Journal of renal care最新文献

Investigating Perceptions of Quality Nephrology Nurse Training 对优质肾脏病护士培训的认知调查。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-12-11 DOI: 10.1111/jorc.70037

Kathy Hill, Anne Britton, Dana Cotton

Background

Nephrology nursing shortages are becoming a critical problem in South Australian renal units due to increasing caseloads and high levels of attrition.

Purpose

We sought to explore this issue from the perspective of renal unit nurse managers, nephrology nurse educators, and nursing staff working within haemodialysis units, home therapies and a renal ward.

Methods

A qualitative approach was taken through individual interviews and several focus groups to allow an open exploration of the current workforce challenges and the aspects of nephrology nurse training that needed to be improved.

Participants

Thirty-three nephrology nurses drawn from four health services participated in a face-to-face interview or a focus group with several others.

Results

Staff shortages are described as chronic, and the problem starts with the undergraduate training programme and limited clinical exposure. This is compounded by employment of nurses with no post graduate qualification and limited desire to study for one. Nephrology nursing is now a buyers’ market with staff attracted to units with no night shift and the simplicity of haemodialysis therapies. This is creating technicians not knowledgeable renal nurses.

Conclusion

To address staff shortages renal units need to consider the reintroduction of clinical rotations and incentives to complete post graduate training.

背景：肾脏病护理短缺正在成为一个关键问题，在南澳大利亚肾单位由于增加的病例负荷和高水平的损耗率。目的：我们试图从肾科护士管理人员、肾脏病护士教育工作者和血液透析病房、家庭治疗和肾科病房的护理人员的角度探讨这一问题。方法：通过个人访谈和几个焦点小组，采用定性方法，对当前的劳动力挑战和需要改进的肾脏病护士培训方面进行开放探索。参与者：从四个卫生服务机构抽取的33名肾病科护士参加了面对面访谈或与其他几个人的焦点小组。结果：人员短缺被描述为慢性的，问题始于本科培训计划和有限的临床暴露。这种情况由于雇用没有研究生资格的护士和有限的学习意愿而变得更加复杂。肾脏护理现在是一个买方市场，工作人员被没有夜班和血液透析治疗简单的单位所吸引。这造就了技术人员，而不是知识渊博的肾脏护士。结论：为了解决人员短缺的问题，肾脏单位需要考虑重新引入临床轮转和激励完成研究生培训。

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引用次数: 0

Lifestyle Interventions, Markers of Metabolic Syndrome and Quality of Life in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis. 肾移植受者生活方式干预、代谢综合征标志物和生活质量：一项系统综述和荟萃分析。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-12-01 DOI: 10.1111/jorc.70038

Ashley Darvell, Annaliese Pretty, Kelly Lambert, Elizabeth P Neale

Background: Kidney transplantation reduces mortality in patients with kidney failure; however, recipients often experience post-transplant complications, such as weight gain, hypertension, dyslipidaemia and new-onset diabetes mellitus.

Objectives: To examine the impact of lifestyle interventions (diet, exercise and behavioural) on markers of metabolic syndrome and quality of life (QoL) in kidney transplant recipients.

Design: Systematic review and meta-analysis.

Methods: Eligible studies were randomised controlled trials assessing the effect of lifestyle interventions on metabolic outcomes (body weight, lipid levels, HbA1c, fasting glucose, blood pressure, albuminuria, proteinuria and C-reactive protein), and QoL in kidney transplant recipients. A systematic search until 27 June 2025 was conducted. Data were synthesised using random-effects meta-analyses, and QoL data were synthesised using a narrative synthesis approach.

Results: A total of 35 studies were included: 13 (37%) of which were exercise interventions, 11 (31%) diet, 2 (6%) behavioural and 9 (26%) were multi-component interventions. Lifestyle intervention resulted in significant reductions in body fat (weighted mean difference: -1.190 kg [95% CI: -2.088 to -0.291]) and significant increases in high-density lipoprotein cholesterol (0.094 mmol/L [95% CI: 0.013, 0.175]), with no other significant changes found. Narrative synthesis found improvements in QoL following lifestyle intervention. Certainty of the body of evidence (assessed using GRADE) ranged from moderate to very low.

