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Chen C, Zheng J, Liu X, Liu J, You L. Role of health literacy profiles in fluid management of individuals receiving haemodialysis: A cross-sectional study. J Adv Nurs 2024; 80:2325-2339. [PMID: 38012855 DOI: 10.1111/jan.15973] [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] [Received: 04/05/2023] [Revised: 10/17/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023]
Abstract
AIMS To identify health literacy profiles in individuals receiving haemodialysis and to explore how these profiles interact with individuals' self-efficacy, engagement with traditional dietary habits, self-reported fluid restriction and relative-interdialytic weight gain. DESIGN A cross-sectional study engaging nephrology departments from four hospitals in Guangdong Province, China. METHODS A sample of 433 individuals receiving haemodialysis participated between December 2018 and July 2019. We assessed health literacy, self-efficacy and self-reported fluid restriction using the Health Literacy Questionnaire, the Fluid Self-efficacy Scale and the Fluid Adherence Subscale, respectively. Traditional dietary habits, including daily tea drinking, soup drinking and preserved food consumption, were measured using three yes/no questions. Relative-interdialytic weight gain was calculated by dividing the mean interdialytic weight gain (from three recent intervals) by dry weight. Latent profile analysis and structural equation modelling were performed. RESULTS Three health literacy profiles were identified: low, moderate and high. Compared to those in the low health literacy profile, individuals in high and moderate health literacy profiles demonstrated an indirect association with reduced relative-interdialytic weight gain. This reduction can be attributed to their higher self-efficacy levels, decreased reliance on dietary habits and higher self-reported fluid restrictions. CONCLUSIONS Most participants exhibited either low or moderate levels of health literacy. Improving health literacy has the potential to promote self-efficacy and foster effective fluid restriction, ultimately leading to a reduction in relative-interdialytic weight gain in individuals receiving haemodialysis. IMPACT This study reveals heterogeneity in health literacy levels among individuals receiving haemodialysis and illuminates the connections between an individual's entire spectrum of health literacy and fluid management. These findings provide valuable insights for developing person-centred fluid management interventions, especially for individuals with diverse cultural dietary backgrounds within the haemodialysis population. REPORTING METHOD We adhered to the STROBE guideline. PATIENT OR PUBLIC CONTRIBUTION Patients were included only for collecting their data.
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Affiliation(s)
- Chen Chen
- Department of Nursing, Shenzhen Second People's Hospital (The First Affiliated Hospital of Shenzhen University), Shenzhen, China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, School of Biomedical Engineering, Shenzhen University Medical school, Shenzhen, China
| | - Jing Zheng
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xu Liu
- Department of Infectious Disease, Guangdong Provincial Engineering Research Center of Molecular Imaging, Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 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
| | - Liming You
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Hussain F, Ashraf S, Arshad M, Rehman MMU, Khan FS, Ahmad MA, Ali S, Asif MA, Munawar A, Mehmood Qadri H. Knowledge, Adherence, and Perception of Patients on Maintenance Hemodialysis to Treatment Regimens at a Tertiary Care Hospital in Pakistan. Cureus 2023; 15:e51341. [PMID: 38288238 PMCID: PMC10824504 DOI: 10.7759/cureus.51341] [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: 12/30/2023] [Indexed: 01/31/2024] Open
Abstract
