Patients' perception of comfort facilitators during hemodialysis procedure: a qualitative study

The effect of footbath applied to patients receiving hemodialysis treatment on comfort, fatigue, and dialysis symptoms: A randomized controlled study

INTRODUCTION

This study aimed to evaluate the effect of warm water footbaths on comfort, fatigue, and dialysis symptoms in patients undergoing hemodialysis.

METHODS

Data were collected from a total of 58 patients, 31 in the intervention group and 27 in the placebo group. The data in the study are collected using the intervention and control group informed volunteer Form, Patient Demonstration Form, foot Bath Application Monitoring Chart, fatigue VAS Scale Form, Dialysis Symptom Index, and Hemodialysis Comfort Scale (HCS).

RESULTS

In the second follow-up in the intervention group, HCS was determined to significantly increase all sub-size and total score averages by the first trace (p < 0.05). VAS fatigue point averages were significantly lower (p < 0.05) in the intervention group.

CONCLUSION

It was determined that the footbath applied to patients who received hemodialysis treatment increased comfort and reduced fatigue and dialysis symptoms.

The impact of logo-therapy on disease acceptance and self-awareness of patients undergoing hemodialysis; a pre-test-post-test research

BACKGROUND

Acceptance is considered a key variable in chronic diseases such as chronic renal failure. To achieve adaptation and acceptance, people face obstacles, and identifying these obstacles primarily requires self-awareness. logo-therapy can help a person achieve this goal. To this end, this study aimed to investigate the effect of logo-therapy on disease acceptance and self-awareness of patients undergoing hemodialysis referred to a medical centers supervised by Kerman medical science university in 2021.

METHODS

This quasi-experimental study was conducted with a pre-test-post-test research design on 80 patients with chronic renal failure undergoing hemodialysis in Kerman. The patients who met the inclusion criteria were selected using convenience sampling and were then randomly assigned to intervention and control groups (40 patients in each group). The logo-therapy training program was performed for the participants in the intervention group during 4 sessions of 45-60 min, individually and three times a week. The instruments used for data collection were a demographic information questionnaire, the Acceptance of Illness Scale (AIS), and the Self-Awareness Outcomes Questionnaire (SAOQ). The collected data were analyzed using SPSS software (version 22).

RESULTS

The analysis didn't show a significant difference in the acceptance of illness scores in the intervention group before and after the intervention (P > 0.05). Besides, a statistically significant difference was observed between the intervention and control groups in terms of self-awareness, indicating that the intervention improved the dialysis patients' self-awareness (P < 0.05). Also, the patients' age, marriage length, and the number of children had statistically significant correlations with self-awareness and acceptance (P < 0.05).

CONCLUSION

The results of this study showed that meaning therapy intervention can positively affect disease acceptance and self-awareness of patients undergoing hemodialysis. Since logo-therapy has been effective in other patients and the patients in this study, health officials and managers are recommended to use this intervention method to promote disease acceptance and self-awareness in these patients.

“Machine-Dependent”: The Lived Experiences of Patients Receiving Hemodialysis in Pakistan

This study aimed to explore the lived experiences of patients receiving maintenance hemodialysis in Pakistan. Purposive sampling was used to recruit 24 patients and six healthcare professionals, each participated in a semi-structured interview. Interpretive Phenomenological Analysis was used to analyze interviews’ data. Two superordinate themes, “The experience of hemodialysis” and “The conceptualizations of hemodialysis” as well as six sub-themes were identified. The experience of hemodialysis was related to, the implications of HD procedure on everyday life, social, cognitive, emotional, financial, and occupational influences. While all participants recognized the importance of hemodialysis for their survival, their conceptualizations of the treatment varied. Despite facing multiple challenges, optimism and independence were observed among participants. Stigma related to hemodialysis, and role adaptation, which appear unique to the Pakistani context, highlight a need for tailored interventions designed to enhance and maintain the mental health of patients receiving hemodialysis in Pakistan.

Effect of aromatherapy on the pain of arteriovenous fistula puncture in patients on hemodialysis: a systematic review

Purpose

This study aims to determine the effect of aromatherapy used in reducing the pain caused by fistula puncture in hemodialysis patients.

Design/methodology/approach

In this study, the effect of aromatherapy application on fistula puncture was analyzed and carried out by scanning the relevant literature. The literature review was conducted between August and October 2020. While reviewing the literature, the authors used “aromatherapy,” “pain,” “fistula,” “puncture,” “hemodialysis” keywords and various combinations of these; moreover, Google scientist, Pubmed, Cochrane, ScienceDirect, Web of Science, Medline and Ovid databases and studies, which were conducted in the last 10 years were reviewed. As a result of the literature review, 1183 studies were reached and seven of them were included in the study by taking the inclusion criteria into account.

