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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 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 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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引用次数: 0
Ambulatory Blood Pressure Monitoring During 52 Hours in Patients With Chronic Kidney Disease and Haemodialysis Treatment—An Exploratory Pilot Study 慢性肾脏疾病患者52小时动态血压监测和血液透析治疗-一项探索性试点研究
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-02-05 DOI: 10.1111/jorc.70009
Jenny Stenberg, Oskar Sandberg, Kerstin Marttala, Maria K. Svensson

Background

Hypertension in patients with haemodialysis is mainly characterised by high pre-dialysis blood pressure (BP) due to body fluid retention before dialysis, and the BP tends to decrease after dialysis due to removal of water during dialysis. Intervals between haemodialysis treatments vary and a long inter-dialytic interval dialysis is associated with increased mortality.

Objective

To examine variations in BP; how ambulatory BP vary during a dialysis treatment performed after the long inter-dialytic interval, that is, the first treatment of the week, compared to dialysis after a short inter-dialytic interval, and in the interval between the two dialysis sessions.

Design

Exploratory non-interventional observational.

Participants

Eleven patients with chronic kidney disease Stage 5 treated with haemodialysis were enroled. The mean age was 69 years (range 48–87) and mean dialysis duration 65 months (range 4–128).

Measurements

Ambulatory BP was recorded for 52 h including two haemodialysis treatments and one inter-dialytic interval. For statistical analyses the Wilcoxon signed ranks test was used.

Results

Significant differences in systolic and diastolic BPs were observed between dialyses after long inter-dialytic interval and short inter-dialytic interval, respectively (systolic 122 mmHg vs. 114 mmHg, p = 0.012 and diastolic 62 mmHg vs. 61 mmHg, p = 0.036). In addition, the BP declined during the first 90 min during dialysis in both settings.

Conclusions

Measuring ambulatory BP for 52 h in patient with chronic kidney disease and haemodialysis is feasible and show that both systolic and diastolic BP differ between dialysis treatments following inter-dialytic intervals of diverse length. These findings should be replicated in larger studies.

背景:血液透析患者高血压的主要特征是透析前体液潴留导致透析前血压(BP)偏高,透析后血压有降低的趋势,因为透析过程中水的清除。血液透析治疗的间隔时间不同,透析间隔时间过长与死亡率增加有关。目的探讨血压的变化;在较长的透析间隔(即一周的第一次治疗)后进行的透析治疗期间,与在较短的透析间隔后进行的透析以及两次透析之间的间隔期间进行的透析治疗相比,动态血压的变化情况。设计探索性非干预性观察。11名接受血液透析治疗的慢性肾脏疾病5期患者被纳入研究。平均年龄69岁(范围48-87),平均透析时间65个月(范围4-128)。动态血压记录52小时,包括两次血液透析治疗和一次透析间期。统计分析采用Wilcoxon符号秩检验。结果长间隔和短间隔两组患者的收缩期和舒张期血压分别有显著差异(收缩期122 mmHg vs. 114 mmHg, p = 0.012;舒张期62 mmHg vs. 61 mmHg, p = 0.036)。此外,两组患者在透析前90分钟血压均有所下降。结论慢性肾脏病血液透析患者52 h动态血压测量是可行的,并显示不同透析治疗的收缩压和舒张压在不同的透析间隔时间后存在差异。这些发现应该在更大规模的研究中得到证实。
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引用次数: 0
A Qualitative Study on Nurses' Caring Experiences With Individuals With Kidney Failure Receiving Haemodialysis 护士对肾衰竭患者血液透析护理经验的质性研究。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-01-28 DOI: 10.1111/jorc.70006
Edward Appiah Boateng, Bernice Bodua-Mango, Joana Kyei-Dompim, Philemon Adoliwine Amooba

Background

Kidney failure is a major health issue globally, particularly in Ghana and other low- and middle-income countries. Nurses are centrally involved in the direct care and technical operations of managing individuals with kidney failure, and they have first-hand exposure to the complexities of kidney failure management, including haemodialysis within resource-constrained settings.

Objective

This study explored the experiences of nurses who provide care to individuals with kidney failure receiving haemodialysis in Ghana.

Methods

A qualitative exploratory descriptive approach was used. Sixteen participants were selected using purposive sampling. Data was collected through in-depth interviews and analysed using reflexive thematic analysis.

Results

Four main themes that reflect the experiences of nurses caring for individuals with kidney failure receiving haemodialysis in Ghana were identified, showing that nurses caring for these individuals consider their care as expensive, demanding, suboptimal and emotionally distressing for nurses.

Conclusion

This study provides valuable insights that could enhance the understanding of the meaning and significance of caring for individuals receiving haemodialysis. Improving the haemodialysis caring experiences of nurses in Ghana requires addressing issues related to cost, emotional stress and workload of nurses, and resource availability. Changes to the healthcare system are needed to enhance the experience of patients and medical professionals involved in haemodialysis.

