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Alshammari B, Alkubati SA, Alrasheeday A, Pasay-An E, Edison JS, Madkhali N, Al-Sadi AK, Altamimi MS, Alshammari SO, Alshammari AA, Alshammari F. Factors influencing fatigue among patients undergoing hemodialysis: a multi-center cross-sectional study. Libyan J Med 2024; 19:2301142. [PMID: 38194427 PMCID: PMC10786431 DOI: 10.1080/19932820.2023.2301142] [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: 11/02/2023] [Accepted: 12/28/2023] [Indexed: 01/11/2024] Open
Abstract
Fatigue has been reported to be the most common symptom experienced by patients receiving hemodialysis (HD) therapy. Fatigue can lead to a reduction in their ability to engage in both routine and self-care activities, which can negatively affect their self-confidence and quality of life. This study aimed to determine the level of fatigue and the factors that affecting its level among patients receiving uHD. METHODS A cross-sectional design was utilized to explore the level of fatigue among patients receiving maintenance HD using the Mul-tidimensional Assessment of Fatigue (MAF) scale. Data were collected from four dialysis centers in two Saudi Arabia cities, Hail and Al-Qassim, between January 2022 and October 2022. RESULTS The questionnaire was completed by 236 patients. Older patients, male patients, and retired pa-tients reported significantly higher levels of fatigue (p < 0.001). In contrast, marital status, educational level, and financial status did not significantly affect the level of fatigue among patients (p = 0.193, 0.285, and 0.126, respectively). Patients who had seven or more dependents reported more fatigue than those who had lower levels of fatigue or who did not have dependents (p = 0.004). In addition, patients who had a regular exercise regimen reported significantly lower fatigue than those who did not have an exercise regimen (p = 0.011). Multiple linear regression demonstrated that employment status (student), comorbidity condition (one chronic disease), dialysis duration, satisfaction with dialysis time, and dialysis time were found to affect the fatigue scores (R2 = 0.302, p ˂ 0.001). CONCLUSION The findings of this study gives a broader understanding of factors influencing fatigue among patients with HD that will help to develop strategies of more focused interventions to reduce fatigue among patients with HD.
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Affiliation(s)
- Bushra Alshammari
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Sameer A. Alkubati
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeidah University, Hodeida, Yemen
| | - Awatif Alrasheeday
- Nursing Administration Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Eddieson Pasay-An
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - J. Silvia Edison
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Norah Madkhali
- Department of Nursing, College of Nursing, Jazan University, Jazan, Saudi Arabia
- Oncology Center, Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Ahmed K. Al-Sadi
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | | | - Sahar Obeid Alshammari
- Nursing Administration Office, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia
| | - Areej A. Alshammari
- Nursing Administration Office, Aja Long Term Care Hospital, Hail health Cluster, Hail, Saudi Arabia
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail, Saudi Arabia
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Namagondlu Seetharamaiah G, Marisiddappa L, Dhareshwar S, Rani S, Das N. Application of therapeutic ultrasonic waves across the dialyzer membrane: A pilot study on the impact on dialyzer clearance and safety. Hemodial Int 2024; 28:313-325. [PMID: 38783838 DOI: 10.1111/hdi.13161] [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: 09/07/2023] [Revised: 03/27/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Progressive clogging of the dialyzer membrane during hemodialysis can compromise solute removal efficiency. Existing solutions fall short in addressing intradialytic reduction of dialyzer clearance. This pilot study aims to assess the impact and safety of applying therapeutic ultrasonic waves to dialyzers for mitigating intradialytic clogging. METHODS In this pilot study, 15 stable maintenance hemodialysis patients (12 males and 3 females) were enrolled. Each patient served as their own control. They underwent one session of hemodialysis with the application of therapeutic ultrasonic waves (Ultrasonic session) and were crossed-over to a second session without the use of ultrasonic waves (Control session). All the study sessions operated at a fixed dialysate flow rate of 500 mL/min and a blood flow rate of 250 or 300 mL/min. The adequacy of dialysis achieved during each session was monitored using Online Clearance Monitoring of the dialysis machines, and clearance K values, varying between 135 and 209 mL/min, were recorded, and plotted. A direct comparison between Control and Ultrasonic sessions was performed to assess the impact and safety of using ultrasonic waves during hemodialysis. FINDINGS The mean percentage decline in dialyzer clearance values was 4.41% for Ultrasonic sessions (SD: 5.3) and 12.69% for Control sessions (SD: 6.35) (p-value <0.001). This indicates that the application of ultrasonic waves reduced the decline in clearance values. The mean differences of the blood component parameters were comparable between both Ultrasonic sessions and Control sessions, suggesting the safety of utilizing ultrasonic waves during dialysis. Microscopic membrane analysis corroborated the safety. DISCUSSION Intradialytic clogging of dialyzer membranes is a significant problem that can cause dialysis inadequacy. Our study tackles this issue by introducing therapeutic ultrasonic waves to improve dialyzer clearance during hemodialysis sessions in patients.