Background The management of end-stage renal disease (ESRD) demands meticulous adherence to treatment regimens, encompassing hemodialysis (HD) sessions, medication protocols, dietary guidelines, and fluid restrictions. The intricate interplay of factors impacting treatment adherence warrants comprehensive exploration, particularly within Pakistan. Objective To assess knowledge, adherence, and perception regarding the treatment regimens and their determinants among ESRD patients. Methodology Employing a nonprobability, consecutive sampling method, this prospective, cross-sectional study was conducted in July and August 2023 at Lahore General Hospital, Lahore, Pakistan. It exclusively enrolled adult patients with a minimum three-month history of hemodialysis. Thorough demographic data were collected, followed by the meticulous administration of a translated version of the End Stage Renal Disease-Adherence Questionnaire (ESRD-AQ) through face-to-face interviews in the native language. IBM SPSS Statistics for Windows, Version 26 (released 2019; IBM Corp., Armonk, New York, United States) was used to acquire descriptive statistics, as well as Pearson's and Spearman's correlations and univariate and multivariate regression analysis. Results The study encompassed 119 patients, with a mean age of 43.13 ± 14.99 years. Adherence scores revealed means of 921.83 ± 28.37 for males and 865.18 ± 28.81 for females, out of 1200. Notably, only 10.1% demonstrated good adherence, 31.9% displayed moderate adherence, and 58% exhibited poor adherence. A statistically significant association emerged between better adherence and access to personal transportation (β=-0.225; 95% CI -178.24 to -20.77, p=0.014), with no other demographic factors predicting adherence. Conclusion The study underscores the sobering reality of minimal optimal adherence. Chief impediments include anxiety, alongside challenges such as fistula complications, financial constraints, transportation barriers, and inadequate counseling and motivation. Evidently, robust patient education, sustained motivation, and unwavering support from healthcare providers and institutional entities are imperative to surmount the multifaceted barriers that compromise treatment adherence.
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Affiliation(s)
| | - Sania Ashraf
- Nephrology, Lahore General Hospital, Lahore, PAK
| | | | | | - Faheem Shahzad Khan
- Epidemiology and Biostatistics, University of Health Sciences, Lahore, Lahore, PAK
| | | | - Salamat Ali
- Internal Medicine, Aziz Bhatti Shaheed Teaching Hospital, Gujrat, PAK
| | | | - Ali Munawar
- Internal Medicine, Shaikh Zayed Hospital, Lahore, PAK
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Karupaiah T, Mat Daud ZA, Khosla P, Khor BH, Sahathevan S, Kaur D, Tallman DA, Rashid HU, Rahman T, Saxena A, Gulati S, Sengupta P, Susetyowati S. Identifying Challenges and Potential Solutions for Sustainable Kidney Nutrition Care Delivery in Selected Asian Countries. J Ren Nutr 2023; 33:S73-S79. [PMID: 37597574 DOI: 10.1053/j.jrn.2023.08.003] [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: 06/29/2022] [Revised: 07/20/2023] [Accepted: 08/03/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Recent surveys highlight gross workforce shortage of dietitians in global kidney health and significant gaps in renal nutrition care, with disparities greater in low/low-middle income countries. OBJECTIVE This paper narrates ground experiences gained through the Palm Tocotrienols in Chronic Hemodialysis (PaTCH) project on kidney nutrition care scenarios and some Asian low-to-middle-income countries namely Bangladesh, India, and Malaysia. METHOD Core PaTCH investigators from 3 universities (USA and Malaysia) were supported by their postgraduate students (n = 17) with capacity skills in kidney nutrition care methodology and processes. This core team, in turn, built capacity for partnering hospitals as countries differed in their ability to deliver dietitian-related activities for dialysis patients. RESULTS We performed a structural component analyses of PaTCH affiliated and nonaffiliated (Myanmar and Indonesia) countries to identify challenges to kidney nutrition care. Deficits in patient-centered care, empowerment processes and moderating factors to nutrition care optimization characterized country comparisons. Underscoring these factors were some countries lacked trained dietitians whilst for others generalist dietitians or nonclinical nutritionists were providing patient care. Resolution of some challenges in low-to-middle-income countries through coalition networking to facilitate interprofessional collaboration and task sharing is described. CONCLUSIONS We perceive interprofessional collaboration is the way forward to fill gaps in essential dietitian services and regional-based institutional coalitions will facilitate culture-sensitive capacity in building skills. For the long-term an advanced renal nutrition course such as the Global Renal Internet Course for Dietitians is vital to facilitate sustainable kidney nutrition care.
