Juthamas Tiansaard, Melissa J. Bloomer, Louise Purtell, Ann Bonner
Background
Advance care planning enables adults to express their goals and preferences for future care. Advance care planning has been widely recognised in oncology and palliative care for decades, but its use in kidney care is variable.
Objective
To examine interventions that promote advance care planning among adults with chronic kidney disease, including those receiving kidney replacement therapy.
Design
Systematic review.
Method
A comprehensive search was conducted in six databases: PubMed, MEDLINE, CINAHL, PsycINFO, Scopus, and Embase. Studies published from databases inception to September 2024 were included. Two independent reviewers identified studies for full-text review and data extraction. Methodological quality was assessed using the Mixed Methods Appraisal Tool. The review protocol was registered in PROSPERO (CRD42024589958).
Results
Twenty-seven studies were included: 22 were quantitative (10 randomised and 12 non-randomised), three were qualitative, and two were mixed-methods designs. Most studies were conducted in the United States of America. Five main strategies to promote advance care planning uptake and improve outcomes were educating and training kidney healthcare professionals; implementing advance care planning conversations; providing educational resources; offering peer facilitators; and integrating palliative care teams. The synthesis of qualitative findings indicated that advance care planning discussions instilled hopefulness about the future and did not induce anxiety.
Conclusion
Advance care planning conversations combined with educational resources and peer support facilitators are likely to improve rates of advance care planning completions in this population, although further evidence is needed. Kidney healthcare professionals should be trained to initiate these conversations with all patients.
{"title":"Advance Care Planning Interventions for Adults With Chronic Kidney Disease: A Systematic Review","authors":"Juthamas Tiansaard, Melissa J. Bloomer, Louise Purtell, Ann Bonner","doi":"10.1111/jorc.70046","DOIUrl":"10.1111/jorc.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Advance care planning enables adults to express their goals and preferences for future care. Advance care planning has been widely recognised in oncology and palliative care for decades, but its use in kidney care is variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine interventions that promote advance care planning among adults with chronic kidney disease, including those receiving kidney replacement therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A comprehensive search was conducted in six databases: PubMed, MEDLINE, CINAHL, PsycINFO, Scopus, and Embase. Studies published from databases inception to September 2024 were included. Two independent reviewers identified studies for full-text review and data extraction. Methodological quality was assessed using the Mixed Methods Appraisal Tool. The review protocol was registered in PROSPERO (CRD42024589958).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies were included: 22 were quantitative (10 randomised and 12 non-randomised), three were qualitative, and two were mixed-methods designs. Most studies were conducted in the United States of America. Five main strategies to promote advance care planning uptake and improve outcomes were educating and training kidney healthcare professionals; implementing advance care planning conversations; providing educational resources; offering peer facilitators; and integrating palliative care teams. The synthesis of qualitative findings indicated that advance care planning discussions instilled hopefulness about the future and did not induce anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Advance care planning conversations combined with educational resources and peer support facilitators are likely to improve rates of advance care planning completions in this population, although further evidence is needed. Kidney healthcare professionals should be trained to initiate these conversations with all patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12833587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Residual kidney function in patients receiving haemodialysis is associated with improved survival, reduced cardiovascular risk and better quality of life. Yet, clinical guidelines on its preservation are limited, and local practices remain unclear.</p> </section> <section> <h3> Objectives</h3> <p>To explore current practices, perceptions and challenges related to residual kidney function preservation among renal clinicians.</p> </section> <section> <h3> Design</h3> <p>Descriptive cross-sectional survey.</p> </section> <section> <h3> Participants</h3> <p>Renal physicians and nurses working in hospital-based haemodialysis units across Western Australia.</p> </section> <section> <h3> Measurements</h3> <p>Role-specific questionnaires were administered to renal physicians and nurses.