The Effect of Health-belief-model-Based Training on Behaviors Preventing Peritonitis in Patients on Peritoneal Dialysis

Self-management training in patients with chronic kidney disease undergoing hemodialysis: A systematic review

The aim of this systematic review is to investigate the effectiveness of different self-management training programs applied to dialysis patients. During the literature review, the flow chart of preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) was utilized. The review was limited by the year. All studies in English were screened in the databases "Ulakbim National Database, Google Scholar, Scopus, PubMed, Science Direct, Web of Science, Medline, EBSCOhost, and Cochrane Library." Eleven studies, including nine randomized controlled and two quasi-experimental, were included in the review.

Peritoneal Dialysis Patient Training Program to Enhance independence and Prevent Complications: A Scoping Review

Background

Peritoneal dialysis (PD) training is essential to ensure patient independence and prevent life-threatening complications, such as peritonitis. The International Society for Peritoneal Dialysis (ISPD) recommends that every PD unit worldwide implement local PD training programs with the goal of improving self-care capabilities. This scoping review aims to give an overview of recent literature and recommendations on PD training programs aiming to improve the quality of care and outcomes for PD patients.

Methods

The literature search was conducted using the PC (Population, Concept) approach. The population of interest in this study is PD patients, and the study concept is the PD training program. Several databases were used to conduct the literature search, including PubMed, Science Direct, and CINAHL. The search process began from July 2022 until January 2023. The inclusion criteria for the search included research articles and recommendations.

Results

The search yielded 22 articles recommending training programs lasting from 5-8 days, with 1-3-hour sessions and a nurse-to-patient ratio of 1:1. A cumulative training time of 15 hours or more is recommended to enhance patient independence and reduce peritonitis rates. Home-based or in-unit PD training, conducted by experienced nurses using adult learning strategies, has shown significant value in improving self-care and preventing peritonitis. Evaluating training outcomes should encompass knowledge, skills, and attitudes, and the impact on peritonitis rates. Training programs should be flexible and consider physiological and psychosocial barriers to achieving the best results.

Conclusion

There are a variety of strategies for dialysis training concerning duration, session length, patient-to-trainer ratio, timing, methods, location, compliance, and the need for retraining. More evidence is needed to assess the impact of PD patient training programs on self-care capabilities and peritonitis incidence. Future studies should investigate the effects of training programs on compliance, self-efficacy, and patient and nurse perspectives.

Mapping Patients' Perceived Facilitators and Barriers to In-Center Hemodialysis Attendance to the Health Belief Model: Insights from a Qualitative Study

BACKGROUND

Previous research has shown that deliberate withdrawal, skipping, and/or shortening hemodialysis sessions has become a major health problem associated with poor clinical outcomes and early mortality in patients with end-stage renal disease (ESRD). However, patients' experiences with this treatment remain largely unexplored. This study aimed to explore patients' perceived facilitators and barriers to in-center hemodialysis attendance and map these findings to the Health Belief Model.

METHODS

A qualitative exploratory study was conducted with a purposive sample. Semi-structured interviews were conducted and submitted to thematic analysis.

RESULTS

Twenty-four patients (66.2 ± 12.3 years old; length of time on hemodialysis: 35.2 ± 51.5 months) were interviewed. Five major facilitators (social support, perceived benefits, self-efficacy, time on dialysis, and risk/susceptibility perception) and two barriers (lack of knowledge about ESRD and hemodialysis, and psychosocial costs) were identified.

CONCLUSION

Adherence to the prescribed regimen of hemodialysis attendance is a complex and multidimensional phenomenon that involves an interaction between modifying factors (social support, disease and treatment knowledge, time on dialysis) and patients' perceived benefits, perceived risks, self-efficacy, and treatment costs. This study findings expand knowledge by suggesting that perceiving health benefits from the beginning of treatment, self-efficacy to deal with dialysis demands, and purpose in life are important facilitators of adherence to in-center hemodialysis sessions. Furthermore, it suggests that the impact of the hemodialysis regimen on the emotional well-being of family members is an important barrier. Future interventions should focus on skills training to promote self-efficacy and family coping with the demands of in-center hemodialysis, improve disease and treatment knowledge, and help balance perceived benefits with dialysis costs.