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Affiliation(s)
- Tilakavati Karupaiah
- Food Security and Nutrition Impact Lab, School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Pramod Khosla
- Department of Nutrition and Food Science, Wayne State University, Detroit, Michigan
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Sharmela Sahathevan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar, Malaysia
| | - Deepinder Kaur
- Department of Nutrition and Food Science, Wayne State University, Detroit, Michigan
| | - Dina A Tallman
- Department of Nutrition and Food Science, Wayne State University, Detroit, Michigan
| | - Harun-Ur Rashid
- Kidney Foundation Hospital and Research Institute Bangladesh, Dhaka, Bangladesh
| | - Tanjina Rahman
- Institute of Food Science and Nutrition, University of Dhaka, Dhaka, Bangladesh
| | - Anita Saxena
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Vasli P, Hosseini M, Nasiri M, Bakhtiari N. Family-centered empowerment approach to optimize phosphate management among hemodialysis patients: an experimental study. BMC Nephrol 2023; 24:259. [PMID: 37661281 PMCID: PMC10476304 DOI: 10.1186/s12882-023-03311-1] [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: 12/05/2022] [Accepted: 08/26/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND This study aimed to investigate the effect of a family-centered empowerment program on hyperphosphatemia management. METHOD This experimental study was performed on 80 randomly selected eligible patients with hyperphosphatemia undergoing hemodialysis. Patients were assigned randomly to two groups of family-centered empowerment program (FCEPG) and control group (CG) by coin toss (40 people per group). Data collection tools were the researcher-made Phosphate Control Knowledge Scale, the researcher-made Adherence to Dietary Restriction of Phosphorus Intake Scale, the eight-item Morisky Medication Adherence Scale, and serum phosphorus measurements. Data were collected before the intervention, one month, and three months after the intervention. Patients in FCEPG participated in a family-centered empowerment program. The statistical significance level was considered to be 0.05. RESULTS Inter-group comparisons showed no significant difference between FCEPG and CG in terms of the mean score of knowledge of phosphate control, adherence to dietary restriction of phosphorus intake, adherence to medication, and the mean serum phosphorus level before the empowerment program, but showed significant differences between them in these respects at one month after the program and three months after the program (p < 0.05). Intra-group comparisons showed a significant difference in FCEPG between the mean and standard deviation of all four variables before the empowerment program and the corresponding values one month and three months after the program (P < 0.05). CONCLUSION The findings of this study can be used in various fields of healthcare in the hospital and community.
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Affiliation(s)
- Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noushin Bakhtiari
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Wang X, Mo Y, Yuan Y, Zhou Y, Chen Y, Sheng J, Liu J. Exploring the influencing factors of unmet palliative care needs in Chinese patients with end-stage renal disease undergoing maintenance hemodialysis: a cross-sectional study. BMC Palliat Care 2023; 22:113. [PMID: 37543565 PMCID: PMC10403855 DOI: 10.1186/s12904-023-01237-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 07/29/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND The role of palliative care for end-stage renal disease (ESRD) patients have been proven in some developed countries, but it is still unclear in the mainland of China. In fact, patients with ESRD experience many unmet palliative care needs, such as physical, psychological, social and spiritual needs, but the factors influencing these needs have not investigated. METHODS A cross-sectional study was conducted at two hemodialysis centers in the mainland of China from January to September 2022. Convenience sampling was used to collect data on the participants' socio-demographics, clinical characteristics, the Palliative Care Outcome Scale (POS), the Dialysis Symptom Index (DSI), the Karnofsky Performance Status Scale (KPS), the Patient Health Questionnaire-9 item (PHQ-9), and the Social Support Rate Scale (SSRS). Data were analyzed using latent profile analysis, Kruskal-Wallis test, one-way analysis of variance (ANOVA), the chi-square test and multinomial logistic regression analysis. RESULTS Three hundred five participants were included in this study, and divided palliative care needs into three categories: Class 1, mild palliative care needs (n = 154, 50.5%); Class 2, moderate palliative care needs (n = 89, 29.2%); Class 3, severe palliative care needs (n = 62, 20.3%). Based on the analysis of three