</p> </section> <section> <h3> Results</h3> <p>Eighty-four completed responses were received (physicians <i>n</i> = 25; nurses <i>n</i> = 59). Over half of physicians (56%, <i>n</i> = 14) reported residual kidney function was present in more than half of patients at haemodialysis initiation, while most nurses (64%, <i>n</i> = 30) indicated it was often or always present. Assessment of this function was reported by 64% of physicians (<i>n</i> = 16) and 61% of nurses (<i>n</i> = 36), predominantly via patient self-reported urine output (physician 100%, <i>n</i> = 16; nurses 86%, <i>n</i> = 31). Most physicians (76%, <i>n</i> = 19) and nearly all nurses (90%, <i>n</i> = 53) believed preservation could improve patient outcomes. Key reported challenges included lack of consensus on optimal approaches (physicians 74%, <i>n</i> = 17; nurses 54%, <i>n</i> = 29), absence of clinical guidelines (nurses 61%, <i>n</i> = 33), difficulty in accurate assessment (physicians 65%, <i>n</i> = 15; nurses 52%, <i>n</i> = 28), and limited patient awareness (physician 57%, <i>n</i> = 13). Nurses identified staff education (83% <i>n</i> = 49) and practice guidelines (81%, <i>n</i> = 48) as key enablers to enhancing preservation efforts.</p> </section> <section> <h3> Conclusions</h3> <p>While the clinical value of residual kidney function is widely recognised, its preservation in haemodialysis remains constrained by the lack of clinical consensus and guideline
{"title":"Preserving Residual Kidney Function in Haemodialysis: Current Practices, Challenges, and Perspectives From Renal Clinicians","authors":"Lijun Zhong, Ulrich Steinwandel, Hugh Davies, Sara Bayes, Jagadish Jamboti, Hemant Kulkarni, Doris Chan","doi":"10.1111/jorc.70045","DOIUrl":"10.1111/jorc.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Residual kidney function in patients receiving haemodialysis is associated with improved survival, reduced cardiovascular risk and better quality of life. Yet, clinical guidelines on its preservation are limited, and local practices remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore current practices, perceptions and challenges related to residual kidney function preservation among renal clinicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Descriptive cross-sectional survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Renal physicians and nurses working in hospital-based haemodialysis units across Western Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Role-specific questionnaires were administered to renal physicians and nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-four completed responses were received (physicians <i>n</i> = 25; nurses <i>n</i> = 59). Over half of physicians (56%, <i>n</i> = 14) reported residual kidney function was present in more than half of patients at haemodialysis initiation, while most nurses (64%, <i>n</i> = 30) indicated it was often or always present. Assessment of this function was reported by 64% of physicians (<i>n</i> = 16) and 61% of nurses (<i>n</i> = 36), predominantly via patient self-reported urine output (physician 100%, <i>n</i> = 16; nurses 86%, <i>n</i> = 31). Most physicians (76%, <i>n</i> = 19) and nearly all nurses (90%, <i>n</i> = 53) believed preservation could improve patient outcomes. Key reported challenges included lack of consensus on optimal approaches (physicians 74%, <i>n</i> = 17; nurses 54%, <i>n</i> = 29), absence of clinical guidelines (nurses 61%, <i>n</i> = 33), difficulty in accurate assessment (physicians 65%, <i>n</i> = 15; nurses 52%, <i>n</i> = 28), and limited patient awareness (physician 57%, <i>n</i> = 13). Nurses identified staff education (83% <i>n</i> = 49) and practice guidelines (81%, <i>n</i> = 48) as key enablers to enhancing preservation efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the clinical value of residual kidney function is widely recognised, its preservation in haemodialysis remains constrained by the lack of clinical consensus and guideline","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fitri Mailani, Emil Huriani, Hema Malini, Setiawan Setiawan, Anisa Rahma Yuni
Background
Nurses play a crucial role in haemodialysis care, yet they often face complex responsibilities, heavy workloads, and emotional strain. Despite their central role, limited evidence exists regarding the barriers and facilitators that influence their experiences, particularly within Indonesia's public hospital settings.
Objective
This study aimed to explore the facilitators and barriers encountered by nursing professionals in delivering haemodialysis care in Indonesia.
Design
A descriptive qualitative design was employed.
Participants
Sixteen dialysis nurses were recruited through purposive sampling from three tertiary government hospitals in Indonesia.
Methods
Data were collected through in-depth interviews and analyzed using Braun and Clarke's thematic analysis approach.
Findings
Three overarching themes emerged as facilitators: team collegiality, adequate equipment and clinical resources, and respect and remuneration, encompassing eight sub-themes. Four major themes were identified as barriers: limited specialised equipment; staffing constraints; patient barriers such as travel cost, cultural beliefs; and adherence to treatment and educational barriers, comprising ten sub-themes.
Conclusion
This study highlights the dual nature of facilitators and barriers influencing nursing practice in haemodialysis units. Understanding these factors is crucial for developing effective strategies to enhance workforce capacity, optimise resource allocation, and foster supportive work environments. Ultimately, addressing these barriers may improve both nurses' professional well-being and the quality of care provided to patients undergoing haemodialysis in Indonesia.
