Journal of renal care最新文献_第4页

Barriers and enablers to exercise in kidney transplant recipients: Systematic review of qualitative studies 肾移植受者锻炼的障碍和促进因素：定性研究的系统回顾。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-05-28 DOI: 10.1111/jorc.12497

Alexander Bates B Med, Meg E. Letton MSc, Ria Arnold PhD, Kelly Lambert PhD

Background

Exercise has the potential to reduce the susceptibility to comorbidity and cardiovascular disease in kidney transplant recipients. However, kidney transplant recipients report lower levels of exercise compared to the general population, prompting an investigation into the barriers and enablers to exercise in this transplant cohort.

Objectives

This systematic review aimed to explore and map the barriers and enablers to exercise in kidney transplant recipients.

Methods

Seven electronic databases were systematically searched. Themes were synthesised and then deductively categorised using the Theoretical Domains Framework.

Results

Eleven studies were included in the review. Commonly reported barriers to exercise were lack of exercise guidance (n = 9 studies), physical limitations (n = 5 studies) and a fear of harming the kidney (n = 7 studies). Enablers were a desire to return to normality (n = 5 studies), physical and mental benefits (n = 3 studies), goal setting and tracking improvements (n = 3 studies). At the local level, barriers identified by kidney transplant recipients were a lack of knowledge, fear of injuring the kidney, bad weather and physical limitations. Perceived enablers were already living an active lifestyle, mental benefits, exercise preferences and social support.

Conclusion

Key findings of this research were an increased demand for specific/explicit exercise information regarding type and intensity, and personalised guidance and support for kidney transplant recipients after transplantation. These findings can be used to inform the development of exercise resources and interventions for kidney transplant recipients and their health care professionals within the local community and at a greater level.

背景：运动有可能降低肾移植受者对合并症和心血管疾病的易感性。然而，与普通人群相比，肾移植受者的运动水平较低，这促使我们对这一移植人群的运动障碍和促进因素进行调查：本系统综述旨在探索和绘制肾移植受者锻炼的障碍和促进因素：方法：系统检索了七个电子数据库。结果：11 项研究被纳入综述：结果：11 项研究被纳入综述。常见的运动障碍包括缺乏运动指导（9 项研究）、身体限制（5 项研究）和害怕伤害肾脏（7 项研究）。促进因素包括：希望恢复正常生活（5 项研究）、身心受益（3 项研究）、设定目标和跟踪改善情况（3 项研究）。在地方层面，肾移植受者发现的障碍包括缺乏知识、担心肾脏受伤、天气恶劣和身体限制。他们认为的有利因素包括：已经在过积极的生活方式、精神上的益处、运动偏好和社会支持：这项研究的主要发现是，肾移植受者在移植后对有关运动类型和强度的具体/明确运动信息以及个性化指导和支持的需求有所增加。这些研究结果可用于为肾移植受者及其医护人员在当地社区和更大范围内开发运动资源和干预措施。

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引用次数: 0

Once-per-week haemodialysis in a financial crisis: Predictors of interdialytic weight gain 金融危机下每周一次的血液透析：透析间期体重增加的预测因素。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-05-26 DOI: 10.1111/jorc.12498

Hemamali M. H. Jagodage Mphil, Charrlotte Seib PhD, Amanda McGuire PhD, Ann Bonner PhD

Background

Several countries are experiencing challenges in maintaining standard haemodialysis services for people with kidney failure.

Objective

This study aimed to investigate the health profile of people receiving haemodialysis and to identify factors associated with interdialytic weight gain.

Design

A cross-sectional study.

Participants

A total of 166 adults with kidney failure and receiving haemodialysis for at least 3 months were included.

Measurements

A structured chart audit form collected, demographic and haemodialysis treatment characteristics, recent biochemical and haematological results, and prescribed treatment regimens from clinical records. Data were analysed descriptively. Odds ratios (OR) were calculated to identify independent risk factors for interdialytic weight gain.

Results

Mean age was 52 years (SD = 12.5), over half were male (60.2%, n = 100), and most were receiving 4 h of haemodialysis once per week (87.3%, n = 145). Approximately half (51.8%, n = 86) had an interdialytic weight gain >2%. Being female (OR = 3.39; 95% CI, 1.51–7.61), increased comorbidities (OR = 1.50; 95% CI, 1.22–1.84) and having BMI outside of the normal range (overweight/obese [OR = 8.49; 95% CI, 3.58–20.13] or underweight [OR = 4.61; 95% CI, 1.39–15.31]) were independent risk factors for increased interdialytic weight gain.