profiles, the influencing factors of unmet needs were further analyzed. Compared with Class 3, senior high school education, the household per capita monthly income < 2,000, low KPS scores, high PHQ-9 scores, and low SSRS scores were less likely to be in Class 1 (OR = 0.03, P = 0.012; OR = 0.003, P < 0.001; OR = 1.15, P < 0.001; OR = 0.55, P < 0.001; OR = 1.35, P = 0.002; respectively) and Class 2 (OR = 0.03, P = 0.007; OR = 0.05, P = 0.011; OR = 1.10, P = 0.001; OR = 0.60, P = 0.001; OR = 1.32, P = 0.003; respectively), and high symptom severity were less likely to be in Class 1 (OR = 0.82, P = 0.001). Moreover, compared with Class 1, the household per capita monthly income < 2,000 (OR = 16.41, P < 0.001), high symptom severity scores (OR = 1.12, P = 0.002) and low KPS scores (OR = 0.95, P = 0.002) were more likely to be in Class 2. CONCLUSIONS This study showed that almost half of ESRD patients receiving MHD presented moderate to severe palliative care needs, and the unmet needs were mainly affected by education level, financial pressure, functional status, symptom burden and social support. In the future, it is important to identify the populations with the greatest need for palliative care and consider the influencing factors of unmet needs from a comprehensive perspective, so as to help them improve health-related quality of life.
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Affiliation(s)
- Xuefei Wang
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Yongzhen Mo
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China.
| | - Yingying Yuan
- School of Nursing, Department of Medicine, Soochow University, Suzhou, Jiangsu, China
| | - Yi Zhou
- School of Nursing, Department of Medicine, Soochow University, Suzhou, Jiangsu, China
| | - Yan Chen
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Juan Sheng
- Jiangsu Province Official Hospital, Nanjing, Jiangsu, China
| | - Jing Liu
- Nanjing BenQ Medical Center, Nanjing, Jiangsu, China
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Sousa H, Ribeiro O, Costa E, Christensen AJ, Figueiredo D. Establishing the criterion validity of self-report measures of adherence in hemodialysis through associations with clinical biomarkers: A systematic review and meta-analysis. PLoS One 2022; 17:e0276163. [PMID: 36256660 PMCID: PMC9578604 DOI: 10.1371/journal.pone.0276163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/01/2022] [Indexed: 11/22/2022] Open
Abstract
Accurate measurement of adherence is crucial to rigorously evaluate interventions aimed at improving this outcome in patients undergoing in-center hemodialysis. Previous research has shown great variability in non-adherence rates between studies, mainly due to the use of different direct (e.g., clinical biomarkers) and indirect (e.g., questionnaires) measures. Although self-reported adherence in hemodialysis has been widely explored, it is still unclear which is the most accurate questionnaire to assess this outcome; therefore, the question of how to optimize adherence measurement in research and clinical practice has emerged as a key issue that needs to be addressed. This systematic review and meta-analysis aimed to explore the criterion validity of self-report measures of adherence in hemodialysis established through the association between test scores and clinical biomarkers (the criterion measure). The protocol was registered in PROSPERO (2021 CRD42021267550). The last search was performed on March 29th, 2022, on Web of Science (all databases included), Scopus, CINHAL, APA PsycInfo, and MEDLINE/PubMed. Twenty-nine primary studies were included, and thirty-eight associations were analyzed. The Hunter-Schmidt's meta-analysis was computed for the associations with more than two studies (n = 20). The results showed that six associations were large (16%), 11 were medium (29%) and the remaining were of small strength. The test scores from the End-Stage Renal Disease Adherence Questionnaire (range: 0.212<rc <0.319) and the Dialysis Diet and Fluid Non-Adherence Questionnaire (range: 0.206<rc <0.359) had medium to large strength associations with interdialytic weight gain, serum phosphorus, and potassium levels, indicating that these questionnaires have reasonable concurrent criterion validity to measure fluid control and adherence to dietary restrictions in patients receiving hemodialysis. The available data did not allow exploring the criterion validity of the test scores in relation to hemodialysis attendance (skipping and/or shortening sessions). These results suggest that the decision to use one questionnaire over another must be made with caution, as researchers need to consider the characteristics of the sample and the objectives of the study. Given that direct and indirect methods have their advantages and disadvantages, the combination of adherence measures in hemodialysis is recommended to accurately assess this complex and multidimensional outcome.