{"title":"Barriers and Facilitators to Haemodialysis Care in Indonesia: Perspectives of Dialysis Nurses","authors":"Fitri Mailani, Emil Huriani, Hema Malini, Setiawan Setiawan, Anisa Rahma Yuni","doi":"10.1111/jorc.70044","DOIUrl":"10.1111/jorc.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nurses play a crucial role in haemodialysis care, yet they often face complex responsibilities, heavy workloads, and emotional strain. Despite their central role, limited evidence exists regarding the barriers and facilitators that influence their experiences, particularly within Indonesia's public hospital settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore the facilitators and barriers encountered by nursing professionals in delivering haemodialysis care in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A descriptive qualitative design was employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Sixteen dialysis nurses were recruited through purposive sampling from three tertiary government hospitals in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected through in-depth interviews and analyzed using Braun and Clarke's thematic analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Three overarching themes emerged as facilitators: team collegiality, adequate equipment and clinical resources, and respect and remuneration, encompassing eight sub-themes. Four major themes were identified as barriers: limited specialised equipment; staffing constraints; patient barriers such as travel cost, cultural beliefs; and adherence to treatment and educational barriers, comprising ten sub-themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the dual nature of facilitators and barriers influencing nursing practice in haemodialysis units. Understanding these factors is crucial for developing effective strategies to enhance workforce capacity, optimise resource allocation, and foster supportive work environments. Ultimately, addressing these barriers may improve both nurses' professional well-being and the quality of care provided to patients undergoing haemodialysis in Indonesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Adults receiving hemodialysis experience many problems. Benson's relaxation technique has been used to manage these problems, but evidence of its effectiveness is limited.</p> </section> <section> <h3> Objectives</h3> <p>To assess Benson's relaxation effects on physical, psychological outcomes, and quality of life in adults receiving hemodialysis.</p> </section> <section> <h3> Design</h3> <p>Systematic review and meta-analysis of randomized controlled trials registered in PROSPERO (CRD42022379551).</p> </section> <section> <h3> Participants</h3> <p>Adults receiving hemodialysis.</p> </section> <section> <h3> Measurements</h3> <p>Eleven databases were searched through January 18, 2024, and updated January 10, 2025. Eligible RCTs involved adults on hemodialysis for at least 3 months, comparing Benson's relaxation with routine care or other interventions. Primary outcomes included physical measures, quality of life, and psychological outcomes; secondary outcomes were narratively reported. Risk of bias was assessed with Cochrane RoB 2.0, and evidence certainty with GRADE. Random-effects meta-analysis and sensitivity analyses used Comprehensive Meta-Analysis v3.</p> </section> <section> <h3> Results</h3> <p>Fourteen trials with 1,104 participants provided low-certainty evidence for small effects on serum phosphate (Hedges' <i>g</i> = 0.39, <i>p</i> = 0.010) and large effects on pain (Hedges' <i>g</i> = 1.21, <i>p</i> = 0.010). Very-low-certainty evidence found moderate effects on quality of life (Hedges' <i>g</i> = 0.65, <i>p</i> = 0.010) and large effects on stress (Hedges' <i>g</i> = 1.58, <i>p</i> = 0.017). High-certainty evidence showed small effects on anxiety (Hedges' <i>g</i> = 0.45, <i>p</i> = 0.001). No significant effects were observed for serum calcium or depression symptoms. Sensitivity analyses showed variable robustness. Secondary outcomes were reported narratively.</p> </section> <section> <h3> Conclusions</h3> <p>Overall, current evidence supports cautious clinical interpretation and highlights the need for further rigorous, adequately powered randomized controlled trials.</p> </section> <section> <h3> Study Registration</h3> <p>This study is registered in PROSPERO (Registration Number: CRD42022379551, registered on December 8, 2022).</p> </section>
