Relationship among symptoms, quality of life, and complementary and alternative medicines use among patients undergoing hemodialysis in French-speaking Switzerland

BACKGROUND

Chronic renal disease is considered a main public health problem due to its high prevalence in the population. The solution of choice currently available is kidney transplantation but when this option is not available, blood purification treatments, notably haemodialysis (HD), are necessary. The presence of chronic renal disease combined with this demanding medical procedure leads to a hard symptomatology. To face this situation, HD patients often resort to complementary and alternative medicines (CAM) as they perceive that the healthcare professionals aren't paying enough attention to their quality of life. Given this background, we aim to describe the prevalence and the type of the CAM used among HD patients and their possible relations with patients' symptomatology and quality of life.

METHODS

We interviewed 88 patients, undergoing hemodialysis in three hemodialysis centers in French-speaking Switzerland, about the presence of symptoms, their quality of life, and the possible use of CAM. Cluster analysis was used to create patients' profiles about CAM use and regression analysis to explore the links between symptoms' presence, patients' quality of life, and CAM use.

RESULTS

Our results show a large use of CAM: almost two HD patients out of three uses at least one CAM. Using cluster analysis, we were able to identify five patients' profiles: non-users (37.5% of our sample), users of herbal medicine (20.5%), users of prayer-based practices (18.2%), people mainly using massages (9.1%), and a residual group including the users of other CAMs, with a predominance of meditation (14.8%). As expected, we observe a negative relation between the number of declared symptoms and patients' quality of life. Contrarily, we observe no relation between the use of CAM and the presence of symptoms. Our results show a positive relationship between the use of CAM and patients' overall perception of health as well as the psychological dimension of their quality of life. No relationship is observed with other dimensions of quality of life, notably the physical dimension.

CONCLUSIONS

Our results suggests that CAMs aren't used as a substitute of official medicine but as a parallel support to HD patients' quality of life.

[The discipline of nursing : Knowledge, teaching, and care]

In recent years, professional skills and the nursing profession in France have undergone major transformations. These have included the recognition of advanced nursing practice and its implementation in 2018, and the creation by the National Council of Universities in 2019 of a “Nursing” section (n° 92), which has paved the way for the development of research and teaching in nursing in an academic environment in France.To support these transformations, the Association de recherche en soins infirmiers (Arsi) (Nursing Research Association) has for several years been organizing seminars and symposia. The seminar “The discipline of nursing : Knowledge, teaching, and care,” held on November 16, 2019 in Paris, was a continuation of those organized in 2014 and 2016.This seminar focused on the acquisition of nursing knowledge, in particular through the analysis of clinical situations using two middle-range theories : comfort and symptom management.The first part of this article describes the objectives and the working methodology of the seminar. The second part provides a recap of the theoretical foundations, while the third and final part presents the results of what the workshops participants produced.

Factors influencing the patient education performance of hemodialysis unit nurses

OBJECTIVE

This study aimed to identify the perceptions, barriers, and facilitators of patient education and factors influencing the performance of patient education among hemodialysis unit nurses.

METHODS

This study used a descriptive correlational design in which a total of 262 nurses from 27 hemodialysis facilities in six provinces in the Republic of Korea participated. Self-administered questionnaires were used to identify the perceptions, barriers, facilitators, and performance of patient education. Data were analyzed using a t-test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression.

RESULTS

Factors influencing patient education performance were nurses' total clinical experience, perceptions, working experience in a hemodialysis unit, facilitators, number of nurses in the hemodialysis unit, and barriers. These variables accounted for 37.2 % of the variance in the final model.

CONCLUSION

Nurses' performance in patient education was significantly influenced by perceptions, facilitators, and barriers. Nurses' total clinical experience, working experience in a hemodialysis unit, and number of nurses in the unit also influenced patient education performance.

PRACTICE IMPLICATIONS

A nurse training program should be developed to reinforce nurses' patient education competency.