Dyspnoea Assessment In Adults With End-Stage Kidney Disease: A Systematic Review

IF 1.5 4区医学 Q3 NURSING Journal of renal care Pub Date : 2020-02-12 DOI:10.1111/jorc.12321

Maria Chilvers, Kylie Johnston, Katia Ferrar, Marie T. Williams

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引用次数: 2

Abstract

Background

Dyspnoea is a common, disabling symptom of people living with end-stage kidney disease (ESKD), which may persist despite optimal management. Dyspnoea assessments can be grouped according to the instruments that assess domains related to: sensory-perception (intensity, sensory quality), affective distress (unpleasantness) and impact/burden (function, quality of life).

Objectives

To describe dyspnoea assessment in adults with ESKD receiving renal replacement therapy (RRT).

Design

Systematic review.

Methods

Five databases were searched. Primary studies reporting an assessment of dyspnoea in adults with ESKD receiving RRT were included. Studies were excluded where participants with ESKD had received palliative/conservative treatment (no dialysis) or renal transplant. Conference abstracts, protocols, commentaries and/or images were excluded. Two independent reviewers screened and extracted the data. Descriptive analysis summarised the (1) number and type of instruments used to assess dyspnoea; (2) which dyspnoea domains to be assessed and (3) rationale and context for dyspnoea assessment.

Results

From 2,234 records screened, 28 studies were eligible for inclusion (observational n = 22 and experimental n = 6). Across studies, 12 different instruments were identified (dyspnoea-specific n = 3, subscale of a comprehensive instrument n = 9). Most instruments (n = 11, 92%) assessed a single domain (intensity n = 6, unpleasantness n = 6 and impact/burden n = 5). Studies reported a rationale for measuring dyspnoea (n = 26) as either a characteristic of the participant cohort (n = 14) or as an outcome (n = 14).

Conclusions

Surprisingly, a few primary studies reported assessment of dyspnoea in people with ESKD receiving RRT. When assessed, there was a predominance of unidimensional instruments. As dyspnoea is associated with adverse clinical outcomes, routine dyspnoea assessment may improve management and relieve suffering.

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终末期肾病患者的呼吸困难评估:一项系统综述

研究背景:呼吸困难是终末期肾脏疾病(ESKD)患者常见的致残症状，尽管进行了最佳治疗，但仍可能持续存在。呼吸困难评估可以根据评估相关领域的工具进行分组:感觉-知觉(强度，感觉质量)，情感困扰(不愉快)和影响/负担(功能，生活质量)。目的描述成人ESKD患者接受肾脏替代治疗(RRT)时的呼吸困难评估。设计系统评审。方法对5个数据库进行检索。纳入了报告接受RRT的成人ESKD患者呼吸困难评估的初步研究。排除ESKD患者接受过姑息/保守治疗(无透析)或肾移植的研究。会议摘要、协议、评论和/或图像不包括在内。两名独立审稿人筛选并提取数据。描述性分析总结了(1)用于评估呼吸困难的仪器的数量和类型;(2)评估哪些呼吸困难域;(3)评估呼吸困难的基本原理和背景。结果从筛选的2234条记录中，有28项研究符合纳入条件(观察性研究n = 22，实验性研究n = 6)。在研究中，确定了12种不同的工具(呼吸困难特异性n = 3，综合工具的子量表n = 9)。大多数工具(n = 11,92%)评估单一域(强度n = 6，不愉快n = 6，影响/负担n = 5)。研究报告了测量呼吸困难(n = 26)作为参与者队列特征(n = 14)或结果(n = 14)的基本原理。令人惊讶的是，一些初步研究报告了接受RRT的ESKD患者呼吸困难的评估。评估时，单维仪器占主导地位。由于呼吸困难与不良的临床结果相关，常规的呼吸困难评估可以改善治疗并减轻痛苦。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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IF 0 Weekly abstract of sanitary reports. United States. Marine Hospital ServicePub Date : 1895-11-01 DOI:

Public Health Weekly Reports for November 8, 1895.

IF 0 Weekly abstract of sanitary reports. United States. Marine Hospital ServicePub Date : 1895-11-08 DOI:

Public Health Weekly Reports for November 15, 1895.

IF 0 Weekly abstract of sanitary reports. United States. Marine Hospital ServicePub Date : 1895-11-15 DOI:

来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.