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Affiliation(s)
| | | | | | | | - Nikhil Das
- Sedign Solutions Pvt. Ltd., Bengaluru, India
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Pitino A, D’Arrigo G, Marino C, Pizzini P, Caridi G, Mallamaci F, Tripepi G, Zoccali C. Socioeconomic Status and Clinical Outcomes in Chronic Kidney Disease: Bootstrap Validation of a Simple Indicator. J Clin Med 2024; 13:3600. [PMID: 38930130 PMCID: PMC11204512 DOI: 10.3390/jcm13123600] [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: 04/17/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Chronic Kidney Disease (CKD) is a complex health condition that interacts significantly with socioeconomic determinants, particularly income status and education. This study developed a simple indicator of socioeconomic status (SES), which is composed of income status and education in CKD patients, and evaluated its impact on health outcomes in this population. Methods: This study was conducted on 561 CKD patients, stages 2-5. The composite SES score was developed by combining the regression coefficients of income and education as predictors of the study endpoint in a multivariable Cox model, normalizing these coefficients to derive weights, and then using these weights to calculate an individual percentage score based on each person's income and education. The composed SES indicator was internally validated through bootstrap analysis. Over a median follow-up time of 36 months, we tracked all-cause death and non-fatal cardiovascular events. Results: Both lack of income (p = 0.020) and low educational level (p = 0.034) were independently related to the combined endpoint. Based on these covariates' regression coefficients, a composite socioeconomic score considering income and educational level was generated. In a Cox regression model, a 10% increase in this composite risk score entailed a 25% increase in the hazard ratio (HR) of the combined endpoint [HR (10% increase): 1.25], and the internally validated 95% CI ranged from 1.14 to 1.41 (p < 0.001). Conclusions: This study underscores the significant impact of a simple, bootstrap-validated composite SES indicator on CKD patients' health outcomes. These findings highlight the importance of considering education and socioeconomic factors in managing and treating CKD patients and inform future research and policy considerations for this population.
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Affiliation(s)
- Annalisa Pitino
- National Research Council of ITALY (CNR), Institute of Clinical Physiology in Rome, 00042 Rome, Italy
| | - Graziella D’Arrigo
- National Research Council of ITALY (CNR), Institute of Clinical Physiology in Reggio Calabria, 00185 Reggio Calabria, Italy
| | - Carmela Marino
- National Research Council of ITALY (CNR), Institute of Clinical Physiology in Reggio Calabria, 00185 Reggio Calabria, Italy
| | - Patrizia Pizzini
- National Research Council of ITALY (CNR), Institute of Clinical Physiology in Reggio Calabria, 00185 Reggio Calabria, Italy
| | - Graziella Caridi
- Nephrology and Renal Transplantation Unit, Grande Ospedale Metropolitano, 20126 Reggio Calabria, Italy
| | - Francesca Mallamaci
- National Research Council of ITALY (CNR), Institute of Clinical Physiology in Reggio Calabria, 00185 Reggio Calabria, Italy
- Nephrology and Renal Transplantation Unit, Grande Ospedale Metropolitano, 20126 Reggio Calabria, Italy
| | - Giovanni Tripepi
- National Research Council of ITALY (CNR), Institute of Clinical Physiology in Reggio Calabria, 00185 Reggio Calabria, Italy
| | - Carmine Zoccali
- Renal Research Institute, New York, NY 10065, USA
- Institute of Molecular Biology and Genetics (Biogem), 21846 Ariano Irpino, Italy
- Carmine Zoccali IPNET, Associazione Ipertensione Nefrologia Trapianto (IPNET), c/o Nefrologia, Grande Ospedale Metropolitano, 89124 Reggio Calabria, Italy
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Siligato R, Gembillo G, Di Simone E, Di Maria A, Nicoletti S, Scichilone LM, Capone M, Vinci FM, Bondanelli M, Malaventura C, Storari A, Santoro D, Di Muzio M, Dionisi S, Fabbian F. Financial Toxicity in Renal Patients (FINTORE) Study: A Cross-Sectional Italian Study on Financial Burden in Kidney Disease-A Project Protocol. Methods Protoc 2024; 7:34. [PMID: 38668141 PMCID: PMC11053909 DOI: 10.3390/mps7020034] [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: 02/21/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