Health beliefs and adherence of the elderly to fall prevention measures: a quasi-experimental study

OBJECTIVE

To evaluate the effect of an educational intervention on health beliefs and adherence of elderly people to fall prevention measures.

METHODS

This is a quasi-experimental study, carried out at the Senior Citizens' Center. Sixty-eight elderly completed the intervention. The intervention consisted of four meetings focused on beliefs about falls and prevention, and the evaluation occurred at baseline and 30 days after completion.

RESULTS

The elderly were predominantly women (83.82%), with one to four years of schooling (36.76%), with health problems (95.59%), and 48.53% had fallen. There was a significant increase in perceived susceptibility, severity, benefits, barriers, and total health belief score post educational intervention. By adding total to partial adherence, there was a significant increase in the adherence of the elderly to fall prevention measures after the educational intervention.

CONCLUSION

Educational intervention was able to improve the beliefs and adherence of the elderly to fall prevention measures.

A Heideggerian Phenomenological Study of the Lived Experiences of Ghanaian Patients Living With End-Stage Renal Disease

There is a lack of knowledge regarding perceptions, feelings, and experiences of Ghanaian patients living with ESRD. This study aimed to discover the experience and meaning of living with ESRD. This qualitative study was conducted using Heideggerian hermeneutic phenomenology. A total of 13 participants were purposefully selected, and data was collected through individual semi-structured interviews. The recorded interviews were transcribed and analyzed using Diekelmann, Allen, and Tanner method. After the final analysis, five main themes emerged: Spiritual fluctuation, Living in uncertainty, Period of agony and frustration, Tough fortification, and Changed roles and status. This study provided deep insight and understanding regarding the lived experiences of patients living with end-stage renal disease in Ghana. The results of this study may benefit nursing care in terms of considering the patients' lived experiences to provide quality and person-centered care.

Validation of Texas Christian University Psychosocial Functioning and Motivation Scales in Iranian Persons Who Use Drugs

BACKGROUND

The psychosocial functioning and motivation scales of the Texas Cristian University (TCU) were translated and validated for the Persons Who Use Drugs (PWUDs).

METHODS

This study was carried out as a methodological research. The scales were translated forward and backward and then, the PWUDs in Kermanshah-based (west of Iran) substance abuse treatment centers in 2019 filled out the scales. Participants included 250 individuals who were selected by convenience sampling method. A demographics form and psychosocial functioning and motivation scales were used to collect data. For data analysis, content validity, face validity, testretest, internal consistency, and construct validity were applied by using exploratory analysis methods in SPSS (v.20) and confirmatory factor analysis in LISREL software.

RESULTS

Exploratory Factor Analysis (EFA) results were obtained by using the main component analysis and Varimax rotation of three factors (psychological function, social function, treatment motivation). Extracted factors, along with the eigenvalues, attributed variance percentage, and cumulative attributed variances by each factor, by 68.56%, showed a total variance of the questionnaire. Moreover, the fitness indexes of the Confirmatory Factor Analysis (CFA) of psychological function, social function, and treatment motivation were 0.059, 0.075 and 0.072, respectively. Therefore, the questionnaire fitness was at an acceptable level. The test-retest reliability coefficient was 0.875, and the Cronbachs alpha coefficient for all the components was higher than 0.71.

CONCLUSION

The results showed that psychosocial functioning, motivation scales have good psychometric properties, and they can be used in research and treatment fields.

"Exercise during hemodialysis and health promoting behaviors: a clinical trial"

BACKGROUND

Health promoting behaviors are among the determinants of health. Hemodialysis causes significant changes in the lives of patients and affects their health promoting behaviors. Accordingly, this study aimed at investigating the effect of exercise during hemodialysis on health promotion behaviors in patients undergoing hemodialysis.