Conclusion

Most patients were receiving 4 h of haemodialysis once per week although only modest alterations in potassium, phosphate, and fluid status were observed. Understanding the patient profile and predictors of interdialytic weight gain will inform the development of self-management interventions to optimise clinician support.

背景：一些国家正面临着为肾衰竭患者维持标准血液透析服务的挑战：一些国家在为肾衰竭患者维持标准血液透析服务方面面临挑战：本研究旨在调查血液透析患者的健康状况，并确定与透析间期体重增加相关的因素：设计：横断面研究：共纳入 166 名肾衰竭且接受血液透析至少 3 个月的成年人：通过结构化病历审核表收集临床记录中的人口统计学和血液透析治疗特征、近期生化和血液学结果以及处方治疗方案。对数据进行描述性分析。计算比值比（OR）以确定透析间期体重增加的独立风险因素：平均年龄为 52 岁（SD = 12.5），一半以上为男性（60.2%，n = 100），大多数患者每周接受一次 4 小时血液透析（87.3%，n = 145）。约有一半（51.8%，n = 86）的患者在透析间期体重增加>2%。女性（OR = 3.39；95% CI，1.51-7.61）、合并症增加（OR = 1.50；95% CI，1.22-1.84）和体重指数超出正常范围（超重/肥胖[OR = 8.49；95% CI，3.58-20.13]或体重不足[OR = 4.61；95% CI，1.39-15.31]）是导致透析间期体重增加的独立风险因素：结论：大多数患者每周接受一次 4 小时血液透析，尽管钾、磷酸盐和体液状态仅有轻微变化。了解透析间期体重增加的患者情况和预测因素将有助于制定自我管理干预措施，优化临床医生的支持。

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引用次数: 0

Issue Information: Journal of Renal Care 2/2024 期刊信息：肾脏护理杂志 2/2024

IF 1.9 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-05-21 DOI: 10.1111/jorc.12470

引用次数: 0

Mind the gap in kidney care: Translating what we know into what we do 关注肾脏护理中的差距：将我们的知识转化为我们的行动。

IF 1.9 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-05-21 DOI: 10.1111/jorc.12495

Valerie A. Luyckx MD, Katherine R. Tuttle MD, Dina Abdellatif MD, Ricardo Correa-Rotter MD, Winston W. S. Fung MD, Agnès Haris MD, Li-Li Hsiao MD, Makram Khalife MSc, Latha A. Kumaraswami BA, Fiona Loud BA, Vasundhara Raghavan BA, Stefanos Roumeliotis MD, Marianella Sierra BA, Ifeoma Ulasi MD, Bill Wang BA, Siu-Fai Lui MD, Vassilios Liakopoulos MD, Alessandro Balducci MD, for the World Kidney Day Joint Steering Committee

Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.

从历史上看，新疗法从临床证据转化为日常实践平均需要 17 年的时间。鉴于目前已有的高效疗法可以预防或延缓肾病的发生和发展，这个时间太长了。现在是缩小我们所知道的与我们所做的之间差距的时候了。对于高血压和糖尿病等肾脏病常见风险因素的预防和管理，已有明确的指导方针，但全世界只有一小部分肾脏病患者被确诊，接受目标治疗的患者则更少。同样，绝大多数肾病患者都不知道自己的病情，因为肾病在早期往往是无声无息的。即使在已经确诊的患者中，许多人也没有接受适当的肾病治疗。考虑到肾病恶化、肾衰竭或死亡的严重后果，必须及早开始适当的治疗。必须从初级保健开始，最大限度地利用早期诊断和治疗肾病的机会。从患者到临床医生，从医疗系统到社会因素，存在着许多系统性障碍。为了维护和改善世界各地每个人的肾脏健康，必须认识到这些障碍中的每一个，以便制定和实施可持续的解决方案，不再拖延。

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引用次数: 0

The experiences of people starting haemodialysis: A qualitative study 开始血液透析者的经历：定性研究。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-05-11 DOI: 10.1111/jorc.12496

Kshama Mehta PhD, Wael F. Hussein MRCPI, Kerstin K. Leuther PhD, Alexandra Fegler BA, Brigitte Schiller MD, Paul N. Bennett PhD

Background and Objective

Starting dialysis is a life-changing transition for people living with kidney disease. People feel overwhelmed with diet changes, medications and surgical interventions, and often experience high levels of anxiety, depression and hospital admissions. The objective of this study was to explore and describe the experiences and perspectives of people starting dialysis.