Findings

The randomized controlled studies are six studies and nonrandomized controlled experimental 1 study were added to the scope of the study and seven studies were included in the sample. In these studies, personal information forms developed by the researchers as data collection tools and the VAS scale, Numerical pain rating, the numeric rating scale were used to evaluate pain.

Practical implications

It has been determined that aromatherapy application in hemodialysis patients has positive effects on reducing pain due to puncture fistula intervention.

Originality/value

This study provides reduction or elimination of fistula needle insertion pain in hemodialysis patients.

Patient experiences of sleep in dialysis: systematic review of qualitative studies

RATIONALE AND OBJECTIVE

Sleep problems affect more than half of patients receiving dialysis and are associated with increased risk of mortality, cardiovascular events, depression and impaired functioning and quality of life. Symptoms such as fatigue and exhaustion may be attributed to sleep problems or sleep disorders, as well as the burden of kidney disease and treatment. This study aims to describe the patient perspectives on the reasons, impact and management of sleep problems in dialysis.

STUDY DESIGN

Systematic review and thematic synthesis of qualitative studies that report patient experience and perspectives on sleep in dialysis.

SETTING AND POPULATION

Patients receiving dialysis.

SEARCH STRATEGY AND SOURCES

MEDLINE, Embase, PsycINFO, CINAHL, reference lists and PhD dissertations were searched from inception to August 2019.

DATA EXTRACTION

All text from the results/conclusion of the primary studies.

ANALYTICAL APPROACH

Thematic synthesis.

RESULTS

We included 48 studies involving 1156 participants from 16 countries. We identified six themes: dominating demands of treatment (with subthemes of: demanding and relentless schedule, regret for wasted time); scheduling and control (managing sleep routines, napping and nocturnal sleep disruption, meditative aids); disruptions due to dialysis (unsettled sleep, hypervigilance and worry); symptoms depriving sleep (difficulty falling asleep, constant waking); overwhelmed and without choice (futility of sleep, uncontrollable exhaustion, restlessness is irrepressible); and as a coping mechanism (avoiding anxiety, alleviating symptoms, combating boredom).

LIMITATIONS

Most studies were conducted in high-income, English-speaking countries.

CONCLUSION

The treatment and symptom burden of dialysis disrupts and deprives patients of sleep, which leads to overwhelming and uncontrollable exhaustion. Better management of symptoms and effective strategies to manage sleep routines may improve sleep quality for better overall health in patients receiving dialysis.

Exploring the concept of social support as a key factor in young women's quality of life

BACKGROUND

According to the fact that women make up half the population of each community and are considered as a family health center, exploring the factors promoting their quality of life and health must be prioritized.

OBJECTIVE

This study aimed to understand the meaning of social support in young women's life.

METHODS

Participants were 40 Iranian youth women who were selected by purposive sampling from the capital of Iran, Tehran. Interviews were carefully recorded and concurrent with data collection, analysis was done using conventional content analysis method. After securing the data saturation, interviews were finished and data were categorized by eight stages of zhang technique.

RESULTS

From the interviews three main themes were identified: (i) financial support; (ii) informational support, and (iii) service-based social support.

DISCUSSION

Awareness about aspects of social support in women' life could help health care providers and politicians in Iran to provide more effective programs to promote QOL and as a result total health of women.

Gait characteristics of CKD patients: a systematic review

BACKGROUND

People with Chronic Kidney Disease (CKD) often present with prevalent gait impairment and high fall rates, particularly in advanced CKD stages. Gait impairment and its consequences is associated with increased hospital admission, institutionalization, and greater need for health care. The objective of this systematic review was to evaluate the quality of studies investigating CKD patients' gait characteristics at different CKD stages, to highlight areas of agreement and contradiction between studies reporting aspects of gait in CKD, and to discuss and emphasize gait parameters associated with fall risk.

METHODS

We performed a literature search of trials in CINAHL (EBSCO), Cochrane Library, EMBASE, Medline (EBSCO), PEDro, PubMed, and Scopus databases from their inception to June 30th 2018 using a two-stage process for the identification of studies. We retrieved English-, German-, Italian-, Spanish-, Portuguese and Dutch-language articles for review. Methodological quality of randomized and non-randomized studies was assessed with an adapted version of the Downs and Black checklist.

