Journal of renal care最新文献_第4页

Nurse's Perceptions and Roles in the Management of Chronic Kidney Disease-Associated Pruritus: A Multicentre Survey Across Europe 护士在慢性肾脏疾病相关瘙痒管理中的认知和作用：一项横跨欧洲的多中心调查

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-05-13 DOI: 10.1111/jorc.70018

Anastasia Liossatou, Afra Masià-Plana, Veronica Strini, Davide Sisti, Ilaria de Barbieri, Sofia Zyga

Background

Chronic kidney disease-associated pruritus is a debilitating condition affecting people on haemodialysis, and nephrology nurses have the potential to play a crucial role in its early identification and management.

Objectives

To investigate the nephrology nurses’ perceptions and roles in the identification and management of chronic kidney disease-associated pruritus among people receiving haemodialysis.

Design

A survey-based, cross-sectional study was conducted by the European Dialysis Transplant Nurses Association/European Renal Care Association, using a structured questionnaire designed by the researchers and distributed online.

Participants

Nephrology nurses working in the haemodialysis field.

Results

A total of 286 questionnaire submissions were received from 15 European countries. The study sample comprised 48 male and 238 female nurses. The findings reveal that 71.9% of nurses participating in the study widely agreed that the people on haemodialysis under their care tend to withhold reporting symptoms of chronic kidney disease-associated pruritus. Nurses perceived that approximately 25% of their people on haemodialysis did not openly discuss their symptoms of pruritus with their care team. Most nurses (76.4%) reported being involved in recommending or prescribing treatments for chronic kidney disease-associated pruritus, with 71.4% specifically addressing treatments for itching. However, 35.5% of healthcare professionals do not fully recognise the link between pruritus and kidney disease.

Conclusion

The study highlights the complex challenges nephrology nurses face in identifying and managing chronic kidney disease-associated pruritus. It emphasises the significant impact of pruritus on people's quality of life and the crucial role nurses can play in early detection and management.

慢性肾脏疾病相关性瘙痒是一种影响血液透析患者的衰弱性疾病，肾脏病护士在其早期识别和管理中发挥着至关重要的作用。目的了解肾科护士对血液透析患者慢性肾病相关性瘙痒的认识及在诊断和处理中的作用。设计一项基于调查的横断面研究由欧洲透析移植护士协会/欧洲肾脏护理协会进行，使用由研究人员设计并在线分发的结构化问卷。参与者：在血液透析领域工作的肾脏科护士。结果共收到来自15个欧洲国家的286份问卷。研究样本包括48名男护士和238名女护士。调查结果显示，参与研究的71.9%的护士普遍认为，在其护理下接受血液透析的患者往往会隐瞒慢性肾脏疾病相关瘙痒的症状。护士认为，大约25%的血液透析患者没有与护理团队公开讨论他们的瘙痒症状。大多数护士（76.4%）报告参与推荐或处方慢性肾脏疾病相关瘙痒的治疗方法，其中71.4%专门针对瘙痒治疗。然而，35.5%的医疗保健专业人员没有充分认识到瘙痒和肾脏疾病之间的联系。结论本研究强调了肾脏病护士在识别和处理慢性肾脏疾病相关瘙痒方面面临的复杂挑战。它强调瘙痒对人们生活质量的重大影响以及护士在早期发现和管理中可以发挥的关键作用。

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引用次数: 0

Influence of Baseline Itch Severity on Treatment Outcomes With Difelikefalin in Adults With Moderate-to-Severe Pruritus Receiving Maintenance Haemodialysis: An Exploratory Analysis 基线瘙痒严重程度对接受维持性血液透析的中度至重度瘙痒成人患者用异花铁素治疗结果的影响：一项探索性分析

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-05-06 DOI: 10.1111/jorc.70017

Kieran McCafferty, Thilo Schaufler, Pablo Molina, Murray Lowe, Warren Wen, Daniel E. Weiner

Background

Difelikefalin is well-tolerated and reduces itch among adults undergoing haemodialysis (HD), with chronic kidney disease-associated pruritus (CKD-aP).