Financial toxicity (FT) refers to the negative impact of health-care costs on clinical conditions. In general, social determinants of health, especially poverty, socioenvironmental stressors, and psychological factors, are increasingly recognized as important determinants of non-communicable diseases, such as chronic kidney disease (CKD), and their consequences. We aim to investigate the prevalence of FT in patients at different stages of CKD treated in our universal health-care system and from pediatric nephrology, hemodialysis, peritoneal dialysis and renal transplantation clinics. FT will be assessed with the Patient-Reported Outcome for Fighting Financial Toxicity (PROFFIT) score, which was first developed by Italian oncologists. Our local ethics committee has approved the study. Our population sample will answer the sixteen questions of the PROFFIT questionnaire, seven of which are related to the outcome and nine the determinants of FT. Data will be analyzed in the pediatric and adult populations and by group stratification. We are confident that this study will raise awareness among health-care professionals of the high risk of adverse health outcomes in patients who have both kidney disease and high levels of FT. Strategies to reduce FT should be implemented to improve the standard of care for people with kidney disease and lead to truly patient-centered care.
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Affiliation(s)
- Rossella Siligato
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98121 Messina, Italy;
| | - Guido Gembillo
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98121 Messina, Italy;
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98121 Messina, Italy;
| | - Emanuele Di Simone
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy; (E.D.S.); (M.D.M.)
| | - Alessio Di Maria
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
| | - Simone Nicoletti
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
| | - Laura Maria Scichilone
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
| | - Matteo Capone
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.B.); (C.M.)
| | - Francesca Maria Vinci
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.B.); (C.M.)
| | - Marta Bondanelli
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.B.); (C.M.)
| | - Cristina Malaventura
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.B.); (C.M.)
| | - Alda Storari
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.B.); (C.M.)
| | - Domenico Santoro
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98121 Messina, Italy;
| | - Marco Di Muzio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy; (E.D.S.); (M.D.M.)
| | - Sara Dionisi
- Nursing, Technical and Rehabilitation, Department DATeR Azienda Unità Sanitaria Locale di Bologna, 40121 Bologna, Italy;
| | - Fabio Fabbian
- Nephrology Unit, University Hospital of Ferrara, 44121 Ferrara, Italy; (R.S.); (A.D.M.); (S.N.); (L.M.S.); (M.C.); (F.M.V.); (A.S.)
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (M.B.); (C.M.)
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Zhang Y, Liu S, Miao Q, Zhang X, Wei H, Feng S, Li X. The Heterogeneity of Symptom Burden and Fear of Progression Among Kidney Transplant Recipients: A Latent Class Analysis. Psychol Res Behav Manag 2024; 17:1205-1219. [PMID: 38524288 PMCID: PMC10959014 DOI: 10.2147/prbm.s454787] [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] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose Kidney transplant recipients (KTRs) may experience symptoms that increase their fear of progression (FoP), but a dearth of research examines the issue from a patient-centered perspective. Our study aimed to first determine the category of symptom burden, then to explore the differences in characteristics of patients in different subgroups, and finally to analyze the impact of symptom subgroup on FoP. Patients and Methods Sociodemographic and Clinical Characteristics, Symptom Experience Scale, and Fear of Progression Questionnaire-Short Form were used. Latent class analysis was used to group KTRs according to the occurrence of symptoms. We used multivariate logistic regression to analyze the predictors of different subgroups. The differences in FoP among symptom burden subgroups were analyzed by hierarchical multiple regression. Results Three subgroups were identified, designated all-high (20.5%), moderate (39.9%), and all-low (39.6%) according to their symptom occurrence. Multivariate logistic regression showed that gender, post-transplant time, per capita monthly income, and hyperuricemia were the factors that distinguished and predicted the all-high subgroup (P < 0.05). Hierarchical multiple regression showed that symptom burden had a significant effect on FoP (class1 vs class3: β = 0.327, P < 0.001; class2 vs class3: β = 0.104, P = 0.046), explaining the 8.0% variance of FoP (ΔR2 = 0.080). Conclusion KTRs generally experience moderate or low symptom burden, and symptom burden is an influencing factor in FoP. Identifying the traits of KTRs with high symptom burden can help clinicians develop targeted management strategies and ease FoP of KTRs.