背景：接受血液透析的成年人会遇到许多问题。本森的放松技术已被用于处理这些问题，但其有效性的证据有限。目的：评估Benson放松对接受血液透析的成人的生理、心理结果和生活质量的影响。设计：系统评价和荟萃分析在PROSPERO注册的随机对照试验（CRD42022379551）。参与者：接受血液透析的成年人。测量：在2024年1月18日之前搜索了11个数据库，并于2025年1月10日更新。符合条件的随机对照试验包括接受血液透析至少3个月的成年人，将Benson放松疗法与常规护理或其他干预措施进行比较。主要结局包括身体测量、生活质量和心理结局；次要结果叙述性报道。用Cochrane RoB 2.0评估偏倚风险，用GRADE评估证据确定性。随机效应荟萃分析和敏感性分析采用综合荟萃分析v3。结果：涉及1104名受试者的14项试验提供了低确定性证据，证明对血清磷酸盐的影响很小（Hedges' g = 0.39, p = 0.010），对疼痛的影响很大（Hedges' g = 1.21, p = 0.010）。非常低确定性的证据发现，对生活质量的影响中等（Hedges的g = 0.65, p = 0.010），对压力的影响很大（Hedges的g = 1.58, p = 0.017）。高确定性证据显示对焦虑的影响很小（Hedges的g = 0.45, p = 0.001）。血清钙或抑郁症状未见明显影响。敏感性分析显示了可变稳健性。次要结果以叙述方式报道。结论：总的来说，目前的证据支持谨慎的临床解释，并强调需要进一步严格、充分有力的随机对照试验。研究注册：本研究在PROSPERO注册（注册号：CRD42022379551，于2022年12月8日注册）。
{"title":"Effect of Benson's Relaxation on Physical, Psychological, and Quality of Life Outcomes in Adults Receiving Hemodialysis: Systematic Review and Meta-Analysis","authors":"Şefika Tuğba Yangöz, Zeynep Karakuş, Zeynep Özer","doi":"10.1111/jorc.70043","DOIUrl":"10.1111/jorc.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adults receiving hemodialysis experience many problems. Benson's relaxation technique has been used to manage these problems, but evidence of its effectiveness is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess Benson's relaxation effects on physical, psychological outcomes, and quality of life in adults receiving hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review and meta-analysis of randomized controlled trials registered in PROSPERO (CRD42022379551).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Adults receiving hemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Eleven databases were searched through January 18, 2024, and updated January 10, 2025. Eligible RCTs involved adults on hemodialysis for at least 3 months, comparing Benson's relaxation with routine care or other interventions. Primary outcomes included physical measures, quality of life, and psychological outcomes; secondary outcomes were narratively reported. Risk of bias was assessed with Cochrane RoB 2.0, and evidence certainty with GRADE. Random-effects meta-analysis and sensitivity analyses used Comprehensive Meta-Analysis v3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen trials with 1,104 participants provided low-certainty evidence for small effects on serum phosphate (Hedges' <i>g</i> = 0.39, <i>p</i> = 0.010) and large effects on pain (Hedges' <i>g</i> = 1.21, <i>p</i> = 0.010). Very-low-certainty evidence found moderate effects on quality of life (Hedges' <i>g</i> = 0.65, <i>p</i> = 0.010) and large effects on stress (Hedges' <i>g</i> = 1.58, <i>p</i> = 0.017). High-certainty evidence showed small effects on anxiety (Hedges' <i>g</i> = 0.45, <i>p</i> = 0.001). No significant effects were observed for serum calcium or depression symptoms. Sensitivity analyses showed variable robustness. Secondary outcomes were reported narratively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, current evidence supports cautious clinical interpretation and highlights the need for further rigorous, adequately powered randomized controlled trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Registration</h3>\u0000 \u0000 <p>This study is registered in PROSPERO (Registration Number: CRD42022379551, registered on December 8, 2022).</p>\u0000 </section>\u0000 ","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Issue Information: Journal of Renal Care 1/2026","authors":"","doi":"10.1111/jorc.70042","DOIUrl":"https://doi.org/10.1111/jorc.70042","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145891563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sevda Tüzün Özdemir, Asiye Akyol, Şengül Özdemir, Ahmet Aykut Sifil
Background
Fear of falling is a common concern among patients undergoing haemodialysis, leading to decreased physical activity, increased dependency, and reduced quality of life. Despite its relevance, the impact of this fear on physical activity in this population remains underexplored.
Objective
To examine the association between fear of falling and physical activity levels in patients receiving haemodialysis.
Design
A descriptive, cross-sectional study was conducted between 20 October and 20 November 2023, at a private dialysis center in Turkey.
Participants
The study included 103 haemodialysis patients aged 18 years or older who were literate, fluent in Turkish, and voluntarily agreed to participate. The sample size was calculated using G*Power software, and post hoc analysis showed the study had 94% power.