Conclusion: Lifestyle intervention was found to lead to improvements in body fat (kg), HDL cholesterol and QoL. While these findings suggest some potential benefits of lifestyle intervention, additional research is needed across a range of lifestyle interventions.

背景：肾移植可降低肾衰竭患者的死亡率；然而，受者经常会出现移植后并发症，如体重增加、高血压、血脂异常和新发糖尿病。目的：探讨生活方式干预（饮食、运动和行为）对肾移植受者代谢综合征标志物和生活质量（QoL）的影响。设计：系统回顾和荟萃分析。方法：符合条件的研究是随机对照试验，评估生活方式干预对肾移植受者代谢结局（体重、脂质水平、糖化血红蛋白、空腹血糖、血压、蛋白尿、蛋白尿和c反应蛋白）和生活质量的影响。在2025年6月27日之前进行了系统搜索。数据采用随机效应荟萃分析综合，生活质量数据采用叙事综合方法综合。结果：共纳入35项研究，其中运动干预13项（37%），饮食干预11项（31%），行为干预2项（6%），多组分干预9项（26%）。生活方式干预导致体脂显著降低（加权平均差：-1.190 kg [95% CI: -2.088至-0.291]），高密度脂蛋白胆固醇显著升高（0.094 mmol/L [95% CI: 0.013, 0.175]），未发现其他显著变化。叙事综合发现生活方式干预后生活质量有所改善。证据体的确定性（使用GRADE评估）范围从中等到极低。结论：生活方式干预可改善体脂（kg）、高密度脂蛋白胆固醇和生活质量。虽然这些发现表明生活方式干预有一些潜在的好处，但需要对一系列生活方式干预进行进一步的研究。

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引用次数: 0

Vaccination Uptake and Patient Perceptions Among Haemodialysis Patients: Insights From a Cross-Sectional Study. 血液透析患者的疫苗接种和患者认知：来自横断面研究的见解。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-12-01 DOI: 10.1111/jorc.70039

Eirini Potamianou, Ioanna Dimitriadou, Maria Saridi, Aikaterini Toska, Evangelos C Fradelos, Paraskevi Theofilou, Dimitrios Papagiannis

Background: Haemodialysis patients face an elevated risk of infectious diseases due to immunosuppression and frequent exposure to healthcare settings. Vaccination is a critical preventive strategy for this population; however, coverage remains inconsistent across different vaccines.

Objective: To evaluate vaccine coverage and perceptions among patients undergoing haemodialysis in Greece and identify factors influencing uptake.

Design: This was a cross-sectional study employing a structured, interviewer-administered questionnaire.

Participants: The study included 201 adult patients undergoing maintenance haemodialysis at selected dialysis centres in Greece.

Measurements: Data collected included demographic characteristics, comorbidities, and self-reported vaccination status for influenza, pneumococcal, meningococcal B, and Haemophilus influenzae type b (Hib) vaccines. Attitudes toward vaccination were assessed using Likert scale items. Statistical analyses involved linear regression, ANOVA, and Pearson's correlation tests.

Results: Vaccination rates were highest for influenza (88.6%) and pneumococcal vaccines (85.1%), while coverage for meningococcal B (25.4%) and Hib (16.9%) was low. Key barriers to vaccination included a perceived low risk of infection, lack of physician recommendations, and inadequate awareness. Age and higher educational attainment were significantly associated with greater vaccine uptake (p < 0.05). A weak but statistically significant correlation (r = .163-0.341) was observed between positive perceptions of vaccines and actual vaccination behaviour.

Conclusion: Although the uptake of some vaccines was high, the coverage of others remained suboptimal. Addressing knowledge gaps and increasing physician-driven recommendations may improve vaccine acceptance among the haemodialysis population.