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Affiliation(s)
- Ying Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Sainan Liu
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Qi Miao
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xu Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - He Wei
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Shuang Feng
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xiaofei Li
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
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Shek Nam Ng M, Kwok Wei So W, Chow Choi K, Chen J, Sze Ho Wong S, Hui YH, Kin Hung Chan A, Hau Sim Ho E, Wing Han Chan C. Hope, quality of life, and psychological distress in patients on peritoneal dialysis: A cross-sectional study. J Health Psychol 2023; 28:1238-1249. [PMID: 37246408 DOI: 10.1177/13591053231176262] [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] [Indexed: 05/30/2023] Open
Abstract
Hope is a goal-directed thought that reflects the sense of control over uncertainties and can promote adjustment to chronic illness. This study aimed to assess the level of hope among patients on peritoneal dialysis and evaluate the association of hope with health-related quality of life and psychological distress. This cross-sectional study included 134 Chinese patients receiving peritoneal dialysis in Hong Kong. Patients' level of hope was assessed using the Adult Trait Hope Scale. Participants who were employed, had a higher income, and received automated peritoneal dialysis reported a higher hope score. Hope was found to have significant correlations with age and social support. A higher hope score was associated with better mental well-being and less severe depressive symptoms. Specific relationships between agency/pathway thinking and these outcomes were identified. The patient subgroups at risk for losing hope need to be identified and received early interventions to prevent adverse outcomes.
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Li X, Luo JK. Perceptions and attitudes of kidney supportive care among elderly patients with advanced chronic kidney disease and dialysis healthcare professionals in China: a qualitative study. BMC Nephrol 2023; 24:316. [PMID: 37884858 PMCID: PMC10604377 DOI: 10.1186/s12882-023-03372-2] [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: 06/23/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
PURPOSE Kidney supportive care (KSC) represents a novel approach wherein a multidisciplinary team of nephrology experts offers active symptom management, advance care planning, shared decision-making, conservative treatment, and end-of-life care. This study is aimed at providing comprehensive insights and evaluations regarding the understanding and perspectives of Chinese healthcare professionals, including nephrologists and dialysis nurses, as well as elderly individuals aged 60 and above who are afflicted with chronic kidney disease. The primary goal is to furnish substantial information support for a better comprehension of KSC within the Chinese context, with the ultimate aim of facilitating its effective implementation in this region. METHODS Employing a phenomenological framework, this qualitative research generated data using semi-structured interviews with 18 elderly patients diagnosed with advanced chronic kidney disease and 10 healthcare professionals across two Class III Grade A medical institutions. The Colaizzi's analytical method was utilized for coding and analyzing the interview data. RESULTS Distinct interviews were executed with patients and healthcare professionals to delineate specific themes for each group. For elderly dialysis patients, the following themes were formed: (1) Lack of understanding of KSC; (2) Concerns of how KSC is perceived; and (3) Perceived benefits of KSC. Within the healthcare professionals cohort, two salient themes emerged: (1) Prospective clinical merits of KSC ; and (2) Mltiple difficulties encountered. CONCLUSIONS This study goes some way in furnishing a holistic understanding of perceptions surrounding KSC among elderly patients undergoing dialysis and healthcare professionals in China. The overarching Chinese cultural ethos poses substantial challenges to the widespread assimilation of KSC. While healthcare professionals advocate for KSC, there remains a limit in the patients' comprehension of this therapeutic paradigm. There is a compelling imperative to cultivate this strategy, grounded in the prevailing medical landscape.
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Affiliation(s)
- Xue Li
- Beijing Friendship Hospital, Nursing Department, Beijing Friendship Hospital, Capital Medical University, Capital Medical University, NO. 95 Yong-An Road, Xi-Cheng District, Beijing, 100050, PR China
| | - Jin Kai Luo
- Beijing Friendship Hospital, Nursing Department, Beijing Friendship Hospital, Capital Medical University, Capital Medical University, NO. 95 Yong-An Road, Xi-Cheng District, Beijing, 100050, PR China.