Objective

This study aims to explore the influence of baseline itch severity on difelikefalin treatment outcomes.

Design

Study 3105 (NCT03998163) was a 12-week, phase 3, single-arm, open-label trial assessing safety and effectiveness of difelikefalin 0.5 µg/kg. We report key endpoints from 3105 by baseline itch severity, determined using the Worst Itching Intensity Numerical Rating Scale (WI-NRS [moderate: WI-NRS < 7; severe: WI-NRS ≥ 7]).

Participants

Adult participants undergoing maintenance HD (n = 222) with mild-to-moderate CKD-aP (WI-NRS score ≥ 5 at baseline).

Measurements

The primary endpoint of 3105 was safety; secondary endpoints included reduction in itch intensity (WI-NRS), and improvements in itch-related quality of life (QoL; 5-D itch scale) and sleep quality (Sleep Quality Numerical Rating Scale).

Findings

Mean (SD) age was 57.1 (13.3) years; mean (SD) baseline WI-NRS scores were 6.0 (0.5) and 8.3 (0.9) for participants with moderate (n = 70/222) or severe (n = 152/222) itch, respectively. No treatment-related deaths occurred, and there were no safety concerns according to baseline itch severity. By week 12, both groups reported residual ‘mild itch’ according to mean (SD) WI-NRS scores (moderate: 2.9 [2.2]; severe: 3.1 [2.3]). Approximately one in four participants demonstrated ‘complete response’ in itch reduction (moderate: 27.1%; severe: 25.0%). Clinically relevant improvements in itch-related QoL and sleep quality occurred among both subgroups.

Conclusions

Difelikefalin was well-tolerated and effective in reducing itch in participants with moderate and severe baseline itch, supporting its broad use in a range of individuals on HD with CKD-aP.

在接受血液透析（HD）并伴有慢性肾脏疾病相关瘙痒（CKD-aP）的成人中，Difelikefalin耐受性良好，可减轻瘙痒。目的探讨痒痒基线严重程度对异蝇虫素治疗效果的影响。Design Study 3105 （NCT03998163）是一项为期12周的3期、单臂、开放标签试验，评估了异花蓟花素0.5µg/kg的安全性和有效性。我们报告了3105个基线瘙痒严重程度的关键终点，使用最严重瘙痒强度数值评定量表(WI-NRS[中度：WI-NRS < 7；重度：WI-NRS≥7])。接受维持性HD的成人受试者（n = 222）伴有轻度至中度CKD-aP（基线WI-NRS评分≥5）。3105的主要终点是安全性；次要终点包括瘙痒强度降低（WI-NRS）和瘙痒相关生活质量改善(QoL；5维瘙痒量表)和睡眠质量（睡眠质量数值评定量表）。平均（SD）年龄为57.1（13.3）岁；中度瘙痒（n = 70/222）和重度瘙痒（n = 152/222）受试者的WI-NRS基线平均（SD）评分分别为6.0（0.5）和8.3（0.9）。没有治疗相关的死亡发生，根据基线瘙痒严重程度也没有安全性问题。到第12周，两组均根据WI-NRS平均（SD）评分报告残余“轻度瘙痒”(中度：2.9 [2.2]；重度：3.1[2.3])。大约四分之一的参与者在瘙痒减轻方面表现出“完全缓解”(中度：27.1%；严重:25.0%)。两个亚组在瘙痒相关生活质量和睡眠质量方面均有临床相关改善。Difelikefalin在中度和重度基线瘙痒患者中耐受性良好，可有效减少瘙痒，支持其在HD合并CKD-aP患者中的广泛应用。

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引用次数: 0

Effect of eHealth Interventions on Medication Adherence in Kidney Transplant Recipients: Meta-Analysis of Randomised Controlled Trials 电子健康干预对肾移植受者药物依从性的影响：随机对照试验的荟萃分析

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-04-08 DOI: 10.1111/jorc.70015

Metin Tuncer, Gülsüm Zekiye Tuncer

Background

Kidney transplant recipients must take immunosuppressive drugs for life, and medication non-adherence is a primary risk factor for graft loss and death. With the advancement of technology, electronic health applications are widely used in chronic disease management and offer the potential to improve medication adherence in kidney transplant recipients.