背景：血液透析患者由于免疫抑制和频繁暴露于医疗机构而面临传染病风险升高。疫苗接种是这一人群的重要预防策略；然而，不同疫苗的覆盖率仍然不一致。目的：评估希腊血液透析患者的疫苗覆盖率和认知，并确定影响接种的因素。设计：这是一项横断面研究，采用结构化的访谈问卷。参与者：该研究包括201名在希腊选定的透析中心接受维持性血液透析的成年患者。测量：收集的数据包括人口统计学特征、合并症和自我报告的流感、肺炎球菌、脑膜炎球菌B和B型流感嗜血杆菌（Hib）疫苗接种情况。使用李克特量表项目评估对疫苗接种的态度。统计分析包括线性回归、方差分析和Pearson相关检验。结果：流感疫苗接种率最高（88.6%），肺炎球菌疫苗接种率最高（85.1%），乙型脑膜炎球菌疫苗接种率较低（25.4%），Hib疫苗接种率较低（16.9%）。接种疫苗的主要障碍包括认为感染风险低、缺乏医生建议和认识不足。年龄和较高的受教育程度与较高的疫苗接种率显著相关(p结论：尽管某些疫苗的接种率很高，但其他疫苗的覆盖率仍不理想。解决知识差距和增加医生驱动的建议可能会提高血液透析人群对疫苗的接受程度。

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引用次数: 0

Digital Self-Monitoring of Intake and Output Among Individuals With Kidney Failure: Awareness, Usability, Acceptance, Attitudes and Key Engagement Factors 肾功能衰竭患者的数字自我监测：意识、可用性、接受度、态度和关键参与因素

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-11-27 DOI: 10.1111/jorc.70036

Felice Fangie Leong, Fazila Aloweni, Raden Nurheryany Binte Sunari, Shu Hui Lim, Andrea Chau Lin Choh, Shin Yuh Ang

Background

Manual intake and output (I&O) recording is often delayed and inaccurate, highlighting the need for patient-involved digital solutions. Evidence on kidney failure individuals’ acceptance, usability and willingness to self-monitor remains limited.

Objective

To assess the awareness, acceptance and usability of the Food IN&OUT application among hospitalised adults with kidney failure, and to identify factors influencing their willingness to continue self-monitoring after discharge.

Methods

A single-centre cross-sectional study was conducted from February to July 2024 in a Singapore teaching hospital. Adults with kidney failure used the application and completed a questionnaire including demographics, the system usability scale and the theoretical framework of acceptability.

Results

A total of 93 participants took part in the study. The application had a mean usability score of 66.2 (SD = 14.4), with 59 participants (63.4%) willing and 34 (36.6%) unwilling to continue self-monitoring I&O post-hospitalisation. Willing participants rated I&O monitoring as more important (p = 0.03), were nearly three times more likely to report confidence in using the app (OR = 2.68, p < 0.02), and gave higher ratings for ease of use and consistency (all p < 0.05). Acceptability scores exceeded 3.0 overall, with significant differences in self-efficacy, perceived effectiveness and opportunity costs between willing and unwilling groups (all p < 0.05). Key motivators for continued use included health benefits, adherence to professional advice and confidence in accurate self-monitoring. Barriers included time constraints, forgetfulness and perceived difficulty with consistent tracking.

Conclusion

The application showed potential to support self-monitoring in kidney failure individuals, but its moderate usability underscores the need for further refinement and patient support.