METHODS

This study was a two-stage (before and after) clinical trial. The sample of the study consisted of 60 hemodialysis patients in two hospitals in Isfahan who were selected randomly and divided into two groups of control and intervention using random allocation method. A 8-week exercise program by stationary bicycles (Mini-bike) was designed for the intervention group, while the control group underwent a 10-min limbering exercise for 8 weeks. Data were collected using demographic questionnaire and the Health Promoting Lifestyle Profile II (HPLP-II) questionnaire before and after the intervention and were analyzed using SPSS21 software.

RESULTS

Based on the independent t-test results, no significant difference was observed between the mean score of health promoting behaviors and its areas before the intervention (P > 0.05). However, the results of this test showed that the mean score of health promoting behaviors and its areas, except for the areas of responsibility (P = 0.052) and spirituality (P = 0.211), was significantly different between the two groups after the intervention (p < 0.05).

CONCLUSIONS

The results of this study showed that exercise with stationary bicycle during hemodialysis could promote health promoting behaviors. Thus, this exercise is recommended to be considered as part of the therapeutic protocol of these patients in hemodialysis departments.

TRIAL REGISTRATION

The clinical trial was found to be in accordance to the ethical principles and the national norms and standards for conducting medical research in Iran. IRCT registration number: IRCT20150116020675N3 . Registration date: 2019-01-18, 1397/10/28 Approval ID: IR.MUI.

RESEARCH

REC.1397.014 Approval Date: 2018-07-01 Evaluated by: Vice-Chancellor in Research Affairs -Medical University of Isfahan.

Transtheoretical Model of Health Behavioral Change: A Systematic Review

Background:

Transtheoretical model (TTM) is one of the most commonly used methods in behavioral change modeling. The aim of this study was to conduct a systematic review (SR) to determine research gaps with regard to this template with an emphasis on intervention for patients with chronic diseases (CDs).

Materials and Methods:

ISI-WOS, Scopus, PubMed, SID, and Magiran databases were examined systematically and on the basis of defined criteria. Titles, abstracts, and full texts of articles retrieved were examined for the presence of defined criteria. Then finalized articles were analyzed in consensus meetings. After that, references of selected articles and full text of those meeting the criteria were also analyzed.

Results:

We screened 103 articles, excluded 27 in abstract review and 34 in full-text review, leaving 42 articles for critical appraisal. Then the references of these 42 articles were also screened. Fifty articles were excluded on abstract review and 5 on full-text review, leaving 15 articles. The result of the analysis of 57 final articles of this SR determined that 28 articles were about aspects of TTM and 5 stages of change were the most commonly used aspect. Eight articles used TTM in intervention about CDs. A total of 21 articles examined TTM's pros and cons, most of which were about TTM's pros.

Conclusions:

The majority of studies focused on the effectiveness of TTM on the behavioral change management. This finding supported the hypothesis that TTM can be applied in the prevention of CDs.

The lived experiences of patients undergoing hemodialysis with the concept of care: a phenomenological study

Background

Providing patient-centered care needs in patients with chronic renal failure undergoing hemodialysis is important in inspiring their confidence to continue their treatment and promote their mental and social health. Therefore, recognizing the concept of care from the viewpoint of these patients can be helpful in designing the care programs of this vulnerable group. Accordingly, the aim of this study was to reveal the meaning and concept of care based on the experience of patients with chronic renal failure undergoing hemodialysis.

Methods

Using a descriptive phenomenological method, this study was conducted on 17 patients who were undergoing hemodialysis. Purposive sampling was performed and data was collected through 30 to 60 min, face-to-face and in-depth semi-structured interviews. Data analysis was performed using Colaizzi’s method.

Results

Seventeen patients (9 women 8 men) aged between 24 and 83, and a minimum of 10 and maximum of 168 months history of hemodialysis participated in the study. After data analysis, 4 themes and 9 sub-themes were extracted, and the concept of care emerged for the participants as empathy, companionship in everyday needs, social support and concern, and good-quality dialysis.

Conclusions

Based on the results of this study, the concept of care from the viewpoint of patients emerged in the form of empathy, companionship in everyday needs, social support and concern, and good-quality dialysis. It is recommended that caregivers of patients consider these concepts in the design of patient-centered care programs.