Aim

This meta-analysis aims to evaluate randomised controlled trials (RCTs) that assess the effectiveness of eHealth interventions in improving medication adherence among kidney transplant recipients.

Methods

This study, which was designed as a systematic review and meta-analysis, followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols in the planning and reporting phases. Electronic databases and manual literature searches were the two main data sources. Full-text RCTs in PubMed, Medline, Web of Science and Scopus databases were systematically searched. The searches covered studies from 2014 to March 2024.

Results

The search yielded 524 articles. Eight RCTs with 779 participants were included in the analysis. The meta-analysis results indicated that, compared with the control group, adherence rates (RR: 1.19; 95% CI: 1.06–1.35; p = 0.01. Heterogeneity: Q = 8.69; p = 0.28; I² = 19%) and adherence scores (SMD: 0.17; 95% CI: 0.05–0.29; p = 0.02. Heterogeneity: Q = 0.45; p = 0.93; I² = 0%) significantly increased in the eHealth intervention group compared with the control group.

Conclusion

The findings of this report show that eHealth interventions to improve medication adherence in kidney transplant recipients show favourable outcomes compared with standard care. We recommend eHealth interventions to improve long-term survival and patient outcomes in kidney transplant recipients.

背景肾移植受者必须终身服用免疫抑制剂，而不坚持服药是导致移植物丢失和死亡的主要风险因素。随着技术的进步，电子健康应用程序被广泛应用于慢性病管理，为改善肾移植受者的服药依从性提供了可能。目的本荟萃分析旨在评估随机对照试验（RCT），这些试验评估了电子健康干预措施在改善肾移植受者服药依从性方面的效果。方法本研究设计为系统综述和荟萃分析，在计划和报告阶段遵循了 PRISMA（系统综述和荟萃分析首选报告项目）协议。电子数据库和人工文献检索是两个主要的数据来源。我们系统地检索了 PubMed、Medline、Web of Science 和 Scopus 数据库中的 RCT 全文。搜索范围包括 2014 年至 2024 年 3 月的研究。结果检索到 524 篇文章。其中有 8 项研究纳入了分析，共有 779 人参与。荟萃分析结果表明，与对照组相比，治疗依从率（RR：1.19；95% CI：1.06-1.35；P = 0.01。异质性：Q=8.69；P=0.28；I2=19%）和依从性评分（SMD：0.17；95% CI：0.05-0.29；P=0.02。异质性：Q = 0.45; p = 0.93; I2 = 0%），与对照组相比，电子健康干预组明显增加。结论本报告的研究结果表明，与标准护理相比，旨在改善肾移植受者服药依从性的电子健康干预措施显示出良好的效果。我们建议采取电子健康干预措施，以提高肾移植受者的长期生存率和患者疗效。

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引用次数: 0

Clinical Assessment of Fluid Status in Adults With Acute Kidney Injury: A Scoping Review 成人急性肾损伤患者体液状态的临床评估：范围综述

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-04-05 DOI: 10.1111/jorc.70014

Karen Nagalingam, Lisa Whiting, Ken Farrington, Janet Migliozzi, Natalie Pattison

Background

Acute kidney injury refers to sudden, potentially reversible, reduction in kidney function. Hypovolaemia is commonly the major risk factor. When acute kidney injury is established, fluid can accumulate leading to fluid overload. Undertaking a rigorous fluid assessment is vital in the management of a patient in hospital with acute kidney injury, as insufficient or excessive fluid can lead to increased morbidity and mortality.