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Xu F, Zhuang B, Wang Z, Wu H, Hui X, Peng H, Bian X, Ye H. Knowledge, attitude, and practice of patients receiving maintenance hemodialysis regarding hemodialysis and its complications: a single-center, cross-sectional study in Nanjing. BMC Nephrol 2023; 24:275. [PMID: 37730535 PMCID: PMC10510168 DOI: 10.1186/s12882-023-03320-0] [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: 04/04/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Good knowledge of and attitudes toward hemodialysis and its complications might be expected to promote good practices and improve adherence. This study investigated, the knowledge, attitude, and practice of patients receiving hemodialysis regarding hemodialysis and its complications. METHODS This cross-sectional study enrolled patients with uremia who were receiving hemodialysis at the Second Affiliated Hospital of Nanjing Medical University (China) between January 9, 2023, and January 16, 2023. A questionnaire was designed that included the following dimensions: demographic/clinical information, knowledge, attitude, and practice. Correlations between knowledge, attitude, and practice scores were evaluated by Pearson correlation analysis. RESULTS The analysis included 493 patients (305 males, 61.87%). The average knowledge, attitude, and practice score was 19.33 ± 7.07 (possible range, 0-31), 28.77 ± 3.58 (possible range, 8-40), and 43.57 ± 6.53 (possible range, 11-55) points, respectively. A higher knowledge score was associated with younger age (P < 0.001), a higher education level (P < 0.001), and not living alone (P < 0.001), while a higher practice score was associated with a shorter history of hemodialysis (P < 0.001). There were positive correlations between the knowledge and practice scores (r = 0.220, P < 0.001) and between the attitude and practice scores (r = 0.453, P < 0.001), although the knowledge and attitude scores were not significantly correlated. CONCLUSIONS The results provide important insights into the knowledge, attitudes, and practices of patients with uremia in Nanjing (China) regarding hemodialysis and its complications. These findings may facilitate education programs to improve self-care practices in patients receiving maintenance hemodialysis in Nanjing (China).
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Affiliation(s)
- Fangfang Xu
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Bing Zhuang
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Zhongxia Wang
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Hao Wu
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Xin Hui
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Hongyan Peng
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China
| | - Xueqin Bian
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China.
| | - Hong Ye
- Center for Kidney Disease, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China.
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Ng MSN, Chan DNS, So WKW. Health inequity associated with financial hardship among patients with kidney failure. PLoS One 2023; 18:e0287510. [PMID: 37352190 PMCID: PMC10289308 DOI: 10.1371/journal.pone.0287510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 06/07/2023] [Indexed: 06/25/2023] Open
Abstract
Financial hardship is a common challenge among patients with kidney failure and may have negative health consequences. Therefore, financial status is regarded as an important determinant of health, and its impact needs to be investigated. This cross-sectional study aimed to identify the differences in patient-reported and clinical outcomes among kidney failure patients with different financial status. A total of 354 patients with kidney failure were recruited from March to June 2017 at two hospitals in Hong Kong. The Dialysis Symptoms Index and Kidney Disease Quality of Life-36 were used to evaluate patient-reported outcomes. Clinical outcomes were retrieved from medical records and assessed using the Karnofsky Performance Scale (functional status) and Charlson Comorbidity Index (comorbidity level). Patients were stratified using two dichotomised variables, employment status and income level, and their outcomes were compared using independent sample t-tests and Mann-Whitney U-tests. In this sample, the employment rate was 17.8% and the poverty rate was 61.2%. Compared with other patients, increased distress of specific symptoms and higher healthcare utilization, in terms of more emergency room visits and longer hospital stays, were found in patients with poorer financial status. Low-income patients reported a decreased mental quality of life. Financially underprivileged patients experienced health inequity in terms of impaired outcomes. Attention needs to be paid to these patients by providing financial assessments and interventions. Additional research is warranted to confirm these findings and understand the experience of financial hardship and health equity.