Study Design

Observational qualitative study using audio-recorded, individual, semi-structured interviews.

Participants

We conducted 20 semi-structured interviews with English-speaking adults who were within 90 days of starting in-centre haemodialysis at centres of a nonprofit dialysis provider in Northern California.

Approach

Trained qualitative researchers conducted interviews that were deidentified and transcribed verbatim before being inductively coded into codes, categories, and themes.

Results

Three overarching themes emerged from the interviews. Being overwhelmed when starting dialysis, realises the emotional unpreparedness of patients starting dialysis and how the centre's environment (waiting and treatment areas) and staff behaviour impact the dialysis start experience. Making sense of it all, covers how the patient's symptoms, behaviour, and dialysis-related experiences impact the dialysis start. Moving forward, describes how education informed optimal decision-making, and can provide hope for a longer and better life.

Limitations

Predominantly college-educated participants were recruited from a single dialysis organisation which may limit the transferability of results.

Conclusion

Understanding the life-changing experiences that patients encounter when starting dialysis assist dialysis clinicians to help patients adjust and develop long-term coping strategies.

背景和目的：对于肾病患者来说，开始透析是一个改变生活的过渡。人们对饮食改变、药物治疗和手术干预感到不知所措，经常会出现高度焦虑、抑郁和入院治疗的情况。本研究旨在探讨和描述开始透析的患者的经历和观点：研究设计：观察性定性研究，采用录音、个人半结构式访谈：我们对北加州一家非营利性透析服务提供商的中心开始中心内血液透析 90 天内的英语成年人进行了 20 次半结构化访谈：方法：训练有素的定性研究人员对访谈内容进行了去身份化处理和逐字记录，然后归纳编码为代码、类别和主题：结果：访谈中出现了三大主题。开始透析时不知所措，认识到患者开始透析时情绪上的不适应，以及透析中心的环境（等待区和治疗区）和工作人员的行为如何影响患者开始透析的体验。理清头绪，包括患者的症状、行为和透析相关经历如何影响透析的开始。展望未来，阐述了教育如何为最佳决策提供信息，并为更长、更美好的生活带来希望：局限性：参与者主要接受过大学教育，是从一家透析机构招募的，这可能会限制结果的可移植性：了解患者在开始透析时遇到的改变生活的经历有助于透析临床医生帮助患者调整并制定长期应对策略。

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引用次数: 0

Challenges in decision-making support processes regarding living kidney donation: A qualitative study 活体肾脏捐赠决策支持过程中的挑战：定性研究

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-04-10 DOI: 10.1111/jorc.12494

Yuri Wada MSN, RN, Takayoshi Ueno MD, PhD, Koji Umeshita MD, PhD, Kuniko Hagiwara RN, PhD

Background

Previous studies on decision-making of living kidney donors have indicated issues regarding donors' autonomy is inherent in decision-making to donate their kidney. Establishing effective decision-making support that guarantees autonomy of living kidney donor candidates is important.

Objectives

The aim of this study was to identify the difficulties in the decision-making support when clinical transplant coordinators advocating for the autonomy of donor candidates of living donor kidney transplantation and to identify the methods to deal with these difficulties.

Design

A qualitative descriptive study.

Participants

Ten clinical transplant coordinators supporting living kidney donors.

Approach

Semi-structured interviews were conducted using an interview guide. The modified grounded theory approach was utilised to analyse.

Results

Three categories related to difficulties were as follows: issues inherent to the interaction between coordinators, donor candidates and their families; issues regarding the environment and institutional background in which coordinators operate; and emotional labour undertaken by coordinators in the decision-making support process. Additionally, five categories related to methods were as follows: assessing the autonomy of donor candidates based on the coordinators nursing experience; interventions for the donor candidates and their family members based on the coordinators nursing experience; smooth coordination with medical staff; clarifying and asserting their views as coordinators; and readiness to protect the donor candidates.

Conclusion

The involvement of highly experienced coordinators with excellent and assertive communication skills as well as the ability to reflect on their own practices is essential. Moreover, we may need to fundamentally review the transplant community, where power domination is inherent.

