Journal of renal care最新文献_第2页

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

Experiences of Loss, Grief and Support Needs of Adults on Haemodialysis and Families: A Qualitative Explorative Study 成人血液透析患者的失去、悲伤和支持需求的经历及其家庭：一项质的探索性研究

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-10-04 DOI: 10.1111/jorc.70030

Jette Marcussen, Rikke Madsen, Ann Bonner, Jette Rude Nielsen, Hanne Agerskov

Background

The burdensome life of haemodialysis impacts both patients and their families. It often leads to a stressful life marked by experiences of loss and grief. Nurses report a lack of knowledge and skills in providing grief support, as well as insufficient time for existential conversations with patients and families.

Objectives

To explore the experiences of loss, grief and support needs of both adults on haemodialysis with no option of a kidney transplant and their family members.

Design

A qualitative explorative study, using a phenomenological-hermeneutical approach and semi-structured interviews. Ricoeur's interpretation theory was used to analyze data involving three steps: Naïve reading, structural analysis and critical interpretation and discussion.

Participants

Nine adults on haemodialysis and eight family members.

Findings

Haemodialysis treatment alters everyday life for families resulting in experiences of anticipatory grief. Both adults on haemodialysis and their family members experienced challenges with identities and changes in social relationships over the course of the illness with psychological consequences for the family. A holistic family-focused grief support was identified as an important need for the participants and ought to include time and room for private existential conversations with nurses.

Conclusion

This study offers unique insights into the impact of loss and anticipatory grief in everyday life for those on haemodialysis and their families. Greater existential support and holistic family-focused grief support is proposed to guide family nursing in kidney care. Healthcare policies and health education in grief ought to reflect the care needs of both patients and family members.

Baggrund

En tilværelse med hæmodialyse påvirker både patienter og deres familier og fører ofte til en stressende hverdag med oplevelser af tab og sorg. Utilstrækkelig psykosocial støtte og manglende familieinvolvering øger yderligere risikoen for patientindlæggelse. Sygeplejersker opleve

血液透析给患者和家属带来了沉重的生活负担。它常常导致以失去和悲伤为特征的压力生活。护士报告缺乏提供悲伤支持的知识和技能，也没有足够的时间与患者和家属进行存在对话。目的探讨无肾移植选择的血液透析成人及其家庭成员的失去、悲伤和支持需求的经历。设计一项定性探索性研究，使用现象学-解释学方法和半结构化访谈。使用Ricoeur的解释理论对数据进行分析，包括Naïve阅读、结构分析和批判性解释与讨论三个步骤。参与者：9名接受血液透析的成年人和8名家庭成员。研究结果：血液透析治疗改变了家庭的日常生活，导致了预期悲伤的经历。接受血液透析的成年人及其家庭成员在疾病过程中经历了身份和社会关系变化的挑战，并对家庭产生了心理影响。以家庭为中心的整体悲伤支持被认为是参与者的重要需求，应该包括与护士进行私人存在对话的时间和空间。结论：本研究对血液透析患者及其家属在日常生活中丧失亲人和预期悲伤的影响提供了独特的见解。提出了更多的存在支持和以家庭为中心的整体悲伤支持来指导肾脏护理的家庭护理。医疗保健政策和健康教育应该反映病人和家庭成员的护理需求。Baggrund En tilværelse med æmodialyse pasverker ba患者与患者之间的关系为：患者与患者之间的关系为：患者与患者之间的关系为：患者与患者之间的关系。Utilstrækkelig心理社会stø øtte ø manglende家庭参与øger ækkelig ø gerderligere risikkoen为患者。Sygeplejersker是一种非常常见的治疗方法，它可以使患者在治疗过程中保持良好的状态，也可以使患者保持良好的状态。正式的在在20øge oplevelser af选项卡中,sorg og behov圣øtte居屋voksne我æmodialyse uden mulighed为nyretransplantation og der ts。设计创造性、创造性、创造性、创造性、规范性、解释性、半结构化访谈。在分析数据的过程中，采用了三种方法对数据进行分析：一种方法对数据进行分析，一种方法对风险进行分析，一种方法对风险进行分析。Deltagere 9 voksne i æmodialyse og 8 p ørende。结果：h æ æ对不同类型的家庭进行了不同程度的处理，结果表明：在不同类型的家庭中，h æ æ对不同类型的家庭进行了不同程度的处理。患者与家庭成员之间的关系，与家庭成员之间的关系，与家庭成员之间的关系。大多数心理学家都认为这是一种家庭行为。这是一种对所有人来说都很重要的行为，比如家庭成员，家庭成员，家庭成员，家庭成员，私人成员，家庭成员，家庭成员，家庭成员。结论：研究给予者的洞察力不同于研究对象的洞察力，而研究对象的洞察力不同于研究对象的洞察力。患者在中风前的症状为：患者在中风前的症状为：患者在中风前的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状为：患者在中风后的症状。Sundhedspolitik是一种对患者和家属行为的干预。