Objectives

The aim of this scoping review is to identify which clinical assessments are useful when undertaking fluid assessment in a patient with acute kidney injury, and to identify signs and symptoms of fluid overload or dehydration in patients in hospital with acute kidney injury.

Design

The JBI methodology for scoping reviews was followed and reported using the PRISMA-ScR checklist. PubMed, CINAHL Plus and SCOPUS were searched for research papers relating to the signs and symptoms or fluid assessments in patients with acute kidney injury.

Results

Fifteen research papers were identified with four key areas being: Fluid balance/urine output and weight; early warning scores; clinical signs and symptoms; holistic assessment. The primary studies included in this scoping review have shown that hypovolaemia may be indicated by low blood pressure, orthostatic hypotension, low Mean Arterial Pressure, elevated heart rate, prolonged capillary refill time on the sternum (> 4.5 s) and subjectively reported cold peripheries. With clinical symptoms including dry mouth, increased thirst and dry skin. Accurate documentation of urine output and fluid balance is crucial in determining fluid status.

Conclusion

The assessment of fluid should be holistic and include history taking, diagnosis, blood tests and associated clinical signs and symptoms.

背景急性肾损伤是指突然发生的、可能可逆的肾功能减退。低氧血症通常是主要的风险因素。急性肾损伤一旦确立，液体就会积聚，导致液体超负荷。对急性肾损伤住院患者进行严格的体液评估至关重要，因为体液不足或过量会导致发病率和死亡率升高。本范围界定综述旨在确定在对急性肾损伤患者进行液体评估时，哪些临床评估是有用的，并确定急性肾损伤住院患者液体超负荷或脱水的体征和症状。设计采用 JBI 方法进行范围界定综述，并使用 PRISMA-ScR 核对表进行报告。检索了 PubMed、CINAHL Plus 和 SCOPUS 中与急性肾损伤患者体征和症状或液体评估相关的研究论文。结果发现了 15 篇研究论文，主要涉及以下四个方面：体液平衡/尿量和体重；早期预警评分；临床体征和症状；整体评估。本次范围界定综述所包含的主要研究表明，低血容量可通过低血压、正压性低血压、平均动脉压低、心率升高、胸骨毛细血管再充盈时间延长（4.5 秒）和主观报告的周身发冷来表示。临床症状包括口干、口渴和皮肤干燥。准确记录尿量和体液平衡对确定体液状况至关重要。结论对体液的评估应该是全面的，包括病史采集、诊断、血液化验以及相关的临床症状和体征。

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引用次数: 0

Clinic-Based Animal-Assisted Intervention for Haemodialysis Patients' Treatment Adherence, Pain and Depression: An Interrupted Time Series Analysis 基于临床的动物辅助干预血液透析患者治疗依从性、疼痛和抑郁：中断时间序列分析

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-04-03 DOI: 10.1111/jorc.70013

Meredith Stensland, Elizabeth Sanford, Adrian Elorriaga, Martha Block, Geoffrey Block, Timothy Houle, Jacie Flaman, Donald McGeary

Background

Maintaining adherence to one's haemodialysis regimen is paramount to overall health and well-being. The purpose of this study was to evaluate the feasibility and preliminary efficacy of a clinic-based animal-assisted intervention for improving patients' treatment adherence.

Methods

Using an interrupted time series analysis, this study examined the probability of unplanned missed haemodialysis treatment not due to hospitalization upon introducing therapy dog visits into the clinic, following a 3-month lead-in phase before dog exposure. An interrupted time series model was used to estimate the odds ratio (OR) of weekly non-adherence after dog exposure relative to pre-exposure adherence. Depression, anxiety and pain were secondary outcomes and were evaluated within-subjects based on self-reported ratings before and after each dog visit.

