首页 > 最新文献

Journal of renal care最新文献

英文 中文
Value of patient decision aids for shared decision-making in kidney failure 肾衰竭患者共同决策辅助工具的价值。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-05-22 DOI: 10.1111/jorc.12468
Anita van Eck van der Sluijs MD, PhD, Sanne Vonk MD, Anna A. Bonenkamp MD, PhD, Karen Prantl MSc, Aase T. Riemann BSc, Brigit C. van Jaarsveld MD, PhD, Alferso C. Abrahams MD, PhD, DOMESTICO study group

Background

It is unknown how often Dutch patient decision aids are used during kidney failure treatment modality education and what their impact is on shared decision-making.

Objectives

We determined the use of Three Good Questions, ‘Overviews of options’, and Dutch Kidney Guide by kidney healthcare professionals. Also, we determined patient-experienced shared decision-making. Finally, we determined whether the experience of shared decision-making among patients changed after a training workshop for healthcare professionals.

Design

Quality improvement study.

Participants

Healthcare professionals answered questionnaires regarding education/patient decision aids. Patients with estimated glomerular filtration rate <20 mL/min/1.73 m2 completed shared decision-making questionnaires. Data were analysed with one-way analysis of variance and linear regression.

Results

Of 117 healthcare professionals, 56% applied shared decision-making by discussing Three Good Questions (28%), ‘Overviews of options’ (31%–33%) and Kidney Guide (51%). Of 182 patients, 61%–85% was satisfied with their education. Of worst scoring hospitals regarding shared decision-making, only 50% used ‘Overviews of options’/Kidney Guide. Of best scoring hospitals 100% used them, needed less conversations (p = 0.05), provided information about all treatment options and more often provided information at home. After the workshop, patients' shared decision-making scores remained unchanged.

Conclusions

The use of specifically developed patient decision aids during kidney failure treatment modality education is limited. Hospitals that did use them had higher shared decision-making scores. However, the degree of shared decision-making experienced by patients remained unchanged after healthcare professionals were trained on shared decision-making and the implementation of patient decision aids.

背景:在肾衰竭治疗模式教育过程中,荷兰患者决策辅助工具的使用频率如何?在肾衰竭治疗方式教育过程中,荷兰患者决策辅助工具的使用频率及其对共同决策的影响尚不清楚:我们确定了肾脏医护人员对 "三个好问题"、"选择概述 "和 "荷兰肾脏指南 "的使用情况。此外,我们还确定了患者对共同决策的体验。最后,我们还确定了医护人员参加培训研讨会后,患者对共同决策的体验是否有所改变:设计:质量改进研究:医护人员回答了有关教育/患者决策辅助工具的问卷。估计肾小球滤过率为 2 的患者填写共同决策问卷。数据采用单因素方差分析和线性回归分析:结果:在 117 名医护人员中,56% 通过讨论 "三个好问题"(28%)、"选择概述"(31%-33%)和 "肾脏指南"(51%)实现了共同决策。在 182 名患者中,61%-85% 的患者对教育表示满意。在共同决策方面得分最差的医院中,只有 50%的医院使用了 "选项概述"/《肾脏指南》。而在得分最高的医院中,100% 的患者都使用了 "选项概述"/"肾脏指南",所需的谈话次数也更少(P = 0.05),提供的信息涉及所有治疗方案,并且更多地在家中提供信息。研讨会结束后,患者的共同决策得分保持不变:结论:在肾衰竭治疗模式教育过程中,专门开发的患者决策辅助工具的使用非常有限。结论:在肾衰竭治疗方式教育过程中,专门开发的患者决策辅助工具的使用非常有限,使用这些辅助工具的医院的共同决策得分较高。然而,在对医护人员进行共同决策培训并使用患者决策辅助工具后,患者的共同决策程度保持不变。
{"title":"Value of patient decision aids for shared decision-making in kidney failure","authors":"Anita van Eck van der Sluijs MD, PhD,&nbsp;Sanne Vonk MD,&nbsp;Anna A. Bonenkamp MD, PhD,&nbsp;Karen Prantl MSc,&nbsp;Aase T. Riemann BSc,&nbsp;Brigit C. van Jaarsveld MD, PhD,&nbsp;Alferso C. Abrahams MD, PhD,&nbsp;DOMESTICO study group","doi":"10.1111/jorc.12468","DOIUrl":"10.1111/jorc.12468","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is unknown how often Dutch patient decision aids are used during kidney failure treatment modality education and what their impact is on shared decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We determined the use of Three Good Questions, ‘Overviews of options’, and Dutch Kidney Guide by kidney healthcare professionals. Also, we determined patient-experienced shared decision-making. Finally, we determined whether the experience of shared decision-making among patients changed after a training workshop for healthcare professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Quality improvement study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Healthcare professionals answered questionnaires regarding education/patient decision aids. Patients with estimated glomerular filtration rate &lt;20 mL/min/1.73 m<sup>2</sup> completed shared decision-making questionnaires. Data were analysed with one-way analysis of variance and linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 117 healthcare professionals, 56% applied shared decision-making by discussing Three Good Questions (28%), ‘Overviews of options’ (31%–33%) and Kidney Guide (51%). Of 182 patients, 61%–85% was satisfied with their education. Of worst scoring hospitals regarding shared decision-making, only 50% used ‘Overviews of options’/Kidney Guide. Of best scoring hospitals 100% used them, needed less conversations (<i>p</i> = 0.05), provided information about all treatment options and more often provided information at home. After the workshop, patients' shared decision-making scores remained unchanged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of specifically developed patient decision aids during kidney failure treatment modality education is limited. Hospitals that did use them had higher shared decision-making scores. However, the degree of shared decision-making experienced by patients remained unchanged after healthcare professionals were trained on shared decision-making and the implementation of patient decision aids.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9497559","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}
引用次数: 0
Reviewer Summary for Journal of Renal Care 《肾脏护理杂志》审稿人摘要
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-04-27 DOI: 10.1111/jorc.12461
{"title":"Reviewer Summary for Journal of Renal Care","authors":"","doi":"10.1111/jorc.12461","DOIUrl":"10.1111/jorc.12461","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9726309","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}
引用次数: 0
Issue Information: Journal of Renal Care 2/2023 发布信息:肾脏护理杂志2/2023
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-04-27 DOI: 10.1111/jorc.12430
{"title":"Issue Information: Journal of Renal Care 2/2023","authors":"","doi":"10.1111/jorc.12430","DOIUrl":"https://doi.org/10.1111/jorc.12430","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50145267","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}
引用次数: 0
The phenomenon of urinary tract infection experienced by women with a kidney transplant 肾移植妇女的尿路感染现象。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-04-19 DOI: 10.1111/jorc.12467
Mette Marie Gad BSN, Maiken Kildahl Rasmussen BSN, Henriette Braüner Ladefoged BSN, Lotte Løntoft Mathiesen MSN, Jeanette Finderup PhD