背景:肾衰竭是全球的一个主要健康问题,在加纳和其他中低收入国家尤其如此。护士是管理肾衰竭患者的直接护理和技术操作的核心人员,她们亲身经历了肾衰竭管理的复杂性,包括在资源有限的环境中进行血液透析:本研究探讨了在加纳为接受血液透析的肾衰竭患者提供护理的护士的经验:方法: 采用定性探索性描述方法。采用目的取样法选出了 16 名参与者。通过深入访谈收集数据,并采用反思性主题分析法对数据进行分析:结果:确定了反映加纳护士护理接受血液透析的肾衰竭患者的经验的四个主要专题,表明护理这些患者的护士认为他们的护理费用高昂、要求高、效果不理想,而且护士在情绪上感到痛苦:本研究提供了宝贵的见解,有助于加深对血液透析患者护理工作的意义和重要性的理解。要改善加纳护士的血液透析护理经验,就必须解决与成本、护士的情绪压力和工作量以及资源可用性有关的问题。需要对医疗保健系统进行改革,以改善血液透析患者和医疗专业人员的体验。
{"title":"A Qualitative Study on Nurses' Caring Experiences With Individuals With Kidney Failure Receiving Haemodialysis","authors":"Edward Appiah Boateng,&nbsp;Bernice Bodua-Mango,&nbsp;Joana Kyei-Dompim,&nbsp;Philemon Adoliwine Amooba","doi":"10.1111/jorc.70006","DOIUrl":"10.1111/jorc.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kidney failure is a major health issue globally, particularly in Ghana and other low- and middle-income countries. Nurses are centrally involved in the direct care and technical operations of managing individuals with kidney failure, and they have first-hand exposure to the complexities of kidney failure management, including haemodialysis within resource-constrained settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study explored the experiences of nurses who provide care to individuals with kidney failure receiving haemodialysis in Ghana.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative exploratory descriptive approach was used. Sixteen participants were selected using purposive sampling. Data was collected through in-depth interviews and analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four main themes that reflect the experiences of nurses caring for individuals with kidney failure receiving haemodialysis in Ghana were identified, showing that nurses caring for these individuals consider their care as expensive, demanding, suboptimal and emotionally distressing for nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides valuable insights that could enhance the understanding of the meaning and significance of caring for individuals receiving haemodialysis. Improving the haemodialysis caring experiences of nurses in Ghana requires addressing issues related to cost, emotional stress and workload of nurses, and resource availability. Changes to the healthcare system are needed to enhance the experience of patients and medical professionals involved in haemodialysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052870","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
Advance care planning intervention in chronic kidney care: A qualitative evaluation 预先护理计划干预慢性肾脏护理:定性评价。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-01-28 DOI: 10.1111/jorc.70000
Christina Egmose Frandsen RN, MSc(Nursing), PhD, Hans Dieperink MD, PhD, Bettina Trettin RN, MSc(Nursing), PhD, Hanne Agerskov RN, MSc(health), PhD

Background

Patients with chronic kidney disease and their families request early and continuous advance care planning. Based on user involvement, an advance care planning intervention was developed to support patients, family members and healthcare professionals (HCPs) in advance care planning conversations in a nephrology outpatient setting.

Objective

To explore the experiences and perceptions of an advance care planning intervention among patients with chronic kidney disease, family members and healthcare professionals.

Design

An exploratory qualitative study with a phenomenological-hermeneutic approach.

Participants

Six patients with chronic kidney disease, four family members and four healthcare professionals.

Approach

Semistructured interviews with patients and family members and a focus group interview with healthcare professionals were conducted. Data were analysed using Ricoeur's interpretation theory.

Findings

Patients and their families were impacted in various ways when the patient received the diagnose of chronic kidney disease. The need for an advance care planning intervention was based on a range of individual needs. The intervention supported patients, their family members, and healthcare professionals through open dialogues and reflections about thoughts and concerns. Healthcare professionals' reflected that it might be too early to deliver an increased amount of care.

Conclusion

When the disease challenged family and everyday life, the advance care planning intervention was useable and facilitated an open dialogue and reflections. The advance care planning conversations developed awareness among the patients and family members about their values, preferences, and needs, and supported them in sharing them. There is a need for training in initiating and conducting advance care planning conversations among healthcare professionals.

