.3389/fpsyt.2022.992404] [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: 07/14/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Self-management in patients with early chronic kidney disease (CKD) can effectively delay damage to renal function. However, with the continuous spread of COVID-19, patients cannot receive timely treatment, which can lead to different affects, resulting in ego depletion and serious challenges to self-management. This study aimed to investigate the mediating and suppressing roles of ego depletion on the relationship between positive and negative affect and self-management among patients with early CKD during the COVID-19 pandemic in China. METHODS A total of 383 patients with early CKD from three tertiary hospitals were enrolled by convenience sampling in our cross-sectional study from September 2021 to March 2022. Participants completed the Sociodemographic Questionnaire, Positive Affect and Negative Affect Scale, Self-Regulating Fatigue Scale and Chronic Kidney Disease Self-Management Instrument. A structural equation model was conducted to test the mediating and suppressing effects of ego depletion on the relationship between positive and negative affect and self-management. RESULTS The average score of the participants' self-management was 84.54 (SD: 19.72), and nearly 60% of them were at low and moderate levels. The mediating effect of positive affect on self-management through ego depletion was significant (β = 0.248, 95% CI: 0.170 to 0.376), accounting for 53.22% of the total effect. The suppressing effect of negative affect on self-management through ego depletion was significant (β = -0.191, 95% CI: -0.310 to -0.118), and the absolute value of the ratio of the suppressing effect to the direct effect was 66.55%. CONCLUSIONS Ego depletion partially mediated the relationship between positive affect and self-management while suppressing the relationship between negative affect and self-management among patients with early CKD during the COVID-19 pandemic. The reduction of patients' ego depletion must be taken as the intervention target to improve self-management and delay the progression of CKD.
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Affiliation(s)
- Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Rong Li
- Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Hua Wang
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Shasha Jin
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Na Liu
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Hongbao Liu
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi'an, China
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