Background

Urinary tract infection is the most common infection among people with a kidney transplant and increases the risk of graft rejection. Women have a higher risk. A literature search did not identify any description of the phenomenon of urinary tract infection experienced by women with a kidney transplant.

Objective

To examine how women with a kidney transplant experienced the phenomenon of a urinary tract infection.

Design

A qualitative study with a phenomenological approach.

Approach

Eight individual semistructured interviews based on van Manen's four lifeworld existentials and analysed using systematic text condensation.

Participants

Women with a kidney transplant and recently been admitted to the hospital due to a urinary tract infection.

Findings

We identified four themes: (1) Feeling both typical and atypical symptoms; (2) Becoming aware of the body and trying her best to prevent urinary tract infection; (3) Having a urinary tract infection is a dual experience, both good and bad; (4) Support from relatives.

Conclusion

The urinary tract infection symptoms pathway varied between participants but also between individual episodes of incidents among each participant. Participants felt secure when they experienced a common symptom pattern, but a new symptom pattern made them insecure. Together with their relatives, they experienced a urinary tract infection as a disruption of their everyday life and it decreased their experiences of happiness. They experienced to be supported by relatives but also by healthcare professionals, but needed more information on how to prevent, observe and react to a urinary tract infection in the future.

背景:尿路感染是肾移植患者中最常见的感染,会增加移植排斥反应的风险。女性的风险更高。在文献检索中没有发现任何关于女性肾移植患者经历尿路感染现象的描述:研究肾移植女性如何经历尿路感染现象:设计:采用现象学方法进行定性研究:方法:根据范马南的四种生活世界存在形式进行八次个人半结构式访谈,并使用系统文本浓缩法进行分析:研究结果:我们发现了四个主题:(1)肾脏移植后的女性,最近因尿路感染入院:我们确定了四个主题:(1) 感受到典型症状和非典型症状;(2) 意识到自己的身体并尽力预防尿路感染;(3) 患尿路感染是一种双重体验,既好又坏;(4) 亲属的支持:结论:尿路感染症状的途径因参与者而异,但在每个参与者的不同事件中也各不相同。参与者在经历共同的症状模式时会感到安全,但新的症状模式会让他们感到不安全。他们与亲属一起经历了尿路感染,认为尿路感染扰乱了他们的日常生活,降低了他们的幸福感。他们得到了亲属和医护人员的支持,但需要更多关于如何预防、观察和应对未来尿路感染的信息。
{"title":"The phenomenon of urinary tract infection experienced by women with a kidney transplant","authors":"Mette Marie Gad BSN,&nbsp;Maiken Kildahl Rasmussen BSN,&nbsp;Henriette Braüner Ladefoged BSN,&nbsp;Lotte Løntoft Mathiesen MSN,&nbsp;Jeanette Finderup PhD","doi":"10.1111/jorc.12467","DOIUrl":"10.1111/jorc.12467","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urinary tract infection is the most common infection among people with a kidney transplant and increases the risk of graft rejection. Women have a higher risk. A literature search did not identify any description of the phenomenon of urinary tract infection experienced by women with a kidney transplant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine how women with a kidney transplant experienced the phenomenon of a urinary tract infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative study with a phenomenological approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Eight individual semistructured interviews based on van Manen's four lifeworld existentials and analysed using systematic text condensation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Women with a kidney transplant and recently been admitted to the hospital due to a urinary tract infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>We identified four themes: (1) Feeling both typical and atypical symptoms; (2) Becoming aware of the body and trying her best to prevent urinary tract infection; (3) Having a urinary tract infection is a dual experience, both good and bad; (4) Support from relatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The urinary tract infection symptoms pathway varied between participants but also between individual episodes of incidents among each participant. Participants felt secure when they experienced a common symptom pattern, but a new symptom pattern made them insecure. Together with their relatives, they experienced a urinary tract infection as a disruption of their everyday life and it decreased their experiences of happiness. They experienced to be supported by relatives but also by healthcare professionals, but needed more information on how to prevent, observe and react to a urinary tract infection in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9422189","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}
引用次数: 0
Nephrology-tailored geriatric assessment as decision-making tool in kidney failure 肾病学定制的老年病学评估作为肾衰竭的决策工具。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-04-08 DOI: 10.1111/jorc.12466
Noeleen C. Berkhout-Byrne RN, MSc, Carlijn G. N. Voorend MSc, Yvette Meuleman MSc, PhD, Simon P. Mooijaart MD, PhD, Anja H. Brunsveld-Reinders RN, MSc, PhD, Willem Jan W. Bos MD, PhD, Marjolijn Van Buren MD, PhD