人工输入和输出（I&；O）记录经常延迟和不准确，强调需要患者参与的数字解决方案。关于肾衰竭个体接受、可用性和自我监测意愿的证据仍然有限。目的了解肾功能衰竭住院成人对食品IN&；OUT应用的认知度、接受度和可用性，并探讨影响其出院后继续自我监测意愿的因素。方法2024年2月~ 7月在新加坡某教学医院进行单中心横断面研究。肾功能衰竭的成年人使用该应用程序并完成一份调查问卷，包括人口统计、系统可用性量表和可接受性的理论框架。结果共93名参与者参加了本研究。该应用程序的平均可用性得分为66.2 (SD = 14.4)， 59名参与者（63.4%）愿意在住院后继续自我监测I&；O， 34名参与者（36.6%）不愿意。有意愿的参与者认为I&；O监测更重要（p = 0.03），报告使用该应用程序的信心的可能性几乎是三倍（OR = 2.68, p < 0.02），并且对易用性和一致性给出了更高的评级（均p <； 0.05）。可接受性得分总体超过3.0，愿意组和不愿意组在自我效能、感知有效性和机会成本上存在显著差异（p < 0.05）。继续使用的主要动机包括健康益处、遵守专业建议和对准确自我监测的信心。障碍包括时间限制、健忘和持续追踪的感知困难。结论：该应用程序显示了支持肾功能衰竭个体自我监测的潜力，但其适度的可用性强调了进一步完善和患者支持的必要性。

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引用次数: 0

The Chain of Cannulation: A Qualitative Comparison of the Cannulation Process and European Guidelines 插管链：插管过程与欧洲指南的定性比较

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-10-31 DOI: 10.1111/jorc.70035

Karin Staaf, Fredrik Uhlin

Background

The cannulation of an arteriovenous fistula can be performed using several different techniques and surrounding routines, which are presently not well-defined. The recently described chain of cannulation includes planning cannulation, pre-cannulation, during cannulation, evaluating cannulation and post-cannulation, and was based on the Swedish context, in which the buttonhole cannulation technique is the most common.

Objectives

To explore whether the chain of cannulation is in agreement with nursing guidelines from other dialysis contexts, in terms of cannulation techniques and their preconditions.

Design

Qualitative comparison of guidelines regarding arteriovenous fistula cannulation.

Participants

Two guidelines regarding the process of arteriovenous cannulation, written in English, were included and compared to a compilation of Swedish local guidelines.

Measurements/Approach

The British and European guidelines were analysed using deductive qualitative content analysis. The utilised categorisation matrix was based on the chain of cannulation and its subcategories. The identified subcategories were compared among guidelines, using qualitative triangulation to find agreement, dissonance or silence.

Results

The majority of subcategories showed partial agreement between at least two of the guidelines. Silence and dissonance were identified in the following subcategories: hygiene routines, preventing pain, how to needle, angle during cannulation, needle withdrawal and haemostasis. Two new subcategories were identified in the British guidelines: patient involvement, and screening and control.

Conclusion

The chain of cannulation, which originated in the Swedish context, showed agreement with needling guidelines from other nursing contexts regarding arteriovenous cannulation techniques and their preconditions.

背景动静脉瘘的插管可以使用几种不同的技术和周围常规，目前还没有明确的定义。最近描述的插管链包括计划插管、预插管、插管期间、评估插管和插管后，并基于瑞典的背景，其中钮孔插管技术是最常见的。目的探讨导管链在导管技术及其前提条件方面是否符合其他透析环境的护理指南。设计对动静脉瘘插管指南进行定性比较。参与者包括两份关于动静脉插管过程的英文指南，并与瑞典当地指南的汇编进行比较。测量/方法英国和欧洲的指南使用演绎定性内容分析进行分析。所使用的分类矩阵基于插管链及其子类别。确定的子类别在指南之间进行比较，使用定性三角测量来找到一致，不一致或沉默。结果大多数亚类在至少两个指南之间显示部分一致。沉默和不和谐在以下子类中被确定：卫生习惯，预防疼痛，如何针刺，插管时的角度，拔针和止血。在英国指南中确定了两个新的子类别：患者参与，筛查和控制。结论：起源于瑞典的插管链与其他护理背景下关于动静脉插管技术及其前提条件的针刺指南一致。

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引用次数: 0

Indicators of Nutritional Health of Patients on Haemodialysis 血液透析患者营养健康指标分析。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-10-27 DOI: 10.1111/jorc.70034

Renata Vogel Raggo, Shannon Morley, Jennifer Utter

Background

This project describes indicators of health risk of patients requiring haemodialysis and their adherence to current renal-specific nutrient guidelines and indicators of overall healthy eating.