Measurements
Data were collected using the Patient Information Form, the Falls Efficacy Scale-International (FES-I), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Descriptive and inferential analyses were performed, including Mann–Whitney U, Kruskal–Wallis H, and Spearman's correlation tests.
Results
The mean age of participants was 65.1 ± 13.5 years. A history of falling was reported by 43.7%, and 67% reported fear of falling. A moderate positive correlation was found between fall history and FES-I scores (r = 0.369, p < 0.01), while a moderate negative correlation was observed between FES-I and IPAQ-SF scores (r = −0.491, p < 0.01).
Conclusion
Fear of falling negatively affects physical activity in haemodialysis patients. Interventions aimed at reducing fall-related fear and enhancing psychological support may promote more active lifestyles and improve overall well-being in this population.
{"title":"The Association Between Fear of Falling and Physical Activity in Haemodialysis Patients","authors":"Sevda Tüzün Özdemir, Asiye Akyol, Şengül Özdemir, Ahmet Aykut Sifil","doi":"10.1111/jorc.70041","DOIUrl":"10.1111/jorc.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fear of falling is a common concern among patients undergoing haemodialysis, leading to decreased physical activity, increased dependency, and reduced quality of life. Despite its relevance, the impact of this fear on physical activity in this population remains underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the association between fear of falling and physical activity levels in patients receiving haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A descriptive, cross-sectional study was conducted between 20 October and 20 November 2023, at a private dialysis center in Turkey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The study included 103 haemodialysis patients aged 18 years or older who were literate, fluent in Turkish, and voluntarily agreed to participate. The sample size was calculated using G*Power software, and post hoc analysis showed the study had 94% power.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Data were collected using the Patient Information Form, the Falls Efficacy Scale-International (FES-I), and the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Descriptive and inferential analyses were performed, including Mann–Whitney <i>U</i>, Kruskal–Wallis <i>H</i>, and Spearman's correlation tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of participants was 65.1 ± 13.5 years. A history of falling was reported by 43.7%, and 67% reported fear of falling. A moderate positive correlation was found between fall history and FES-I scores (<i>r</i> = 0.369, <i>p</i> < 0.01), while a moderate negative correlation was observed between FES-I and IPAQ-SF scores (<i>r</i> = −0.491, <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fear of falling negatively affects physical activity in haemodialysis patients. Interventions aimed at reducing fall-related fear and enhancing psychological support may promote more active lifestyles and improve overall well-being in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nga Thi Thuy Nguyen, Nuzul Sri Hertanti, Yeu-Hui Chuang
Background
Constipation significantly affects the quality of life and health outcomes of patients undergoing haemodialysis. Despite its common occurrence in this population, there is a lack of systematic reviews and meta-analyses on the prevalence of constipation among patients receiving haemodialysis.
Objectives
To determine the global prevalence and risk factors of constipation among patients receiving haemodialysis.
Design
A systematic review and meta-analysis following PRISMA guidelines.
Participants
Adult patients undergoing haemodialysis.
Methods
A comprehensive search strategy was conducted across PubMed, Embase, CINAHL, Web of Science, and Medline to identify relevant articles. A random-effects model was used with 95% confidence intervals. Heterogeneity, meta-regression, moderators, and publication bias were also analysed. The methodological quality was assessed according to Hoy's guidelines and the Risk of Bias tool 2.0. Risk factors were determined based on odds ratios, along with 95% confidence intervals or p-values.
Results
Twenty-two studies involving 4963 patients receiving haemodialysis were included. The pooled prevalence of constipation among patients with haemodialysis was 42.2%. The Asian region reported a significantly higher proportion of constipation than other regions. No publication bias was identified using Egger's test. The Rome criteria were mostly used among the included studies. Significant risk factors for constipation were diabetes and low levels of physical activity.
Conclusion
Constipation is prevalent among patients with haemodialysis, affecting nearly half of this population, particularly in Asia. The Rome criteria were the predominant method used for diagnosing constipation. Diabetes and limited physical activity were significant risk factors for constipation. The findings emphasise the importance of healthcare professionals conducting regular screening and designing tailored interventions to effectively manage constipation in this population.