Background

Dialysis might not benefit all older patients with kidney failure, particularly those with multimorbid conditions and frailty. Patients' and healthcare professionals' awareness of the presence of geriatric impairments could improve outcomes by tailoring treatment plans and decisions for individual patients.

Objective

We aimed to explore the perspectives of patients and healthcare professionals on nephrology-tailored geriatric assessment to fuel decision-making for treatment choices in older patients with kidney failure.

Design

In an exploratory qualitative study using focus groups, participants discussed perspectives on the use and value of nephrology-tailored geriatric assessment for the decision-making process to start or forego dialysis.

Participants and Measurements

Patients (n = 18) with kidney failure, caregivers (n = 4), and professionals (n = 25) were purposively sampled from 10 hospitals. Interviews were audio-recorded, transcribed verbatim and inductively analysed using thematic analysis.

Results

Three main themes emerged that supported or impeded decision-making in kidney failure: (1) patient psycho-social situation; (2) patient-related factors on modality choice; (3) organisation of health care. Patients reported feeling vulnerable due to multiple chronic conditions, old age, experienced losses in life and their willingness to trade longevity for quality of life. Professionals recognised the added value of nephrology-tailored geriatric assessment in three major themes: (i) facilitating continual holistic assessment, (ii) filling the knowledge gap, and (iii) uncovering important patient characteristics.

Conclusions

nephrology-tailored geriatric assessment was perceived as a valuable tool to identify geriatric impairments in older patients with kidney failure. Integration of its outcomes can facilitate a more holistic approach to inform choices and decisions about kidney replacement therapy.

背景:透析可能无法惠及所有老年肾衰竭患者,尤其是那些患有多病和体弱的患者。患者和医护人员对老年病障碍的认识可为患者量身定制治疗方案和决定,从而改善治疗效果:我们旨在探讨患者和医护人员对肾病学定制老年病学评估的看法,以帮助老年肾衰竭患者做出治疗选择决策:设计:在一项采用焦点小组的探索性定性研究中,参与者讨论了在开始或放弃透析的决策过程中,肾病学定制的老年病学评估的使用和价值:从 10 家医院有针对性地抽取了肾衰竭患者(18 人)、护理人员(4 人)和专业人员(25 人)。对访谈进行录音、逐字记录,并采用主题分析法进行归纳分析:结果:支持或阻碍肾衰竭患者决策的三大主题分别是:(1)患者的社会心理状况;(2)患者选择治疗方式的相关因素;(3)医疗机构的组织结构。患者表示,由于患有多种慢性疾病、年事已高、经历过生命损失以及愿意用寿命来换取生活质量,他们感到非常脆弱。专业人士认为肾脏病学定制的老年病学评估在三个主要方面具有附加价值:(i)促进持续的整体评估;(ii)填补知识空白;(iii)发现重要的患者特征。整合评估结果有助于采取更全面的方法,为肾脏替代疗法的选择和决策提供依据。
{"title":"Nephrology-tailored geriatric assessment as decision-making tool in kidney failure","authors":"Noeleen C. Berkhout-Byrne RN, MSc,&nbsp;Carlijn G. N. Voorend MSc,&nbsp;Yvette Meuleman MSc, PhD,&nbsp;Simon P. Mooijaart MD, PhD,&nbsp;Anja H. Brunsveld-Reinders RN, MSc, PhD,&nbsp;Willem Jan W. Bos MD, PhD,&nbsp;Marjolijn Van Buren MD, PhD","doi":"10.1111/jorc.12466","DOIUrl":"10.1111/jorc.12466","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dialysis might not benefit all older patients with kidney failure, particularly those with multimorbid conditions and frailty. Patients' and healthcare professionals' awareness of the presence of geriatric impairments could improve outcomes by tailoring treatment plans and decisions for individual patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to explore the perspectives of patients and healthcare professionals on nephrology-tailored geriatric assessment to fuel decision-making for treatment choices in older patients with kidney failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>In an exploratory qualitative study using focus groups, participants discussed perspectives on the use and value of nephrology-tailored geriatric assessment for the decision-making process to start or forego dialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants and Measurements</h3>\u0000 \u0000 <p>Patients (<i>n</i> = 18) with kidney failure, caregivers (<i>n</i> = 4), and professionals (<i>n</i> = 25) were purposively sampled from 10 hospitals. Interviews were audio-recorded, transcribed verbatim and inductively analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three main themes emerged that supported or impeded decision-making in kidney failure: (1) patient psycho-social situation; (2) patient-related factors on modality choice; (3) organisation of health care. Patients reported feeling vulnerable due to multiple chronic conditions, old age, experienced losses in life and their willingness to trade longevity for quality of life. Professionals recognised the added value of nephrology-tailored geriatric assessment in three major themes: (i) facilitating continual holistic assessment, (ii) filling the knowledge gap, and (iii) uncovering important patient characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>nephrology-tailored geriatric assessment was perceived as a valuable tool to identify geriatric impairments in older patients with kidney failure. Integration of its outcomes can facilitate a more holistic approach to inform choices and decisions about kidney replacement therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12466","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9337430","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}
引用次数: 0
Effectiveness of teach-back for chronic kidney disease patient education: A systematic review 对慢性肾病患者进行回授教育的效果:系统综述。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-04-03 DOI: 10.1111/jorc.12462
Hemamali M. H. Jagodage MPhil, Amanda McGuire PhD, Charrlotte Seib PhD, Ann Bonner PhD