Results

Of the eligible clinic dialysis patients, 100% enrolled (17 of 17) and 82% (14 of 17) completed the study. The effect estimate for the reduction in probability of missing haemodialysis treatments following dog exposure phase compared to pre-exposure was OR 0.24 [95% CI: 0.09–0.62] (p = 0.003). Significant immediate mean reductions were also observed in self-reported pain (p = 0.004), depression (p = 0.029), anxiety (p = 0.019) and negative affect (p = 0.006).

Conclusion

As the first study to evaluate therapy dog visits as a treatment adherence intervention for patients receiving haemodialysis, findings indicate this animal-assisted intervention is feasible and well accepted by patients based on high rates of study engagement and low rates of dropout. Meaningful human-animal interaction in the clinic setting may provide motivation to avoid appointment no-shows.

背景：坚持血液透析方案对整体健康和福祉至关重要。本研究的目的是评估临床动物辅助干预提高患者治疗依从性的可行性和初步疗效。方法采用中断时间序列分析，本研究在犬接触前的3个月引入治疗犬后，检查了非由于住院治疗而导致的意外错过血液透析治疗的概率。使用中断时间序列模型来估计狗暴露后每周不依从性相对于暴露前依从性的比值比（OR）。抑郁、焦虑和疼痛是次要结果，并在每次狗来访前后根据受试者的自我报告评分进行评估。在符合条件的临床透析患者中，100%（17 / 17）入组，82%（17 / 14）完成研究。与暴露前相比，暴露后犬缺少血液透析治疗的概率降低的效应估计为OR 0.24 [95% CI: 0.09-0.62] （p = 0.003）。在自我报告的疼痛（p = 0.004）、抑郁（p = 0.029）、焦虑（p = 0.019）和消极情绪（p = 0.006）方面也观察到显着的即时平均减少。作为第一项评估治疗犬访视作为血液透析患者治疗依从性干预的研究，研究结果表明，基于高研究参与率和低退出率，这种动物辅助干预是可行的，并且被患者广泛接受。在临床环境中，有意义的人与动物的互动可能会提供动机，以避免预约不来。

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引用次数: 0

Issue Information: Journal of Renal Care 2/2025 发行信息：Journal of Renal Care 2/2025

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-04-03 DOI: 10.1111/jorc.12500

引用次数: 0

Reviewer Summary for Journal of Renal Care 《肾脏护理杂志》审稿人摘要

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-03-28 DOI: 10.1111/jorc.70016

引用次数: 0

Clinical Relevance of an Online Self-Management Intervention in Haemodialysis: A Secondary Data Analysis of the ‘Connected We St@nd’ Programme 在线自我管理干预血液透析的临床意义：“连接我们St@nd”计划的二次数据分析

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-03-04 DOI: 10.1111/jorc.70012

Helena Sousa, Oscar Ribeiro, Ana Bártolo, Mário Rodrigues, Elísio Costa, Joana Quental, Fernando Ribeiro, Constança Paúl, Daniela Figueiredo

Background

The ‘Connected We St@nd’ programme is an Internet-mediated self-management intervention that combines health education with psychosocial support, with evidenced feasibility and acceptability in haemodialysis.

Objectives

To evaluate the clinical relevance of the programme and to better understand which intervention outcomes/health-related self-report measures are most sensitive to reflect changes between pre- and post-intervention assessments.

Design

This study followed a pre-post quasi-experimental design.

Participants

Twenty-six individuals (16 people on haemodialysis and 10 family caregivers) completed the intervention.

Measurements

Participants filled out a web-based assessment protocol before and after the intervention. To determine the clinical relevance of within-group pre-post changes, effect sizes, minimal clinically important differences, and reliable change indexes were calculated.

Results

Clinically meaningful results were found on outcome measures with reasonable sensitivity to detect pre-post changes in the positive affect dimension of subjective well-being, purpose in life, overall quality of life, and psychological health. The latter was the variable that obtained the greatest number of respondents with reliable post-intervention improvements.