背景以往关于活体肾脏捐献者决策的研究表明，捐献者的自主权问题是捐献肾脏决策的固有问题。本研究旨在确定临床移植协调员在倡导活体肾脏移植捐献者自主权时在决策支持方面遇到的困难，并确定应对这些困难的方法。结果与困难相关的三个类别如下：协调员、捐献者候选人及其家属之间互动的固有问题；协调员所处环境和机构背景的问题；协调员在决策支持过程中所付出的情感劳动。此外，与方法有关的五个类别如下：根据协调员的护理经验评估捐献者的自主性；根据协调员的护理经验对捐献者及其家属进行干预；与医务人员顺利协调；作为协调员阐明并坚持自己的观点；随时准备保护捐献者。此外，我们可能需要从根本上审视移植团体，因为在这个团体中，权力支配是固有的。

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引用次数: 0

Health-literacy, self-efficacy and health-outcomes of patients undergoing haemodialysis: Mediating role of self-management 血液透析患者的健康素养、自我效能感和健康结果：自我管理的中介作用。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-03-24 DOI: 10.1111/jorc.12493

Shu-Hua Hsu RN, MS, Yu-Li Lin MD, Malcolm Koo PhD, Debra K. Creedy RN, PhD, Ying Tsao RN, PhD

Background

Health literacy, self-efficacy and self-management are known to influence health-related well-being. However, the precise influence of self-management, health literacy and self-efficacy on health outcomes in Asian countries is under-researched.

Objectives

To examine the impact of health literacy and self-efficacy (independent variables) and self-management (mediator) on patients' health outcomes (dependent variable).

Design

An observational, cross-sectional design was conducted between 1 March 2022 and 31 August 2022.

Participants

Outpatients receiving haemodialysis (n = 200) at a Taiwanese medical centre were assessed.

Measurements

The survey included demographic questions and standardised scales: the 3-item Brief Health Literacy Screen, the 8-item Perceived Kidney/Dialysis Self-Management Scale as a measure of self-efficacy, and the 20-item Haemodialyses Self-Management Instrument. Health outcomes were responses on the 12-item Short-Form Health Survey version 2 and clinical blood results from the past 3 months.

Results

Participants aged over 60 exhibited common comorbidities, with 34% showing low health literacy. Biochemical markers (e.g., haemoglobin and albumin) significantly correlated with physical and mental health scores. Mediating coefficients revealed that self-management significantly influenced associations between health outcomes, health literacy (β = 0.31; p < 0.01), and self-efficacy (β = 0.19; p < 0.01).

Implications for Practice

Self-management can modify the overall influence of health literacy and self-efficacy on patients' quality of physical and emotional health. When managing a chronic condition, ‘knowing’ how to self-manage does not always result in ‘doing so’ by the patient. Continuous monitoring and promoting self-management behaviours and support by nurses are crucial to enhance health outcomes.

背景：众所周知，健康素养、自我效能感和自我管理会影响与健康相关的幸福感。然而，在亚洲国家，自我管理、健康素养和自我效能对健康结果的确切影响还没有得到充分研究：研究健康素养和自我效能（自变量）以及自我管理（中介变量）对患者健康结果（因变量）的影响：设计：在2022年3月1日至2022年8月31日期间进行观察性横断面设计：调查对象：在台湾一家医疗中心接受血液透析的门诊患者（n = 200）：调查内容包括人口统计学问题和标准化量表：3 个项目的简明健康素养筛查、8 个项目的肾脏/透析自我管理感知量表（用于衡量自我效能）和 20 个项目的血液透析自我管理工具。健康结果是对 12 项短式健康调查第 2 版和过去 3 个月的临床血液结果的回答：结果：60 岁以上的参与者患有常见的合并症，其中 34% 的人健康知识水平较低。生化指标（如血红蛋白和白蛋白）与身体和心理健康评分有显著相关性。中介系数显示，自我管理对健康结果和健康素养之间的关联有明显影响（β = 0.31; p 对实践的启示：自我管理可以改变健康素养和自我效能对患者身心健康质量的整体影响。在管理慢性病时，"知道 "如何进行自我管理并不总能使患者 "做到"。护士持续监测和促进自我管理行为并提供支持，对于提高健康效果至关重要。

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引用次数: 0

Effects of an ice roller on chronic kidney disease-associated pruritus in patients receiving haemodialysis 冰辊对血液透析患者慢性肾病相关瘙痒症的影响

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-03-14 DOI: 10.1111/jorc.12491

Jong-Ni Lin RN, PhD, Chiu-Feng Chen RN, BSN, Chih-Yuan Huang MD, MS, Feng-Min Lai PhD, Chi-Jane Wang RN, PhD

Background

Chronic kidney disease-associated pruritus is a distressing symptom and has a far-reaching impact on patients' sleep and quality of life for most patients receiving haemodialysis. Traditional therapies have limited effectiveness.