Background

Education is an essential component in optimising chronic disease self-management. Teach-back is a robust approach in patient education, which is suitable for varying health literacy although its effectiveness in chronic kidney disease patient education is unknown.

Objective

To evaluate the impact of teach-back method in health education for improving self-management and adherence to treatment regimens in chronic kidney disease.

Design

Systematic review.

Participants

Adults with any chronic kidney disease grade or treatment modality.

Measurements

A comprehensive search was undertaken in MEDLINE, CINHAL, EMBASE, Cochrane library, PsychINFO, Web of Science, ERIC, JBI library and WHO International Clinical Trial Registry to identify published studies from September 2013 to December 2022. The methodological quality of studies was assessed using Joanna Briggs Institute guidelines.

Results

Six studies involving 520 participants were retrieved for this review. A meta-analysis could not be conducted due to substantial heterogeneity between studies. Nevertheless, there was some evidence that teach-back could improve self-management, self-efficacy and knowledge. There was limited evidence on improvement in psychological outcomes or health-related quality of life.

Conclusion

Teach-back seems to improve both objective and patient-reported outcomes, although further studies are needed. Using teach-back can improve both understanding of health information and the development of skills. Kidney care teams could use teach-back for all patients as it takes account of varying patient health literacy abilities. Teach-back assists with communicating important health information to improve patients' knowledge, confidence and skills in self-managing this disease and its treatment.

背景:教育是优化慢性病自我管理的重要组成部分。虽然回授法在慢性肾脏病患者教育中的效果尚不清楚,但它是患者教育中的一种有效方法,适用于不同的健康素养:目的:评估回授法在健康教育中对改善慢性肾病患者自我管理和坚持治疗方案的影响:设计:系统回顾:参与者:任何慢性肾脏病等级或治疗方式的成年人:在MEDLINE、CINHAL、EMBASE、Cochrane图书馆、PsychINFO、Web of Science、ERIC、JBI图书馆和世界卫生组织国际临床试验注册中心进行了全面检索,以确定2013年9月至2022年12月期间发表的研究。研究的方法学质量根据乔安娜-布里格斯研究所指南进行评估:本综述共检索到六项研究,涉及 520 名参与者。由于研究之间存在很大的异质性,因此无法进行荟萃分析。尽管如此,仍有一些证据表明,回训可以改善自我管理、自我效能和知识。关于改善心理结果或与健康相关的生活质量的证据有限:尽管还需要进一步的研究,但回教似乎可以改善客观结果和患者报告的结果。使用回授技术可以提高对健康信息的理解和技能的发展。肾脏护理团队可对所有患者使用 "背教",因为它考虑到了患者不同的健康素养能力。回教有助于传达重要的健康信息,从而提高患者在自我管理疾病和治疗方面的知识、信心和技能。
{"title":"Effectiveness of teach-back for chronic kidney disease patient education: A systematic review","authors":"Hemamali M. H. Jagodage MPhil,&nbsp;Amanda McGuire PhD,&nbsp;Charrlotte Seib PhD,&nbsp;Ann Bonner PhD","doi":"10.1111/jorc.12462","DOIUrl":"10.1111/jorc.12462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Education is an essential component in optimising chronic disease self-management. Teach-back is a robust approach in patient education, which is suitable for varying health literacy although its effectiveness in chronic kidney disease patient education is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the impact of teach-back method in health education for improving self-management and adherence to treatment regimens in chronic kidney disease.</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> Participants</h3>\u0000 \u0000 <p>Adults with any chronic kidney disease grade or treatment modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>A comprehensive search was undertaken in MEDLINE, CINHAL, EMBASE, Cochrane library, PsychINFO, Web of Science, ERIC, JBI library and WHO International Clinical Trial Registry to identify published studies from September 2013 to December 2022. The methodological quality of studies was assessed using Joanna Briggs Institute guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies involving 520 participants were retrieved for this review. A meta-analysis could not be conducted due to substantial heterogeneity between studies. Nevertheless, there was some evidence that teach-back could improve self-management, self-efficacy and knowledge. There was limited evidence on improvement in psychological outcomes or health-related quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Teach-back seems to improve both objective and patient-reported outcomes, although further studies are needed. Using teach-back can improve both understanding of health information and the development of skills. Kidney care teams could use teach-back for all patients as it takes account of varying patient health literacy abilities. Teach-back assists with communicating important health information to improve patients' knowledge, confidence and skills in self-managing this disease and its treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9227816","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}
引用次数: 0
Relationships and dynamics in families with a child with a kidney transplant—A study of parents' everyday life experiences 肾移植患儿家庭的关系和动态--父母日常生活经验研究。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-03-22 DOI: 10.1111/jorc.12465
Hanne Agerskov RN, PhD, Helle C. Thiesson MD, PhD, Helen Schultz RN, PhD, Birthe D. Pedersen RN, PhD