RESULTS

Thirty-one studies (22 cross-sectional with 3901 participants) and 9 longitudinal intervention studies (1 randomized control trial, 5 controlled clinical trials and 3 one-group pre-post-test; with 659 participants) were considered. The studies revealed a primary emphasis on gait speed measures within clinical tests, and a neglect of spatiotemporal gait variables. Most of the studies showed that CKD progression is associated with slowing of walking speed. No studies analysed the relation between gait parameters and fall risk.

CONCLUSIONS

There was a paucity of studies investigating aspects of gait quality in patients with CKD. In the majority of studies, only gait speed is analysed as a performance indicator. The relation between gait parameters and fall risk in CKD is not investigated. We formulate several recommendations to fill the current research gap, encourage the use of standardized gait analysis protocols that include assessment of spatiotemporal parameters in clinical care of patients with CKD, aimed at prevention of mobility decline and falls risk.

Psychological problems as the major cause of fatigue in clients undergoing hemodialysis: A qualitative study

Background

It is obvious that hemodialysis is a stressful process, leading to numerous social and psychological problems, and may cause fatigue and helplessness.

Objective

This study aimed to explain the experiences of hemodialysis clients regarding the effect of psychological problems on fatigue.

Methods

This article was extracted from a qualitative study conducted on clients undergoing hemodialysis in Khorramabad. To this end, a total of 15 participants were purposefully selected using the snowball sampling method and the required data was collected using individual, face to face, detailed and semi-structured interviews. There were 12 client interviewees and one doctor, one nurse and one hemodialysis client's spouse. Content analysis was used to analyze the data.

Results

Continuous analysis of data and documents obtained from the interviews on the hemodialysis clients' experiences and comments regarding the main causes of fatigue revealed two main categories: 1) Psychological effects with subcategories of psychological stress and exhaustion; 2) Needs and constraints with subcategories of individual and social needs and constraints.

Conclusion

According to the clients' speech and expression analysis, psychological impacts and disease-induced needs and constraints were the most important cause of fatigue and its continuation among these clients.

A framework of comfort for practice: An integrative review identifying the multiple influences on patients' experience of comfort in healthcare settings

Purpose

Comfort is central to patient experience but the concept of comfort is poorly defined. This review aims to develop a framework representing patients' complex perspective of comfort to inform practice and guide initiatives to improve the quality of healthcare.

Data sources

CINAHL, MEDLINE Complete, PsycINFO and Google Scholar (November 2016); reference lists of included publications.

Study selection

Qualitative and theoretical studies advancing knowledge about the concept of comfort in healthcare settings. Studies rated for methodological quality and relevance to patients' perspectives.

Data extraction

Data on design, methods, features of the concept of comfort, influences on patients' comfort. Data were systematically coded and categorized using Framework method.

Results of data synthesis

Sixty-two studies (14 theoretical and 48 qualitative) were included. Qualitative studies explored patient and staff perspectives in varying healthcare settings including hospice, emergency departments, paediatric, medical and surgical wards and residential care for the elderly. From patients' perspective, comfort is multidimensional, characterized by relief from physical discomfort and feeling positive and strengthened in one's ability to cope with the challenges of illness, injury and disability. Different factors are important to different individuals. We identified 10 areas of influence within four interrelated levels: patients' use of self-comforting strategies; family presence; staff actions and behaviours; and environmental factors.

Conclusion

Our data provide new insights into the nature of comfort as a highly personal and contextual experience influenced in different individuals by different factors that we have classified into a framework to guide practice and quality improvement initiatives.

Factors Associated with Hemodialysis Machine Dependency

Introduction:

Hemodialysis is one of major stresses in patients’ daily lives since there is no other path for life maintenance but to accept the machine and its’ related rules.

Purpose:

of this study was to explore factors associated with dependency on dialysis machine as reported by the patients.

Material and Methods:

The sample of the study included 250 patients undergoing hemodialysis. For data collection a questionnaire specially designed for the needs of the research was used. More specifically, socio-demographic and clinical characteristics as well as several other self-reported variables were collected.

Results:

Of the 250 participants, 53.2% was men while 65.2% was aged over 60 years. The study showed that 44% of the patients reported that their life depended very much on hemodialysis machine. Statistically significant association was observed between dependency on dialysis machine as reported by the patients and gender (p=0.030), education (p=0.022), job (p=0.001) and place of residence (p=0.001). Additionally, statistically significant association was observed between dependency on dialysis machine as reported by the patients and the degree of information about their problem (p=0.001) and whether patients reported adherence to treatment guidelines (p=0.001) or followed the proposed diet (p=0.001). Finally, statistically significant association was observed between dependency on dialysis machine as reported by the patients and relations with nursing staff (p=0.001), whether patients had noticed change in body image (p=0.001), whether they faced difficulties in social (p=0.001) and family environment (p=0.030), whether they hid their problem (p=0.006), whether they needed help in daily activities (p=0.001) and whether their lifestyle had changed (p=0.001).