Objectives

This study aimed to invent a self-operated ice roller and evaluate its efficacy in relieving pruritus, sleep quality, and quality of life.

Design

This study was experimental with a two-arm parallel group design.

Participants

A convenient sampling method was used to recruit 60 patients receiving haemodialysis who reported pruritus (5D-Itch Scale score >5) lasting over 4 weeks in Taiwan. The participants were randomly assigned to one of two groups: the intervention group used an ice roller for 7 days, while the control group received no anti-pruritus treatment.

Measurements

This study was experimental with a two-arm parallel group design. The measurement instruments included the 5D-Itch Scale, Pittsburgh Sleep Quality Index and WHOQOL-BREF-Taiwan Version. The analysis of covariance, chi-square, Independent t tests, and partial Eta² (η²p) were used to analyse the data.

Results

The participants' mean age was 62.77 years. Application of the ice roller significantly decreased overall pruritus (p < .05; η²p = .09) and distribution of pruritus-associated bodily parts (p = .03; η²p = .08). There were no statistically significant differences in sleep quality and related indicators between the experimental and control groups at the study endpoint. Regarding quality of life, only the social relationship domain significantly differed between the two groups (p = .02; η²p = .08).

Conclusions

The ice roller can decrease pruritus and its distribution in patients receiving haemodialysis, serving as an adjunct therapy alongside conventional anti-pruritus treatments.

背景：对于大多数接受血液透析的患者来说，慢性肾脏病相关性瘙痒症是一种令人痛苦的症状，对患者的睡眠和生活质量影响深远。传统疗法效果有限：本研究旨在发明一种可自行操作的冰辊，并评估其在缓解瘙痒、提高睡眠质量和生活质量方面的功效：本研究采用双臂平行分组实验设计：本研究采用方便抽样法，在台湾招募了 60 名接受血液透析且瘙痒症状（5D-瘙痒量表评分大于 5 分）持续时间超过 4 周的患者。参与者被随机分配到两组中的一组：干预组使用冰辊7天，对照组不接受任何止痒治疗：本研究采用双臂平行分组实验设计。测量工具包括 5D 痒痒量表、匹兹堡睡眠质量指数和 WHOQOL-BREF 台湾版。数据分析采用协方差分析、卡方检验、独立 t 检验和部分 Eta2 (η2 p)：结果：参与者的平均年龄为 62.77 岁。使用冰辊能明显减轻总体瘙痒感（p 2 p = .09）和瘙痒相关身体部位的分布（p = .03; η2 p = .08）。在研究终点，实验组和对照组在睡眠质量和相关指标方面没有明显的统计学差异。在生活质量方面，只有社会关系领域在两组之间存在显著差异（p = .02；η2 p = .08）：结论：冰辊可减少血液透析患者的瘙痒及其分布，是传统止痒疗法的辅助疗法。

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引用次数: 0

The futility of post-haemodialysis blood glucose levels: A retrospective cohort study 血液透析后血糖水平的无效性：回顾性队列研究。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-03-13 DOI: 10.1111/jorc.12492

Jing Zhang MN, Richard K. Le Leu PhD, Qunyan Xu PhD, Paul Bennett PhD

Background

Frequent blood glucose tests are performed for people with diabetes receiving haemodialysis.

Objectives

To determine the rate of out-of-range post-haemodialysis blood glucose levels that are clinically acted upon, the intervention and outcome of each intervention, and the associations between post-haemodialysis blood glucose levels and relevant clinical predictors.

Design

12-month retrospective cohort medical record review in one Australian haemodialysis centre. Post-haemodialysis blood glucose levels, prehaemodialysis blood glucose levels, time of treatment, diabetes medications, intradialytic fluid removal, dialysate dextrose concentration, clinical actions, interventions, and outcomes on out-of-range blood glucose levels were retrieved.

Participants

22 participants with a median time receiving dialysis 3.1 years (interquartile range 2.3−4.7).

Measurements and Results

The proportion of out-of-range post-haemodialysis blood glucose levels was 87.3% (95% confidence interval, 86.1%−88.5%). No out-of-range post-haemodialysis blood glucose levels were clinically acted upon. Out-of-range post-haemodialysis blood glucose levels were 4.6 times more likely if a higher dextrose bath was used (95% confidence interval: 3.3; 6.3. p < 0.001). The odds of the post-haemodialysis blood glucose levels increased by each 1 mmol/L. Intradialytic fluid removal, dialysate dextrose concentration, sex, dialysis time, anti-hyperglycaemic agents were also associated with out-of-range post-haemodialysis blood glucose levels.