背景：便秘显著影响血液透析患者的生活质量和健康结局。尽管便秘在这一人群中很常见，但缺乏对血液透析患者中便秘患病率的系统综述和荟萃分析。目的：了解血液透析患者便秘的全球患病率及危险因素。设计：遵循PRISMA指南进行系统评价和荟萃分析。参与者：接受血液透析的成年患者。方法：在PubMed， Embase， CINAHL， Web of Science和Medline上进行综合搜索策略，以确定相关文章。采用随机效应模型，置信区间为95%。异质性、元回归、调节因子和发表偏倚也进行了分析。方法学质量根据Hoy指南和风险偏倚工具2.0进行评估。根据比值比、95%置信区间或p值确定危险因素。结果：纳入22项研究，涉及4963例接受血液透析的患者。血液透析患者中便秘的总患病率为42.2%。亚洲地区报告的便秘比例明显高于其他地区。Egger检验未发现发表偏倚。纳入的研究大多采用Rome标准。便秘的重要危险因素是糖尿病和低水平的体育活动。结论：便秘在血液透析患者中很普遍，影响了近一半的患者，特别是在亚洲。罗马标准是诊断便秘的主要方法。糖尿病和有限的体力活动是便秘的重要危险因素。研究结果强调了卫生保健专业人员进行定期筛查和设计量身定制的干预措施以有效管理这一人群便秘的重要性。
{"title":"Global Prevalence and Risk Factors of Constipation Among Patients Receiving Haemodialysis: A Systematic Review and Meta-Analysis","authors":"Nga Thi Thuy Nguyen, Nuzul Sri Hertanti, Yeu-Hui Chuang","doi":"10.1111/jorc.70040","DOIUrl":"10.1111/jorc.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Constipation significantly affects the quality of life and health outcomes of patients undergoing haemodialysis. Despite its common occurrence in this population, there is a lack of systematic reviews and meta-analyses on the prevalence of constipation among patients receiving haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the global prevalence and risk factors of constipation among patients receiving haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A systematic review and meta-analysis following PRISMA guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Adult patients undergoing haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search strategy was conducted across PubMed, Embase, CINAHL, Web of Science, and Medline to identify relevant articles. A random-effects model was used with 95% confidence intervals. Heterogeneity, meta-regression, moderators, and publication bias were also analysed. The methodological quality was assessed according to Hoy's guidelines and the Risk of Bias tool 2.0. Risk factors were determined based on odds ratios, along with 95% confidence intervals or <i>p</i>-values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two studies involving 4963 patients receiving haemodialysis were included. The pooled prevalence of constipation among patients with haemodialysis was 42.2%. The Asian region reported a significantly higher proportion of constipation than other regions. No publication bias was identified using Egger's test. The Rome criteria were mostly used among the included studies. Significant risk factors for constipation were diabetes and low levels of physical activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Constipation is prevalent among patients with haemodialysis, affecting nearly half of this population, particularly in Asia. The Rome criteria were the predominant method used for diagnosing constipation. Diabetes and limited physical activity were significant risk factors for constipation. The findings emphasise the importance of healthcare professionals conducting regular screening and designing tailored interventions to effectively manage constipation in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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。
{"title":"Lifestyle Interventions, Markers of Metabolic Syndrome and Quality of Life in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis","authors":"Ashley Darvell, Annaliese Pretty, Kelly Lambert, Elizabeth P. Neale","doi":"10.1111/jorc.70038","DOIUrl":"10.1111/jorc.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Vaccination Uptake and Patient Perceptions Among Haemodialysis Patients: Insights From a Cross-Sectional Study","authors":"Eirini Potamianou, Ioanna Dimitriadou, Maria Saridi, Aikaterini Toska, Evangelos C. Fradelos, Paraskevi Theofilou, Dimitrios Papagiannis","doi":"10.1111/jorc.70039","DOIUrl":"10.1111/jorc.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate vaccine coverage and perceptions among patients undergoing haemodialysis in Greece and identify factors influencing uptake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This was a cross-sectional study employing a structured, interviewer-administered questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The study included 201 adult patients undergoing maintenance haemodialysis at selected dialysis centres in Greece.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> < 0.05). A weak but statistically significant correlation (<i>r</i> = .163–0.341) was observed between positive perceptions of vaccines and actual vaccination behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Investigating Perceptions of Quality Nephrology Nurse Training","authors":"Kathy Hill, Anne Britton, Dana Cotton","doi":"10.1111/jorc.70037","DOIUrl":"10.1111/jorc.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nephrology nursing shortages are becoming a critical problem in South Australian renal units due to increasing caseloads and high levels of attrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Thirty-three nephrology nurses drawn from four health services participated in a face-to-face interview or a focus group with several others.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To address staff shortages renal units need to consider the reintroduction of clinical rotations and incentives to complete post graduate training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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