Conclusions:

Socio-demographic and clinical characteristics as well as hemodialysis patients’ beliefs are associated with machine dependency. This study contributed in outlining factors affecting dependency on dialysis machine, thus reinforcing multidisciplinary health care teams to develop interventions in order to address hemodialysis patients’ needs.

Exploring experiences of the quality of nursing care among patients, nurses, caregivers and physicians in a haemodialysis department

BACKGROUND AND OBJECTIVES

Providing high-quality care to patients undergoing haemodialysis (HD) is a priority for nurses. The present study was conducted to explore the experiences of the quality of nursing care among patients, nurses, caregivers and physicians in an HD department in Iran.

METHODS

This was a qualitative study, set in the HD department of Kowsar Hospital in Semnan, Iran. A total of 20 participants (patients, caregivers, nurses and doctors) were selected and were invited to semi-structured interviews with open-ended questions. The data obtained were analysed using conventional content analysis.

FINDINGS

The analysis of the data led to the extraction of four themes: maintaining health, person/client, nursing responsibility and environment.

CONCLUSION

The findings of the present study showed that maintaining health, person/client interaction, nursing responsibility and environment are four important nursing metaparadigms that affect the quality of nursing care in HD departments.

The Effect of Continuous Care Model on the Sleep Quality of Hemodialysis Patients

Background

One of the most prevalent problems in hemodialysis patients is sleep disturbance. Poor sleep quality has unpleasant bio-psycho-social outcomes. The positive effects of implementing the continuous care model (CCM) were verified with different variables, including sleep quality. This study was done with different populations, using two groups.

Objectives

This study aims to identify the sleep quality of hemodialysis patients in the city of Ilam and determine the effects of CCM on sleep quality.

Patients and Methods

We performed a quasi-experimental research study with 56 hemodialysis patients at the Shahid Mostafa Hospital in Ilam during 2014 and 2015. Pretests and posttests were conducted with the study groups and the control groups. Pretests were conducted over a one-month period, then repeated immediately before the study. Posttests were conducted immediately after the study and then repeated one month later. Participants were selected by census method and randomly divided into two groups. Ethical considerations were observed. Based on the continuous care model, interventions were performed through educational sessions over a three-week period. Consultations for continuous sleep monitoring, controls, and evaluations were conducted with the study group over the next nine weeks. Data were gathered from patient demographics questionnaires and PQSI, then introduced in SPSS 22 and analyzed with descriptive and analytic statistics (t-paired, ANOVA with repeated measures, follow-up tests such as S-N-K, Duncan, Sheffe and Tukey).

Results

One month prior to the study, 94.6% of the participants suffered from poor sleep quality. Immediately before and after the study, 91% complained of poor sleep quality. And one month after intervention, the figure dropped to 82%. Applying the CCM positively affected the sleep quality of hemodialysis patients in Ilam, and was statistically meaningful one month after intervention (P = 0.001).

Conclusions

Hemodialysis patients need a consistent care plan to manage poor sleep quality. This research has proven the effectiveness of implementing CCM as an intervention for improving the sleep quality of hemodialysis patients. CCM provides a comprehensive model for caring for hemodialysis patients, and its executive stages are congruent with the many stages of the nursing process. Practitioners in different domains of nursing care, education, and management can derive great benefit from this valuable care model

Impact of comfort care on quality of life in colorectal cancer patients undergoing radical surgery

AIM: To assess the impact of comfort care on quality of life in colorectal cancer patients undergoing radical surgery.

METHODS: One hundred and twelve colorectal cancer patients who underwent radical resection at our hospital from January 2012 to June 2014 were randomly divided into either a comfort care group or a conventional care group, with 56 cases in each group. The conventional care group received routine care, and the comfort care group received comfort care. Care results were compared for the two groups.

RESULTS: Psychological, physiological and social and environmental comfort scores differed significantly between the two groups (P < 0.05). The quality of life score was significantly higher in the comfort care group than in the conventional care group (55.3 ± 6.4 vs 44.7 ± 6.1, P < 0.05). The rate of postoperative complications was significantly lower in the comfort care group than in the conventional care group (3.6% vs 16.1%, P < 0.05).

CONCLUSION: Comfort care in patients with colorectal cancer undergoing radical surgery is feasible and can improve the quality of life and reduce postoperative complications.