Conclusions

Participation in the programme led to clinically important and reliable improvements in several intervention outcomes, hinting that this evidence-informed intervention has the potential to be a valuable resource for promoting successful psychosocial adjustment among this population. Suggestions were made to fine-tune the evaluation and implementation of a large-scale trial to, in due course, encourage the integration of this technology-assisted interdisciplinary initiative into existing kidney care services.

背景“互联我们St@nd”计划是一项互联网媒介的自我管理干预，将健康教育与社会心理支持相结合，在血液透析中具有可行性和可接受性。目的评估该方案的临床相关性，并更好地了解哪些干预结果/健康相关自我报告措施最敏感地反映干预前后评估之间的变化。本研究采用前后准实验设计。26个人（16名血液透析患者和10名家庭护理人员）完成了干预。参与者在干预前后填写了一份基于网络的评估协议。为了确定组内前后变化的临床相关性，计算效应量、最小临床重要差异和可靠变化指数。结果在检测主观幸福感、生活目的、整体生活质量和心理健康的积极影响维度的前后变化方面，结果具有合理的敏感性，具有临床意义。后者是在干预后获得可靠改善的受访者数量最多的变量。参与该项目的几个干预结果在临床上取得了重要且可靠的改善，这表明这种循证干预有可能成为促进这一人群成功的社会心理适应的宝贵资源。建议对大规模试验的评估和实施进行微调，以便在适当的时候鼓励将这种技术辅助的跨学科倡议整合到现有的肾脏护理服务中。

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引用次数: 0

Clinician Perspectives on Using Plastic Cannula for Vascular Access in Haemodialysis: Outcomes of a National Web-Based Survey 临床医生对在血液透析中使用塑料套管进行血管通路的看法：一项全国网络调查的结果

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-02-14 DOI: 10.1111/jorc.70011

Vicki Smith, Monica Schoch

Background

Plastic cannulae were introduced into Australia over a decade ago as a safer alternative to metal dialysis needles for arteriovenous fistula cannulation, decreasing the risk of infiltration resulting in haematoma formation, bruising, and pain for patients.

Objectives

To explore the uptake and current practices for using plastic cannulae for vascular access in Australian dialysis units.

Design

A 31-item exploratory descriptive web-based cross-sectional survey.

Participants

Renal clinicians who cannulate arteriovenous fistulae or arteriovenous grafts for haemodialysis in Australian haemodialysis units.

Results

A total of 185 clinicians responded to the questionnaire, with the majority of respondents from the Australian east coast Australia, specifically Queensland (36%, n = 66), New South Wales (27%, n = 50) and Victoria (26%, n = 48). Sixty-five percent of respondents were either registered nurses (47%, n = 88) or clinical nurse specialists (18%, n = 34). Of 140 participants who reported plastic cannula availability, only 62 (44%) used them personally. Plastic cannulae were mainly used with new (n = 55/65, 85%) and established (n = 56/60, 90%) vascular access, but rarely in home haemodialysis (n = 7/60, 11%). Plastic cannula was commonly used for the first 2 weeks with new fistula, then switched to metal needles due to high cost, however 41% (n = 22/54) reported that decisions on long-term cannula use was based on patient clinical needs. Training and gauge of cannula varied by state, with 16-guage the most common.

Conclusion

Plastic cannula use is increasing across Australia, but cost and training barriers still exist. Nevertheless, plastic cannulae remain a viable alternative to metal needles.