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Affiliation(s)
- Helena Sousa
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Oscar Ribeiro
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Elísio Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO–REQUIMTE), Faculty of Pharmacy and Competence Center on Active and Healthy Ageing (Porto4Ageing), University of Porto, Porto, Portugal
| | - Alan Jay Christensen
- Department of Psychology, East Carolina University, Greenville, North Carolina, United States of America
| | - Daniela Figueiredo
- CINTESIS@RISE, School of Health Sciences, University of Aveiro, Aveiro, Portugal
- * E-mail:
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Kazak A, Özkaraman A, Topalı H, Duran S. Evaluation of the relationship between health literacy and self-efficacy: A sample of hemodialysis patients. Int J Artif Organs 2022; 45:659-665. [PMID: 35761789 DOI: 10.1177/03913988221108754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The aim of this study was to evaluate self-efficacy and health literacy of patients undergoing hemodialysis, to investigate the relationship between health literacy and self-efficacy, and to determine the factors affecting self-efficacy. METHODS The study was conducted in Eskisehir and Gumushane state hospitals affiliated to the Public Hospitals Association with the participation of 198 patients receiving hemodialysis treatment for chronic renal failure. The inclusion criteria were as follows: being ⩾18 years old, receiving hemodialysis, and agreeing to participate in the study. The study data were collected using face-to-face interview technique, and they were analyzed using descriptive statistics, correlation, and regression analysis. RESULTS The mean age of the patients was 59.73 ± 16.32 years. Of the patients, 46% were primary school graduates, and 63.6% reported having other chronic diseases. The mean health literacy and self-efficacy scores were found to be 79.43 ± 26.09 and 23.98 ± 7.42, respectively. The results showed that the self-efficacy scores of the patients increased as the general health literacy scores increased, with a strong linear correlation between these variables (r = 0.712; p ˂ 0.001). Patients with advanced age, low educational level, and widowed patients had lower self-efficacy and health literacy scores than others (respectively eta2 = 0.263, 0.116, 0.268, 0.141). CONCLUSION High score of health literacy positively affects the self-efficacy score of hemodialysis patients.