Background

Paediatric kidney transplantation is often the best choice of treatment for kidney failure with replacement therapy and represents an important change in the child's well-being. There are, however, still a number of challenges in addition to the parental role. The magnitude of intensive parental caregiving and support required by children with a kidney transplant could be disruptive to family relationships and dynamics.

Objective

To explore the experiences of family relationships and dynamics among parents of a child with a kidney transplant.

Design

An explorative study using a qualitative method.

Participants

Twelve parents (seven mothers and five fathers) of seven children with a kidney transplant were included.

Approach

A phenomenological–hermeneutic approach was applied.

Method

Semistructured, individual interviews were conducted. The data were analysed using Ricoeur's theory of interpretation on three levels: naïve reading, structural analysis and critical interpretation and discussion.

Findings

Three themes were generated: Emotions during ups and downs in everyday life; Balancing different needs among children; and Opportunities and having consideration in the family.

Conclusion

Relationships between parents that are based on mutual emotional support are significant and essential during periods of severe illness in a child. Parents who are alone or emotionally marked by their child's disease history feel vulnerable and struggle to overcome challenges. Different health situations among siblings lead to challenges in bringing up the children and emotional dilemmas among parents that impact family dynamics. Resilience in parents is a shifting phenomenon that can influence how they deal with family relationships and dynamics.

背景:小儿肾移植通常是治疗肾衰竭替代疗法的最佳选择,是儿童福祉的重要改变。然而,除了父母的角色外,还有许多挑战。肾移植患儿需要父母大量的照顾和支持,这可能会破坏家庭关系和动力:探讨肾移植患儿父母在家庭关系和动态方面的经验:设计:采用定性方法进行探索性研究:参与者:七名肾移植患儿的十二名父母(七名母亲和五名父亲):方法:采用现象学-遗传学方法:方法:进行了半结构化的个别访谈。采用呂科爾的詮釋理論,從三個層次對資料進行分析:天真解讀、結構分析和批判性詮釋與討論:产生了三个主题结论:父母之间的关系建立在相互尊重的基础上:结论:在儿童重病期间,建立在相互情感支持基础上的父母之间的关系是重要和必要的。孤身一人或因孩子的病史而在情感上留下烙印的父母会感到脆弱,并努力克服困难。兄弟姐妹之间不同的健康状况会给抚养子女带来挑战,父母之间的情感困境也会影响家庭动态。父母的复原力是一种不断变化的现象,会影响他们如何处理家庭关系和动态。
{"title":"Relationships and dynamics in families with a child with a kidney transplant—A study of parents' everyday life experiences","authors":"Hanne Agerskov RN, PhD,&nbsp;Helle C. Thiesson MD, PhD,&nbsp;Helen Schultz RN, PhD,&nbsp;Birthe D. Pedersen RN, PhD","doi":"10.1111/jorc.12465","DOIUrl":"10.1111/jorc.12465","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paediatric kidney transplantation is often the best choice of treatment for kidney failure with replacement therapy and represents an important change in the child's well-being. There are, however, still a number of challenges in addition to the parental role. The magnitude of intensive parental caregiving and support required by children with a kidney transplant could be disruptive to family relationships and dynamics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the experiences of family relationships and dynamics among parents of a child with a kidney transplant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An explorative study using a qualitative method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Twelve parents (seven mothers and five fathers) of seven children with a kidney transplant were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>A phenomenological–hermeneutic approach was applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Semistructured, individual interviews were conducted. The data were analysed using Ricoeur's theory of interpretation on three levels: naïve reading, structural analysis and critical interpretation and discussion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Three themes were generated: Emotions during ups and downs in everyday life; Balancing different needs among children; and Opportunities and having consideration in the family.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Relationships between parents that are based on mutual emotional support are significant and essential during periods of severe illness in a child. Parents who are alone or emotionally marked by their child's disease history feel vulnerable and struggle to overcome challenges. Different health situations among siblings lead to challenges in bringing up the children and emotional dilemmas among parents that impact family dynamics. Resilience in parents is a shifting phenomenon that can influence how they deal with family relationships and dynamics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9513936","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}
引用次数: 0
Perceptions of peritonitis risk, prevention, diagnosis and stigma: Findings from a mixed methods study with patients and relatives using peritoneal dialysis 对腹膜炎风险、预防、诊断和耻辱的看法:对使用腹膜透析的患者和亲属进行的混合方法研究结果。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-03-22 DOI: 10.1111/jorc.12464
Jessica Baillie BN (Hons), PhD, RN, Paul Gill BSc (Hons), PhD, RN, Molly Courtenay BSc (Hons), PhD, RGN