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引用次数: 0

Changes in Physical Activity Among Spanish Kidney Transplant Recipients: A 12-Month Longitudinal Study 西班牙肾移植受者身体活动的变化：一项为期12个月的纵向研究

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-08-21 DOI: 10.1111/jorc.70029

Emilia Ferrer-López, Víctor Cantín-Lahoz, Francisco Javier Rubio-Castañeda, Isabel Blázquez-Ornat, Isabel Antón-Solanas, Fernando Urcola-Pardo

<div> <section> <h3> Background</h3> <p>Physical activity is crucial for improving cardiovascular risk and overall health in kidney transplant recipients. However, changes in physical activity before and after transplantation remain underexplored.</p> </section> <section> <h3> Objective</h3> <p>To assess energy expenditure and physical activity before and after kidney transplantation over 1 year, analysing their relationship with cardiovascular risk factors.</p> </section> <section> <h3> Design</h3> <p>Descriptive, longitudinal, prospective study.</p> </section> <section> <h3> Participants</h3> <p>A total of 112 individuals who had received a kidney transplant (aged ≥ 18 years) at a single transplant centre.</p> </section> <section> <h3> Measurements</h3> <p>Sociodemographic and clinical data were extracted from medical records. The International Physical Activity Questionnaire was administered at baseline and at 3, 6 and 12 months after transplantation to evaluate physical activity (as metabolic equivalent minutes per week). Laboratory parameters were also collected.</p> </section> <section> <h3> Analysis</h3> <p>Descriptive statistics summarised participant characteristics. Inferential analyses (chi-square, <i>t</i>-tests, ANOVA, Mann–Whitney <i>U</i>, Kruskal–Wallis) examined associations between physical activity and clinical variables (significance <i>p</i> < 0.05).</p> </section> <section> <h3> Results</h3> <p>Participants had a median age of 58 years; 70.5% were men. Overall physical activity declined at 3 months, rebounded at 6, and decreased again at 12 months, remaining below the levels observed before transplantation. Men, participants not requiring dialysis before transplantation, individuals with overweight, and individuals with a history of cerebrovascular disease exhibited higher physical activity throughout follow-up. Physical activity correlated with certain laboratory parameters, suggesting that better clinical status may foster greater physical activity engagement.</p> </section> <section> <h3> Conclusion</h3> <p>Tailored physical activity targeting comorbidities and nutritional status are recommended to improve long-term outc

背景：体育活动对改善肾移植受者心血管风险和整体健康至关重要。然而，移植前后身体活动的变化仍未得到充分研究。目的评价肾移植前后1年的能量消耗和体力活动，分析其与心血管危险因素的关系。设计描述性、纵向、前瞻性研究。参与者在单个移植中心接受过肾移植（年龄≥18岁）的112人。从医疗记录中提取社会人口学和临床数据。在基线和移植后3、6和12个月进行国际身体活动问卷调查，以评估身体活动（每周代谢当量分钟数）。同时采集实验室参数。描述性统计总结了参与者的特征。推断分析（卡方检验、t检验、方差分析、Mann-Whitney U、Kruskal-Wallis）检验了体力活动与临床变量之间的关联（显著性p <； 0.05）。结果参与者的中位年龄为58岁；70.5%为男性。总体体力活动在3个月时下降，6个月时反弹，12个月时再次下降，仍低于移植前观察到的水平。男性、移植前不需要透析的参与者、超重个体和有脑血管疾病史的个体在随访期间表现出较高的体力活动。体力活动与某些实验室参数相关，表明更好的临床状态可能促进更多的体力活动参与。结论：建议针对合并症和营养状况进行量身定制的体育活动，以改善肾移植受者的长期预后，尤其是女性、老年人和有多种合并症的患者。