Conclusion

Routine post-haemodialysis blood glucose levels testing has limited clinical utility in care for people with diabetes receiving maintenance haemodialysis. Higher dextrose dialysate may require individual titration depending on prehaemodialysis blood glucose levels.

背景：对接受血液透析的糖尿病患者进行频繁的血糖检测：目的：确定血液透析后血糖超标并采取临床措施的比例、每次干预的干预措施和结果，以及血液透析后血糖水平与相关临床预测因素之间的关联。设计：对澳大利亚一家血液透析中心进行为期 12 个月的回顾性队列病历审查。检索了血液透析后血糖水平、血液透析前血糖水平、治疗时间、糖尿病药物、析出液清除量、透析液葡萄糖浓度、临床行动、干预措施以及血糖超标的结果：透析后血糖水平超出范围的比例为 87.3%（95% 置信区间为 86.1%-88.5%）。临床上没有对超出范围的血液透析后血糖水平采取任何行动。如果使用较高的葡萄糖浴，血液透析后血糖超标的可能性要高出 4.6 倍（95% 置信区间：3.3；6.3：p 结论：对接受维持性血液透析的糖尿病患者进行常规血液透析后血糖水平检测的临床实用性有限。较高的葡萄糖透析液可能需要根据血液透析前的血糖水平进行个别滴定。

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引用次数: 0

Educational interventions and identification of risk factors to prevent and reduce peritonitis in peritoneal dialysis: A scoping review 预防和减少腹膜透析中腹膜炎的教育干预和风险因素识别：范围综述。

IF 1.5 4区医学 Q3 NURSING

Journal of renal care

Pub Date : 2024-02-20 DOI: 10.1111/jorc.12490

Elena Fernàndez Labadía MSc, Olga Masot PhD, Lorena Lourdes Tejero Vidal PhD, Teresa Botigué PhD, Sara Bielsa-Gracia PhD

Background

Peritonitis is a common and serious complication of peritoneal dialysis and is one of the main causes of peritoneal dialysis technique failure and long-term hemodialysis conversion.

Objectives

The aim of the review was to identify and clarify peritonitis risk factors and learn about strategies employed at international level to prevent and reduce the occurrence of peritoneal dialysis associated infections and their complications.

Design

A scoping review.

Participants

Adults in pertitoneal dialysis.

Measurements

The methodology framework of Arksey and O'Malley and PRISMA for Scoping Reviews guidelines were applied. A search was conducted of PubMed, Scopus and CINAHL using terms to identify peritoneal dialysis -associated risk factors and interventions carried out for the prevention and reduction of peritonitis in adult persons living at home.

Results

The 17 studies selected were based on work carried out in nine different countries. Eleven articles analysed modifiable risk factors (low educational level, being a foreigner and low adherence to aseptic technique) and non-modifiable risk factors (age and comorbidities) that predispose to peritonitis in peritoneal dialysis. The other six studies applied an intervention to improve the prevalence of peritonitis considering educational practices adapted to patient characteristics and the application of retraining.

Conclusions

Personalised patient training and the identification of risk factors for peritonitis are key to reducing complications and enhancing the survival of peritoneal dialysis patients and the effectiveness of the technique.

背景：腹膜炎是腹膜透析常见的严重并发症，也是腹膜透析技术失败和长期血液透析转换的主要原因之一：综述旨在确定和阐明腹膜炎的风险因素，了解国际上为预防和减少腹膜透析相关感染及其并发症的发生而采取的策略：设计：范围界定审查：参与者：接受腹膜透析的成年人：采用Arksey和O'Malley的方法框架以及PRISMA范围界定综述指南。在PubMed、Scopus和CINAHL上进行了搜索，使用的术语包括腹膜透析相关风险因素以及为预防和减少居家成年人腹膜炎而采取的干预措施：所选的 17 项研究基于在 9 个不同国家开展的工作。其中 11 篇文章分析了腹膜透析过程中容易导致腹膜炎的可改变风险因素（教育水平低、外国人和不遵守无菌技术）和不可改变风险因素（年龄和合并症）。其他六项研究采用了干预措施，考虑到根据患者特点进行教育实践和应用再培训，以提高腹膜炎的发病率：结论：个性化的患者培训和腹膜炎风险因素的识别是减少并发症、提高腹膜透析患者存活率和腹膜透析技术有效性的关键。

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