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Affiliation(s)
- Marques Shek Nam Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Le LTH, Tran TT, Duong TV, Dang LT, Hoang TA, Nguyen DH, Pham MD, Do BN, Nguyen HC, Pham LV, Nguyen LTH, Nguyen HT, Trieu NT, Do TV, Trinh MV, Ha TH, Phan DT, Nguyen TTP, Nguyen KT, Yang SH. Digital Healthy Diet Literacy and Fear of COVID-19 as Associated with Treatment Adherence and Its Subscales among Hemodialysis Patients: A Multi-Hospital Study. Nutrients 2023; 15:nu15102292. [PMID: 37242175 DOI: 10.3390/nu15102292] [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: 04/08/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Treatment adherence (TA) is a critical issue and is under-investigated in hemodialysis patients. A multi-center study was conducted from July 2020 to March 2021 on 972 hemodialysis patients in eight hospitals in Vietnam to explore the factors associated with TA during the COVID-19 pandemic. Data were collected, including socio-demographics, an End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), 12-item short-form health literacy questionnaire (HLS-SF12), 4-item digital healthy diet literacy scale (DDL), 10-item hemodialysis dietary knowledge scale (HDK), 7-item fear of COVID-19 scale (FCoV-19S), and suspected COVID-19 symptoms (S-COVID19-S). Bivariate and multivariate linear regression models were used to explore the associations. Higher DDL scores were associated with higher TA scores (regression coefficient, B, 1.35; 95% confidence interval, 95%CI, 0.59, 2.12; p = 0.001). Higher FCoV-19S scores were associated with lower TA scores (B, -1.78; 95%CI, -3.33, -0.24; p = 0.023). In addition, patients aged 60-85 (B, 24.85; 95%CI, 6.61, 43.11; p = 0.008) with "very or fairly easy" medication payment ability (B, 27.92; 95%CI, 5.89, 44.95; p = 0.013) had higher TA scores. Patients who underwent hemodialysis for ≥5 years had a lower TA score than those who received <5 years of hemodialysis (B, -52.87; 95%CI, -70.46, -35.28; p < 0.001). These findings suggested that DDL and FCoV-19S, among other factors, should be considered in future interventions to improve TA in hemodialysis patients.
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Affiliation(s)
- Lan T H Le
- Training and Direction of Healthcare Activity Center, Thai Nguyen National Hospital, Thai Nguyen City 241-24, Vietnam
- Biochemistry Department, Thai Nguyen National Hospital, Thai Nguyen City 241-24, Vietnam
- Director Office, Thai Nguyen National Hospital, Thai Nguyen City 241-24, Vietnam
| | - Tu T Tran
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan
- Department of Internal Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 241-17, Vietnam
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan
| | - Loan T Dang
- Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi 115-20, Vietnam
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112-19, Taiwan
| | - Trung A Hoang
- Hemodialysis Department, Nephro-Urology-Dialysis Center, Bach Mai Hospital, Hanoi 115-19, Vietnam
| | - Dung H Nguyen
- Hemodialysis Department, Nephro-Urology-Dialysis Center, Bach Mai Hospital, Hanoi 115-19, Vietnam
| | - Minh D Pham
- Department of Nutrition, Military Hospital 103, Hanoi 121-08, Vietnam
- Department of Nutrition, Vietnam Military Medical University, Hanoi 121-08, Vietnam
| | - Binh N Do
- Department of Military Science, Vietnam Military Medical University, Hanoi 121-08, Vietnam
- Department of Infectious Diseases, Vietnam Military Medical University, Hanoi 121-08, Vietnam
| | - Hoang C Nguyen
- Director Office, Thai Nguyen National Hospital, Thai Nguyen City 241-24, Vietnam
- President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City 241-17, Vietnam
| | - Linh V Pham
- Department of Pulmonary & Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong 042-12, Vietnam
- President Office, Hai Phong University of Medicine and Pharmacy, Hai Phong 042-12, Vietnam
| | - Lien T H Nguyen
- Department of Pulmonary & Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong 042-12, Vietnam
| | - Hoi T Nguyen
- Director Office, Hai Phong International Hospital, Hai Phong 047-08, Vietnam
| | - Nga T Trieu
- Hemodialysis Division, Hai Phong International Hospital, Hai Phong 047-08, Vietnam
| | - Thinh V Do
- Director Office, Bai Chay Hospital, Ha Long 011-21, Vietnam
| | - Manh V Trinh
- Director Office, Quang Ninh General Hospital, Ha Long 011-08, Vietnam
| | - Tung H Ha
- Director Office, General Hospital of Agricultural, Hanoi 125-16, Vietnam
| | - Dung T Phan
- Faculty of Nursing, Hanoi University of Business and Technology, Hanoi 116-22, Vietnam
- Nursing Office, Thien An Obstetrics and Gynecology Hospital, Hanoi 112-06, Vietnam
| | - Thao T P Nguyen
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue 491-20, Vietnam
| | - Kien T Nguyen
- Department of Health Promotion, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi 119-10, Vietnam
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Research Center of Geriatric Nutrition, Taipei Medical University, Taipei 110-31, Taiwan
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