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引用次数: 0

Efficacy of Interventions to Reduce Arteriovenous Fistula Cannulation-Related Pain in Patients Undergoing Haemodialysis: A Systematic Review and Meta-Analysis 干预措施减少血液透析患者动静脉瘘插管相关疼痛的疗效：系统回顾和荟萃分析

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-07-18 DOI: 10.1111/jorc.70028

Nurten Ozen, Nese ALTINOK. Ersoy, Gulsah Kesik

Background

Experiencing continued pain affects the level of haemodialysis adherence in patients and ultimately decrease quality of life. Therefore, pain control is an important priority in these patients. No systematic review and meta-analyses study about the effect of intervention (invasive and noninvasive intervention) on the arteriovenous fistula cannulation-related pain has yet been carried out.

Objectives

This systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of intervention to reduce the arteriovenous fistula cannulation-related pain in patients undergoing haemodialysis.

Methods

Using English databases, including PubMed, Web of Science, Scopus, Science Direct, ProQuest, ProQuest Dissertations & Theses Global, and EBSCOHOST were systematically searched from their inception to April 2025. Two reviewers independently assessed the risk of bias using the JBI RCT checklist. The Comprehensive Meta-Analysis® software version 3.0 (Biostat) was used for data analysis.

Results

Twenty-two randomised controlled trials examined the effects of interventions to alleviate the arteriovenous fistula cannulation-related pain including invasive and noninvasive interventions related studies. Invasive interventions buttonhole cannulation, using plastic needle and using indwelling needles. Noninvasive methods include cryotherapy or using a local skin cooling device, aromatherapy, foot reflexology, US-guided cannulation, antistress balls, listening to music or running water, virtual reality distraction, breathing exercise, and acupressure on patients with haemodialysis.

Conclusion

The study demonstrated that invasive and noninvasive interventions had beneficial effects on the fistula cannulation-related pain. However, due to the heterogeneity and the lack of follow-up studies, more high-quality studies are needed to confirm the results of our review and to clarify the long-term effects of interventions.

背景：持续疼痛会影响患者血液透析依从性，最终降低生活质量。因此，在这些患者中，疼痛控制是一个重要的优先事项。目前还没有关于干预（有创和无创干预）对动静脉瘘插管相关疼痛影响的系统综述和荟萃分析研究。目的：本系统综述采用荟萃分析来评估干预措施减少血液透析患者动静脉瘘插管相关疼痛的有效性。方法使用PubMed、Web of Science、Scopus、Science Direct、ProQuest、ProQuest dissertation &等英文数据库；从成立到2025年4月，对这些网站和EBSCOHOST进行了系统的检索。两名审稿人使用JBI RCT检查表独立评估偏倚风险。采用综合meta分析软件3.0版（Biostat）进行数据分析。结果22项随机对照试验考察了干预措施对缓解动静脉瘘插管相关疼痛的影响，包括有创和无创干预相关研究。有创干预措施：钮孔插管、塑料针和留置针。非侵入性方法包括冷冻疗法或使用局部皮肤冷却装置、芳香疗法、足部反射疗法、美国引导插管、抗压力球、听音乐或自来水、虚拟现实分心、呼吸运动和对血液透析患者的指压。结论有创性和无创性干预措施对瘘管插管相关疼痛的治疗效果良好。然而，由于异质性和缺乏随访研究，需要更多高质量的研究来证实我们综述的结果，并阐明干预措施的长期效果。

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引用次数: 0

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