Methods

The current study analysed nutritional intakes reported by a single-day 24-h recall by patients undergoing haemodialysis in an outpatient centre. Participants (n = 37) were clients of a 12-chair unit, based in South Brisbane, Australia. Information on patient characteristics and cardiovascular and health risk were collected from patient charts. Nutritional intakes were compared to references provided by the KDOQI Clinical Practice Guideline, Nutrient Reference Values and/or general healthy eating guidelines.

Results

Approximately half of the patients had lipid levels indicating cardiovascular risk, 40% had BMIs in the obese category, and 20% were assessed as malnourished. Patients met, on average, 80% of their energy and 106% of protein requirements. When using renal-specific guidelines, this population met recommendations for sodium, but not fibre. Using guidelines for the general population, this population consumed too much energy from saturated fat. Phosphorus, calcium and potassium appeared to be below the nutrient reference values. Most patients reported consuming two or more vegetables per day while few met the recommendations for fruit, fish and legumes.

Conclusions

The intakes of this cohort suggested compliance with traditional renal-specific dietary advice, but perhaps at the expense of an overall healthy diet. Dietitians who work with patients requiring haemodialysis may choose to prioritize general healthy eating advice, such as that based on the Mediterranean Diet, to better support this patient population.

背景：本项目描述了需要血液透析的患者的健康风险指标，以及他们对当前肾脏特异性营养指南的依从性和整体健康饮食指标。方法：目前的研究分析了在门诊中心接受血液透析的患者一天24小时回忆报告的营养摄入量。参与者（n = 37）是澳大利亚南布里斯班一个12椅子单位的客户。从患者图表中收集有关患者特征以及心血管和健康风险的信息。将营养摄入量与KDOQI临床实践指南、营养参考值和/或一般健康饮食指南提供的参考资料进行比较。结果：大约一半的患者的血脂水平表明心血管风险，40%的患者的bmi属于肥胖类别，20%的患者被评估为营养不良。患者平均能满足80%的能量需求和106%的蛋白质需求。当使用肾脏特定指南时，这一人群的钠摄入量符合建议，但纤维摄入量不符合建议。根据针对一般人群的指南，这些人群从饱和脂肪中摄入了过多的能量。磷、钙、钾均低于营养参考值。大多数患者报告每天食用两种或两种以上的蔬菜，而很少有人符合水果、鱼类和豆类的建议摄入量。结论：该队列的摄入量表明遵循传统的肾脏特定饮食建议，但可能以牺牲整体健康饮食为代价。与需要血液透析的患者一起工作的营养师可能会选择优先考虑一般健康饮食建议，例如基于地中海饮食的建议，以更好地支持这类患者。

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引用次数: 0

Decisional Conflicts in Kidney Replacement Therapy for Patients With Grade 5 Chronic Kidney Disease: A Qualitative Meta-Synthesis 5级慢性肾病患者肾脏替代治疗的决策冲突：定性综合

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-10-24 DOI: 10.1111/jorc.70033

Yao Xu, Yujuan Zheng, Zhiqiao Long, Liyang Chang

Background

Patients with chronic kidney disease are faced with complex decisions on kidney replacement therapy, which are prone to conflict and affect the quality of decision-making.

Objectives

To systematically review and synthesise qualitative evidence related to decisional conflicts regarding kidney replacement therapy in patients with Grade 5 chronic kidney disease.

Design

CINAHL, Embase, Web of Science, Cochrane Library, MEDLINE, PubMed, OvidPsycINFO, CNKI, VIP, Wan Fang Database, and Sino Med were searched from the time of database establishment to March 2025.

Results

Overall, 15 studies involving 488 participants were included. We identified the following six themes related to decisional conflicts: emotional conflicts (negative emotions about starting kidney replacement therapy and uncertainty about the future), physical conflicts, information conflicts about kidney replacement therapy (insufficient or overwhelming kidney replacement therapy information, different understanding of information, challenges in doctor–patient communication and information asymmetry), support conflicts (insufficient kidney replacement therapy decision-making support), weak willingness to make decisions to kidney replacement therapy and others.