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Affiliation(s)
- Aysun Kazak
- First and Emergency Aid, Medical Services and Techniques Department, Vocational School of Health Sciences, Mersin University, Mersin, Turkey
| | - Ayşe Özkaraman
- Faculty of Health Sciences, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Hasret Topalı
- Anesthesia Program, Medical Services and Techniques Department, Vocational School of Health Sciences, Bitlis Eren University, Bitlis, Turkey
| | - Secil Duran
- Dialysis Program, Medical Services and Techniques Department, Şiran Vocational School of Health Sciences, Gümüşhane University, Gumushane, Turkey
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Teong LF, Khor BH, Radion Purba K, Gafor AHA, Goh BL, Bee BC, Yahya R, Bavanandan S, Ng HM, Sahathevan S, Narayanan SS, Daud ZAM, Khosla P, Karupaiah T. A Mobile App for Triangulating Strategies in Phosphate Education Targeting Patients with Chronic Kidney Disease in Malaysia: Development, Validation, and Patient Acceptance. Healthcare (Basel) 2022; 10:healthcare10030535. [PMID: 35327013 PMCID: PMC8950478 DOI: 10.3390/healthcare10030535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Hyperphosphatemia afflicts end-stage chronic kidney disease (CKD) patients, contributing to comorbidities and mortality. Management strategies are dialysis, phosphate binder, and limiting dietary phosphate intake, but treatment barriers are poor patient compliance and low health literacy arising from low self-efficacy and lack of educational resources. This study describes developing and validating a phosphate mobile application (PMA). The PMA development based on the seven-stage Precaution Adoption Process Model prioritized titrating dietary phosphate intake with phosphate binder dose supported by educational videography. Experts (n = 13) first evaluated the PMA for knowledge-based accuracy, mobile heuristics, and clinical value. Adult HD patients validated the improved PMA using the seven-point mHealth App Usability Questionnaire (MAUQ). Patient feedback (n = 139) indicated agreement for ease of use (69.2%), interface and satisfaction (69.0%), and usefulness (70.1%), while 72.7% said they would recommend this PMA. The expectation confirmation for 25 PMA features ranged from 92.1% (lifestyle) up to 100.0% (language option); and the utilization rate of each feature varied from 21.6% (goal setting and feature-based log) to 91.4% (information on dietary phosphate and phosphate binder). The Conclusions: MyKidneyDiet-Phosphate Tracker PMA was acceptable to adult Malaysian HD patients as part of clinical phosphate management in low-resource settings.
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Affiliation(s)
- Lee-Fang Teong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia; (L.-F.T.); (S.S.N.)
- Department of Dietetics and Food Service, Selayang Hospital, Batu Caves 68100, Malaysia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia;
| | - Kristo Radion Purba
- School of Computer Science, University of Southampton Malaysia, Iskandar Puteri 79100, Malaysia;
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur 56000, Malaysia;
| | - Bak-Leong Goh
- Clinical Research Center, Serdang Hospital, Kajang 43000, Malaysia;
| | - Boon-Cheak Bee
- Department of Nephrology, Selayang Hospital, Lebuh Raya Selayang-Kepong, Batu Caves 68100, Malaysia;
| | - Rosnawati Yahya
- Department of Nephrology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur 53000, Malaysia; (R.Y.); (S.B.)
| | - Sunita Bavanandan
- Department of Nephrology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur 53000, Malaysia; (R.Y.); (S.B.)
| | - Hi-Ming Ng
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia;
- Department of Dietetics & Nutrition Services, Sunway Medical Center, Petaling Jaya 47500, Malaysia
| | - Sharmela Sahathevan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar 31900, Malaysia;
| | - Sreelakshmi Sankara Narayanan
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia; (L.-F.T.); (S.S.N.)
| | - Zulfitri Azuan Mat Daud
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Malaysia;
| | - Pramod Khosla
- Department of Nutrition & Food Sciences, College of Liberal Arts & Sciences, Wayne State University, Detroit, MI 48202, USA;
| | - Tilakavati Karupaiah
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Malaysia; (L.-F.T.); (S.S.N.)