Background

Peritonitis is the main treatment-related complication of peritoneal dialysis and a primary concern for patients and their relatives. Therefore, understanding their perceptions of peritonitis is important.

Objectives

To explore patients' and relatives' perceptions of peritoneal dialysis-associated peritonitis risk, prevention measures and experiences of diagnosis, and experience of perceived stigma.

Design

A sequential mixed methods study design was used, including a questionnaire and semi-structured interviews.

Participants

Patients using peritoneal dialysis and relatives (n = 75) from six National Health Service organisations from the United Kingdom.

Measurements

A structured questionnaire was administered with patients and relatives (n = 75) using peritoneal dialysis; data were analysed using descriptive statistics. Thirty questionnaire respondents were then purposively sampled and interviewed in-depth; data were analysed thematically. Data were collected 2017−2018. Ethical and governance approvals were gained.

Results

Qualitative and quantitative analyses were integrated and three themes presented:

  • Perceptions of risk: participants assessed their risk of developing peritonitis and possible implications on their health and relatives. Participants felt greatly responsible for preventing infection.

  • Preventing peritonitis: participants reported similar and some differing measures to minimise their risk of developing peritonitis. Participants wanted to be seen as “clean”.

  • Diagnosis of peritonitis: peritonitis diagnosis was embarrassing and stigmatising for many individuals. This was influenced by the response of healthcare profes

背景:腹膜炎是腹膜透析治疗相关的主要并发症,也是患者及其亲属最关心的问题。因此,了解他们对腹膜炎的看法非常重要:目的:探讨患者及其亲属对腹膜透析相关腹膜炎风险、预防措施和诊断经验的看法,以及对耻辱感的感受:采用顺序混合法研究设计,包括问卷调查和半结构化访谈:参与人员:使用腹膜透析的患者及其亲属(n = 75),他们来自英国的六个国民健康服务机构:对使用腹膜透析的患者和亲属(n = 75)进行结构化问卷调查;使用描述性统计对数据进行分析。然后有目的地抽取 30 名问卷调查对象进行深入访谈;对数据进行专题分析。数据收集时间为 2017-2018 年。结果:综合定性和定量分析,提出了三个主题:- 对风险的认知:参与者评估了自己患腹膜炎的风险以及对其健康和亲属可能造成的影响。参与者认为自己对预防感染负有重大责任。- 预防腹膜炎:参与者报告了类似和一些不同的措施,以最大限度地降低其患腹膜炎的风险。与会者希望自己被视为 "干净 "的人。- 腹膜炎的诊断:腹膜炎的诊断让许多人感到尴尬和耻辱。这受到医护人员的反应和腹膜炎病因的影响:医护人员必须意识到患者和亲属在预防腹膜炎方面的责任感、这种责任感所带来的情绪影响,以及最重要的是这种影响可能对寻求帮助产生的影响。
{"title":"Perceptions of peritonitis risk, prevention, diagnosis and stigma: Findings from a mixed methods study with patients and relatives using peritoneal dialysis","authors":"Jessica Baillie BN (Hons), PhD, RN,&nbsp;Paul Gill BSc (Hons), PhD, RN,&nbsp;Molly Courtenay BSc (Hons), PhD, RGN","doi":"10.1111/jorc.12464","DOIUrl":"10.1111/jorc.12464","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peritonitis is the main treatment-related complication of peritoneal dialysis and a primary concern for patients and their relatives. Therefore, understanding their perceptions of peritonitis is important.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore patients' and relatives' perceptions of peritoneal dialysis-associated peritonitis risk, prevention measures and experiences of diagnosis, and experience of perceived stigma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A sequential mixed methods study design was used, including a questionnaire and semi-structured interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients using peritoneal dialysis and relatives (<i>n</i> = 75) from six National Health Service organisations from the United Kingdom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>A structured questionnaire was administered with patients and relatives (<i>n</i> = 75) using peritoneal dialysis; data were analysed using descriptive statistics. Thirty questionnaire respondents were then purposively sampled and interviewed in-depth; data were analysed thematically. Data were collected 2017−2018. Ethical and governance approvals were gained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Qualitative and quantitative analyses were integrated and three themes presented:</p>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 <p>Perceptions of risk: participants assessed their risk of developing peritonitis and possible implications on their health and relatives. Participants felt greatly responsible for preventing infection.</p>\u0000 </li>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 <p>Preventing peritonitis: participants reported similar and some differing measures to minimise their risk of developing peritonitis. Participants wanted to be seen as “clean”.</p>\u0000 </li>\u0000 \u0000 <li><span>• </span>\u0000 \u0000 <p>Diagnosis of peritonitis: peritonitis diagnosis was embarrassing and stigmatising for many individuals. This was influenced by the response of healthcare profes","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9509353","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}
引用次数: 0
Nurse-led clinical activity in kidney transplantation care in Spain: A cross-sectional observational study 西班牙肾移植护理中护士主导的临床活动:横断面观察研究。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-03-12 DOI: 10.1111/jorc.12463
Guillermo Pedreira-Robles PhD, MSc, Paloma Garcimartín PhD, Sonia Sevilla-Guerra PhD, Anna Bach-Pascual MSc, Marta García-Martínez PhD, MSc, Victoria Morín-Fraile PhD