Conclusions

Patients with Grade 5 chronic kidney disease experience decisional conflicts, including severe negative emotions, insufficient awareness of kidney replacement therapy decision-making, insufficient or overwhelming information, and weak decision-making support. Healthcare professionals should be aware of these conflicts and offer personalised discussions to improve kidney replacement therapy decision-making in clinical practice.

背景：慢性肾脏疾病患者在肾脏替代治疗中面临复杂的决策，这些决策容易产生冲突，影响决策质量。目的：系统回顾和综合与5级慢性肾病患者肾替代治疗决策冲突相关的定性证据。设计：检索自建库至2025年3月，检索CINAHL、Embase、Web of Science、Cochrane Library、MEDLINE、PubMed、OvidPsycINFO、CNKI、VIP、万方数据库、Sino Med。结果：总共纳入了15项研究，涉及488名参与者。我们确定了以下六个与决策冲突相关的主题：情绪冲突（对开始肾脏替代治疗的负面情绪和对未来的不确定性），身体冲突，肾脏替代治疗的信息冲突（肾脏替代治疗信息不足或压倒性，对信息的理解不同，医患沟通困难，信息不对称），支持冲突（肾脏替代治疗决策支持不足），决定是否接受肾脏替代治疗的意愿较弱。结论：5级慢性肾病患者存在决策冲突，主要表现为负面情绪严重、对肾脏替代治疗决策认知不足、信息不足或压倒性、决策支持薄弱。医疗保健专业人员应该意识到这些冲突，并提供个性化的讨论，以改善临床实践中的肾脏替代治疗决策。

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引用次数: 0

Remote Patient Monitoring—Understanding by Nurses Who Support Home Dialysis Patients 支持家庭透析患者的护士对患者远程监护的理解。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-10-09 DOI: 10.1111/jorc.70031

Louise Collingridge, Nadine Tinsley, Rosemary Simmonds, Glenda Rayment, Josephine S. F. Chow

Background

Adherence to home dialysis is the focus of renal nurse support. Remote patient monitoring (RPM) promises improved adherence and clinical tools. Remote monitoring has been available for more than a decade. Limited findings of how nurses use and perceive RPM are available in published literature.

Objective

To understand renal nurses' experience of RPM when supporting patients undergoing ambulatory peritoneal dialysis at home.

Approach

Qualitative description of renal nurses' accounts of their experiences of using RPM across three centres delivering support for home dialysis. Focus group and interview data were audio-recorded, transcribed verbatim and interpreted with the aid of NVivo software.

Findings

Participants reported that RPM is valued for the programming of machines remotely. Patient health benefits were described as complex with no direct link to reduced hospitalisations. RPM is a tool that helps maintain relationships with patients. Routine checking of remote monitoring reports was only common when first introduced, and in smaller centres. Costs and data privacy can complicate the uptake. Results were similar across three different centres.

Conclusion

Renal nurses supporting home dialysis patients monitor adherence to treatment, using RPM as a tool that is most beneficial for the remote adjust of dialysis machine programs, but which also serves as a tool for building on their relationship with patients which in turn supports adherence, thus justifying overcoming barriers to use such as costs or availability of technology.

背景：坚持家庭透析是肾脏护理支持的重点。远程患者监测（RPM）有望改善依从性和临床工具。远程监控已经有十多年的历史了。有限的发现如何护士使用和感知RPM可在已发表的文献。目的：了解肾脏护理人员在家支持非卧床腹膜透析患者时的RPM经验。方法：定性描述肾脏护士在三个提供家庭透析支持的中心使用RPM的经历。对焦点小组和访谈资料进行录音、逐字转录，并借助NVivo软件进行翻译。研究结果：参与者报告说，RPM对远程机器编程很有价值。患者健康益处被描述为复杂的，与减少住院没有直接联系。RPM是一种帮助维持与患者关系的工具。对远程监测报告的例行检查只有在首次引入时才普遍，而且是在较小的中心。成本和数据隐私可能会使这种做法变得复杂。三个不同中心的结果相似。结论：支持家庭透析患者的肾脏护理人员监测治疗依从性，使用RPM作为最有利于远程调整透析机程序的工具，但它也可以作为建立与患者关系的工具，从而支持依从性，从而证明克服使用障碍（如成本或技术可用性）是合理的。