- Correspondence:
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Duan DF, Liu M, Chen Y, Huang YY, Shi YY. Food Literacy and Its Associated Factors in Non-Dialysis Patients with Chronic Kidney Disease in China: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:439-447. [PMID: 35210760 PMCID: PMC8863322 DOI: 10.2147/ppa.s348227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Nephrology professionals' understanding of food literacy (FL) and influencing factors is significant for nutrition management, which is key to controlling disease progress among non-dialysis patients with chronic kidney disease (CKD). However, few studies have explored FL in CKD patients. Hence, this study aimed to investigate the level of FL of non-dialysis patients with CKD and to analyze influencing factors in China. PATIENTS AND METHODS A total of 203 CKD patients without dialysis were recruited from August to December 2020 to participate in a cross-sectional study. Food literacy was assessed by a modified short food literacy questionnaire for adults. Related influencing factors were measured by the motivation for dietary self-control scale and the satisfaction with dietary behavior scale. Data were also collected regarding patients' health information-seeking behavior (four items), satisfaction and compliance with dietary advice from healthcare professionals (two items), and demographics and clinical diagnoses. RESULTS The mean age of patients was 44.5 years (range 18 to 75), and 42.5% were male. Most (50.2%) were in stages 1-2 of CKD. The mean FL score of these patients was 38.75±0.38. The multivariable linear regression analysis shows that secondary educational level (β=0.221, p=0.004), motivation for controlling diet (β=0.198, p=0.003), satisfaction with dietary behaviors (β=0.319, p<0.001), and health information-seeking behavior (β=0.146, p=0.019) were significant influencing factors. CONCLUSION Food literacy of Chinese CKD patients without dialysis should be improved. Patients with higher education levels exhibit more active information-seeking behaviors, have greater satisfaction with dietary behaviors, and their motivation for dietary self-control is more likely to be associated with better FL. Healthcare workers should be aware of factors influencing FL and attempt to integrate assessment of FL into routine food-related education for CKD patients.
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Affiliation(s)
- Di-Fei Duan
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China
- West China School of Nursing, Sichuan University, Chengdu, People’s Republic of China
| | - Min Liu
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China
- West China School of Nursing, Sichuan University, Chengdu, People’s Republic of China
| | - Yi Chen
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China
- West China School of Nursing, Sichuan University, Chengdu, People’s Republic of China
| | - Yue-Yang Huang
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China
- West China School of Nursing, Sichuan University, Chengdu, People’s Republic of China
| | - Yun-Ying Shi
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China
- Correspondence: Yun-Ying Shi, Department of Nephrology, West China Hospital of Sichuan University, No. 37 Guoxuexiang Wuhou District, Chengdu, Sichuan, People’s Republic of China, Email
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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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Tang L, Fu Z. The effects of the transtheoretical model combined with nutritional intervention in hemodialysis patients. Am J Transl Res 2021; 13:7898-7905. [PMID: 34377268 PMCID: PMC8340176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the effects of the transtheoretical model combined with nutritional intervention (TTMNI) in hemodialysis (HD) patients. METHODS The clinical data of 100 HD patients recorded from October 2018 to October 2020 were retrospectively collected and divided into two groups according to the intervention method each patient underwent. Group A (n=49) underwent routine nursing intervention and group B (n=51) underwent TTMNI combined with routine nursing intervention. The two groups were compared before and after intervention in terms of their nutritional indices, Renal Adherence Attitudes Questionnaire (RAAQ) scores, their Renal Adherence Behavior Questionnaire (RABQ) scores, their Subjective Global Assessment (SGA) statuses, their anthropometric indicators such as their serum creatinine (SCr), blood urea nitrogen (BUN), mid-arm muscle circumference (MAMC), triceps skinfold (TSF), body mass index (BMI), urea clearance index (KT/V), and urea reduction ratios (URR%). RESULTS Compared with group A, group B showed higher transferrin (TRF), prealbumin (PA), and albumin (ALB) levels, higher RAAQ and RABQ scores, higher MAMC, TSF, and BMI levels and lower SGA scores, and lower SCr, and BUN levels (P<0.05). After the intervention, the attainment rate of target KT/V was 94.12% in group B, higher than the 63.27% in group A, and the patients with target URR% accounted for 96.07% in group B, higher than the 61.22% in group A (P<0.05). CONCLUSION TTMNI for HD patients is helps improve patients' nutritional statuses and their dietary compliance as well as their liver function, and it increases their dialysis attainment rate.
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Affiliation(s)
- Lihua Tang
- Hemodialysis Room, First People's Hospital of Fuzhou Fuzhou 344000, Jiangxi Province, China
| | - Zhihui Fu
- Hemodialysis Room, First People's Hospital of Fuzhou Fuzhou 344000, Jiangxi Province, China
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