Objectives

To explore the presence of specialist outpatient nursing activity in care for kidney transplant recipients in Spain and to determine the level of competence development of this activity according to the Advanced Practice Nurse model.

Design

Descriptive, cross-sectional study.

Participants and Measurements

All outpatient nurses specialising in renal transplantation in the 39 transplant hospitals in Spain were included. To fulfil the study objectives, an ad hoc questionnaire and the ‘Advanced Practice Nurse Role Definition Instrument (IDREPA)’ were administered to assess the nurses' level of competence development.

Results

Of the facilities included in the study, 25 (64.1%) had posttransplant nursing activity, 13 (33.3%) had pretransplant nursing activity and 11 (28.2%) had nursing activity involving kidney donor candidates. Twenty-seven specialist nurse's offices were identified. The results of the IDREPA reflect the presence of advanced practice in the domains of ‘expert care planning’ and ‘comprehensive care’. Three (11.1%) nurses met all criteria for advanced nursing practice.

Conclusion

The results on specialised outpatient nursing activity at the 39 transplantation facilities in Spain indicate a low presence of this type of activity, with an even lower presence of advanced practice nurses.

Implications for Clinical Practice

Management teams should consider investing in the quality of care provided by advanced nurse practice to ensure that suitable treatment is provided and better clinical outcomes are obtained.

目的探讨在西班牙肾移植受者护理中是否存在专科门诊护理活动,并根据高级实践护士模式确定该活动的能力发展水平:描述性横断面研究:西班牙 39 家移植医院中所有肾移植专科门诊护士均被纳入研究范围。为实现研究目标,我们采用了一份特别问卷和 "高级实践护士角色定位工具(IDREPA)"来评估护士的能力发展水平:在参与研究的机构中,25 家(64.1%)开展了移植后护理活动,13 家(33.3%)开展了移植前护理活动,11 家(28.2%)开展了涉及肾脏捐献者候选人的护理活动。确定了 27 个专科护士办公室。IDREPA 的结果反映出在 "专家护理计划 "和 "全面护理 "领域存在高级实践。三名护士(11.1%)符合高级护理实践的所有标准:结论:西班牙 39 家移植机构的专科门诊护理活动结果表明,这类活动很少,高级实践护士的比例更低:对临床实践的启示:管理团队应考虑对高级实习护士提供的护理质量进行投资,以确保提供合适的治疗并取得更好的临床效果。
{"title":"Nurse-led clinical activity in kidney transplantation care in Spain: A cross-sectional observational study","authors":"Guillermo Pedreira-Robles PhD, MSc,&nbsp;Paloma Garcimartín PhD,&nbsp;Sonia Sevilla-Guerra PhD,&nbsp;Anna Bach-Pascual MSc,&nbsp;Marta García-Martínez PhD, MSc,&nbsp;Victoria Morín-Fraile PhD","doi":"10.1111/jorc.12463","DOIUrl":"10.1111/jorc.12463","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore the presence of specialist outpatient nursing activity in care for kidney transplant recipients in Spain and to determine the level of competence development of this activity according to the Advanced Practice Nurse model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Descriptive, cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants and Measurements</h3>\u0000 \u0000 <p>All outpatient nurses specialising in renal transplantation in the 39 transplant hospitals in Spain were included. To fulfil the study objectives, an ad hoc questionnaire and the ‘Advanced Practice Nurse Role Definition Instrument (IDREPA)’ were administered to assess the nurses' level of competence development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the facilities included in the study, 25 (64.1%) had posttransplant nursing activity, 13 (33.3%) had pretransplant nursing activity and 11 (28.2%) had nursing activity involving kidney donor candidates. Twenty-seven specialist nurse's offices were identified. The results of the IDREPA reflect the presence of advanced practice in the domains of ‘expert care planning’ and ‘comprehensive care’. Three (11.1%) nurses met all criteria for advanced nursing practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results on specialised outpatient nursing activity at the 39 transplantation facilities in Spain indicate a low presence of this type of activity, with an even lower presence of advanced practice nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for Clinical Practice</h3>\u0000 \u0000 <p>Management teams should consider investing in the quality of care provided by advanced nurse practice to ensure that suitable treatment is provided and better clinical outcomes are obtained.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9455392","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}
引用次数: 0
Evaluating the feasibility and acceptability of home-based urinalysis for albumin-creatinine ratio with smartphone technology: A quality improvement project 评估利用智能手机技术进行白蛋白-肌酐比值家庭尿液分析的可行性和可接受性:质量改进项目。
IF 1.9 4区 医学 Q1 Nursing Pub Date : 2023-02-14 DOI: 10.1111/jorc.12460
Nicola Thomas PhD, Catriona Ewart MA, Carolyn Hill MSc