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引用次数: 0

Patient-Reported Outcome Measures to Determine Sleep Problems in Adults With Chronic Kidney Disease: A Systematic Review 确定成人慢性肾病患者睡眠问题的患者报告结果措施：一项系统综述

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-10-04 DOI: 10.1111/jorc.70032

Wan-Shan Chiang, Louise Purtell, Katina Corones-Watkins, Ann Bonner

Background

Adults with chronic kidney disease are prone to sleep problems, which can impact sleep quality and harm physical and mental wellbeing. Subjective sleep instruments help assess sleep quality and symptom severity. Evaluating the characteristics and psychometric properties of these instruments aids health practitioners in selecting suitable tools.

Objective

To identify optimal patient-reported outcome measures for assessing sleep quality and/or problems in the chronic kidney disease population.

Design

Systematic review.

Participants

Adults with chronic kidney disease.

Measurements

A comprehensive search was conducted in CINAHL, MEDLINE, Embase, the Cochrane Library, PsycINFO, and JBI for studies published between January 2010 and December 2023. Methodological quality was evaluated using COSMIN-COMIT guidelines.

Results

Nineteen instruments were identified. The Pittsburgh Sleep Quality Index, assessing both sleep quality and problems, was used in 73.8% of studies and has only been validated in kidney transplant populations. The Athens Insomnia Scale and Epworth Sleepiness Scale, while useful for insomnia and daytime sleepiness, provide narrower coverage, and the STOP-BANG and Berlin Questionnaire target sleep apnoea risk but are less practical for broad sleep assessment. These limitations may explain their less frequent use compared with the Pittsburgh Sleep Quality Index.

Conclusion

Future research should validate sleep instruments in non-transplant chronic kidney disease populations through comprehensive psychometric testing. Clinicians and researchers should carefully select multiple instruments to assess both overall sleep quality and sleep disorder-specific symptoms.

患有慢性肾脏疾病的成年人容易出现睡眠问题，这可能会影响睡眠质量，损害身心健康。主观睡眠仪器有助于评估睡眠质量和症状严重程度。评估这些仪器的特征和心理测量特性有助于卫生从业人员选择合适的工具。目的确定评估慢性肾病人群睡眠质量和/或问题的最佳患者报告结果指标。设计系统评审。参与者是患有慢性肾脏疾病的成年人。我们在CINAHL、MEDLINE、Embase、Cochrane图书馆、PsycINFO和JBI中进行了全面的检索，检索了2010年1月至2023年12月间发表的研究。采用COSMIN-COMIT指南评价方法学质量。结果共鉴定出19种仪器。评估睡眠质量和睡眠问题的匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index）被用于73.8%的研究，只在肾移植人群中得到验证。雅典失眠症量表和埃普沃斯嗜睡量表虽然对失眠和白天嗜睡很有用，但覆盖范围较窄，STOP-BANG和柏林问卷针对的是睡眠呼吸暂停风险，但对广泛的睡眠评估不太实用。与匹兹堡睡眠质量指数相比，这些限制可能解释了它们使用频率较低的原因。结论未来的研究应通过全面的心理测试来验证非移植慢性肾病人群的睡眠仪器。临床医生和研究人员应该仔细选择多种工具来评估整体睡眠质量和睡眠障碍的特定症状。

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引用次数: 0

Issue Information: Journal of Renal Care 4/2025 期刊信息：Journal of Renal Care 4/2025

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-10-04 DOI: 10.1111/jorc.12502

引用次数: 0