塑料套管在十多年前被引入澳大利亚，作为一种更安全的替代金属透析针用于动静脉瘘插管，降低了渗透导致血肿形成、挫伤和患者疼痛的风险。目的探讨在澳大利亚透析单位使用塑料套管进行血管通路的吸收和目前的做法。设计一个包含31个条目的基于网络的探索性描述性横断面调查。参与者：在澳大利亚血液透析单位为血液透析插管动静脉瘘或动静脉移植物的肾脏临床医生。结果共有185名临床医生参与了问卷调查，其中大部分受访者来自澳大利亚东海岸，特别是昆士兰州（36%,n = 66）、新南威尔士州（27%,n = 50）和维多利亚州（26%,n = 48）。65%的受访者是注册护士（47%,n = 88）或临床专科护士（18%,n = 34）。在140名报告塑料套管可用性的参与者中，只有62人（44%）亲自使用。塑料管主要用于新建（n = 55/65, 85%）和已建立（n = 56/60, 90%）血管通路，但很少用于家庭血液透析（n = 7/60, 11%）。塑料套管通常用于新瘘管的前2周，然后由于成本高而切换到金属针，但41% （n = 22/54）报告说，根据患者的临床需要决定长期使用套管。套管的训练和规格因州而异，以16规格最为常见。结论塑料套管的使用在澳大利亚各地都在增加，但成本和培训障碍仍然存在。尽管如此，塑料套管仍然是金属针的可行替代品。

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引用次数: 0

Two-Year Follow-Up of a Communication Intervention on Medication Adherence and Health Literacy in Kidney Transplanted Recipients—A Randomised Controlled Study 肾移植受者服药依从性和健康素养交流干预的两年随访——一项随机对照研究

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2025-02-11 DOI: 10.1111/jorc.70010

Tone K. Vidnes, Astrid K. Wahl, Marie H. Larsen, Käthe B. Meyer, Åsmund Hermansen, Marit H. Andersen

Background

Patients with chronic conditions, including kidney transplanted recipients, are required to actively participate in their continuous care and maintain motivation to adhere consistently to treatment.

Objectives

Our study aimed to test long-term effectiveness of a new health communication intervention designed to improve on medication adherence and health literacy in kidney transplant recipients 2 years following transplantation.

Design

A randomised controlled non-blinded study was conducted between March 2020 and August 2023.

Participants

One hundred and ninety-five kidney transplant recipients were included.

Measurements

Primary outcomes were self-reported medication adherence, measured by the BAASIS questionnaire, and health literacy, measured by the Health Literacy Questionnaire. The response rate was 87% (170 of 195 patients).

Results

This study showed a significant difference between groups in favour of the intervention group for medication adherence (p < 0.02) and two essential Health Literacy Questionnaire domains—‘navigating the health care system’ (p < 0.02) and ‘having social support for health’ (p > 0.03)—2 years after transplantation. Regarding health literacy, three Health Literacy Questionnaire domains showed a significant correlation with adherence: ‘having sufficient information to manage health’ (p < 0.04), ‘having social support for health’ (p < 0.04), and ‘ability to understand health information well enough to know what to do’ (p < 0.05).

Conclusion

The findings in the study highlight the pivotal role of health communication in enhancing medication adherence and supporting important health literacy aspects for kidney transplant recipients.

慢性疾病患者，包括肾移植受者，需要积极参与他们的持续护理，并保持坚持治疗的动力。本研究旨在测试一种新的健康沟通干预的长期有效性，该干预旨在改善肾移植后2年受者的药物依从性和健康素养。设计一项随机对照非盲法研究于2020年3月至2023年8月进行。参与者包括195名肾移植受者。主要结果是自我报告的药物依从性（通过basasis问卷测量）和健康素养（通过健康素养问卷测量）。有效率为87%（195例患者中170例）。结果本研究显示，支持干预组的两组在药物依从性（p < 0.02）和移植后2年的两个基本健康素养问卷领域-“医疗保健系统导航”（p < 0.02）和“健康社会支持”（p < 0.03）方面存在显著差异。关于健康素养，健康素养问卷的三个领域显示出与依从性的显著相关性：“拥有足够的信息来管理健康”（p < 0.04），“拥有健康方面的社会支持”（p < 0.04），以及“能够充分理解健康信息以知道该做什么”（p < 0.05）。结论本研究结果强调了健康沟通在提高肾移植受者药物依从性和支持重要健康素养方面的关键作用。

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