Background

Despite albumin-creatinine ratio (urine) testing being recommended for detection of chronic kidney disease among adults with diabetes, testing rates are suboptimal.

Aim

We implemented and evaluated a quality improvement project in an inner-city diabetes population in London, UK to assess the feasibility and acceptability of implementing novel home-based urinalysis using smartphone technology.

Methods

After eligible patients were identified and consented, testing kits were sent to the patient's home. Test results and patient feedback were collected through the smartphone application. Focus group discussions were conducted to evaluate primary care staff perspectives on uptake and delivery of the service.

Results

In total 2370 patients agreed to take part. Of these, 1244 completed the test (61% of those eligible) and of these, 465 (37%) had clinically significant albuminuria. 98% of patients found the test easy or very easy to use. Staff in primary care found the service to be beneficial for patients, and reported ease of set up and minimal administrative processes. Concerns regarding barriers among patients with lower digital literacy and non-English speakers were raised although these concerns were not substantiated.

Conclusion

Home-based albumin-creatinine ratio urine testing may improve the testing rates of people with diabetes at higher risk of chronic kidney disease. This is important post-pandemic, as healthcare services are trying to return to pre-pandemic levels of care. The study also found that the use of smartphone technology in an underserved (deprived) community is feasible, despite reservations about levels of digital literacy and possible language barriers. Further evaluation of effectiveness and costs is required.

背景:目的:我们在英国伦敦市中心的糖尿病患者中实施并评估了一个质量改进项目,以评估使用智能手机技术进行新型家庭尿液分析的可行性和可接受性:方法: 在确定符合条件的患者并征得其同意后,将检测试剂盒送至患者家中。通过智能手机应用程序收集检测结果和患者反馈。此外,还开展了焦点小组讨论,以评估基层医疗人员对这项服务的接受程度和提供情况的看法:结果:共有 2370 名患者同意参加测试。其中,1244 人完成了测试(占符合条件者的 61%),其中 465 人(37%)有临床意义的白蛋白尿。98% 的患者认为该检测易于使用或非常易于使用。基层医疗机构的工作人员认为该服务对患者有益,并表示设置简单,行政程序最少。有人担心数字素养较低的患者和不讲英语的患者会遇到障碍,但这些担忧并未得到证实:家庭白蛋白-肌酐比值尿液检测可提高慢性肾病高危糖尿病患者的检测率。这在大流行后非常重要,因为医疗保健服务正在努力恢复到大流行前的水平。研究还发现,在服务不足(贫困)的社区使用智能手机技术是可行的,尽管人们对数字扫盲水平和可能存在的语言障碍持保留意见。需要进一步评估其有效性和成本。
{"title":"Evaluating the feasibility and acceptability of home-based urinalysis for albumin-creatinine ratio with smartphone technology: A quality improvement project","authors":"Nicola Thomas PhD,&nbsp;Catriona Ewart MA,&nbsp;Carolyn Hill MSc","doi":"10.1111/jorc.12460","DOIUrl":"10.1111/jorc.12460","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite albumin-creatinine ratio (urine) testing being recommended for detection of chronic kidney disease among adults with diabetes, testing rates are suboptimal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We implemented and evaluated a quality improvement project in an inner-city diabetes population in London, UK to assess the feasibility and acceptability of implementing novel home-based urinalysis using smartphone technology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After eligible patients were identified and consented, testing kits were sent to the patient's home. Test results and patient feedback were collected through the smartphone application. Focus group discussions were conducted to evaluate primary care staff perspectives on uptake and delivery of the service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total 2370 patients agreed to take part. Of these, 1244 completed the test (61% of those eligible) and of these, 465 (37%) had clinically significant albuminuria. 98% of patients found the test easy or very easy to use. Staff in primary care found the service to be beneficial for patients, and reported ease of set up and minimal administrative processes. Concerns regarding barriers among patients with lower digital literacy and non-English speakers were raised although these concerns were not substantiated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Home-based albumin-creatinine ratio urine testing may improve the testing rates of people with diabetes at higher risk of chronic kidney disease. This is important post-pandemic, as healthcare services are trying to return to pre-pandemic levels of care. The study also found that the use of smartphone technology in an underserved (deprived) community is feasible, despite reservations about levels of digital literacy and possible language barriers. Further evaluation of effectiveness and costs is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767558","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}
引用次数: 0
期刊
Journal of renal care
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1