背景:慢性肾脏病患者及其家属要求尽早、持续地制定预先护理计划。在用户参与的基础上,我们开发了一种预先医疗规划干预措施,以支持患者、家属和医疗保健专业人员(HCPs)在肾脏科门诊环境中进行预先医疗规划对话:探讨慢性肾病患者、家属和医护人员对预先医疗规划干预的体验和看法:设计:一项探索性定性研究,采用现象学-医学方法:六名慢性肾病患者、四名家庭成员和四名医护人员:方法:对患者和家属进行半结构化访谈,对医护人员进行焦点小组访谈。采用呂科爾的詮釋理論分析資料:当患者被诊断出患有慢性肾病时,患者及其家属受到了不同程度的影响。对预先护理规划干预的需求是基于一系列个人需求。干预措施通过开放式对话以及对想法和担忧的反思,为患者、其家人和医护人员提供了支持。医护人员认为,现在就增加护理服务可能为时过早:结论:当疾病对家庭和日常生活构成挑战时,预先护理规划干预措施是可行的,并促进了公开对话和反思。预先护理规划对话提高了患者和家属对其价值观、偏好和需求的认识,并支持他们分享这些价值观、偏好和需求。有必要对医护人员进行启动和开展预先护理规划对话的培训。
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引用次数: 0
Educational or Behavioural Interventions to Improve Long-Term Haemodialysis Vascular Access Self-Management: A Systematic Review 教育或行为干预改善长期血液透析血管通路自我管理:系统综述。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-01-28 DOI: 10.1111/jorc.70005
Colette Wembenyui, Nicole Marsh, Emily Larsen, Ann Bonner

Background

Globally, haemodialysis is the most frequent type of kidney replacement therapy and necessitates access to the bloodstream either through a native arteriovenous fistula, arteriovenous graft or central venous catheter. Vascular access complications are a major cause of morbidity and mortality in adults receiving haemodialysis, and effective vascular access self-management is required.

Objective

To examine the effectiveness of educational or behavioural interventions designed to improve self-management of long-term vascular access in adults receiving haemodialysis.

Design

Systematic review.

Method

English language publications from January 2013 to May 2023 retrieved from PubMed, Embase, CINAHL, Cochrane Library, PsycINFO and Joanna Briggs Institute (JBI) databases were undertaken. Two independent reviewers identified studies for full-text review, data extraction and quality assessment. Data synthesis and quality assessment followed the JBI guidelines for quantitative reviews.

Results

Seven studies involving 540 participants were included: two studies were randomised control trials and five were quasiexperimental. All studies involved patient education, predominantly provided by nurses, and employed a variety of teaching resources, such as education booklets, practical demonstrations and videos. Outcomes measured included vascular access self-management behaviours, self-efficacy and vascular access knowledge although there was no consistency between studies. Overall, vascular access self-management significantly improved following education.

Conclusion

Educational interventions led to improvements in self-management behaviours in adults with long-term haemodialysis vascular access. However, there was insufficient evidence for the delivery and duration of intervention education. Further research is needed. An evidence-based nurse-led codesign intervention could lead to improvements in vascular access self-management.

背景:在全球范围内,血液透析是最常见的肾脏替代治疗类型,需要通过原生动静脉瘘、动静脉移植物或中心静脉导管进入血液。血管通路并发症是接受血液透析的成人发病和死亡的主要原因,需要有效的血管通路自我管理。目的:探讨教育或行为干预的有效性,旨在提高接受血液透析的成人长期血管通路的自我管理。设计:系统回顾。方法:检索PubMed、Embase、CINAHL、Cochrane Library、PsycINFO和Joanna Briggs Institute (JBI)数据库中2013年1月至2023年5月的英文出版物。两名独立审稿人确定了研究的全文审查、数据提取和质量评估。数据综合和质量评估遵循JBI定量审查指南。结果:纳入7项研究,涉及540名受试者:2项研究为随机对照试验,5项为准实验。所有研究都涉及患者教育,主要由护士提供,并采用各种教学资源,如教育小册子,实践演示和视频。测量的结果包括血管通路自我管理行为、自我效能和血管通路知识,尽管研究之间没有一致性。总体而言,教育后血管通路自我管理显著改善。结论:教育干预导致长期血液透析血管通路成人自我管理行为的改善。然而,关于干预教育的提供和持续时间的证据不足。需要进一步的研究。循证护士主导的协同设计干预可以改善血管通路自我管理。
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引用次数: 0
Co-Producing Peritoneal Dialysis Nursing Sensitive Indicators for Quality Care: A Multinational Consensus Building Design 联合生产腹膜透析护理敏感指标的质量护理:多国共识建设设计。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-01-28 DOI: 10.1111/jorc.70008
Jessica Baillie, Ann Bonner, Sonia Guillouet, Cornelia Mikut, Sally Punzalan, Anna Kaczmarek, Lawrence Climaco Wenzyl, Jeanette Finderup

Background

Nursing sensitive indicators are a way of measuring aspects of patient care that are most affected by the actions of the nurse. Despite the existence of nursing sensitive indicators, these are largely not suitable to measure peritoneal dialysis nursing practice.

Objective

This project aimed to co-develop a set of peritoneal dialysis nursing-sensitive indicators.

Design

Informed by the Donabedian quality framework (structure, process, outcome), a multinational co-production consensus design was used.

Participants and Measurements

First, an expert panel of seven professionals proposed potential indicators from clinical expertise and examining peer-reviewed articles and clinical guidelines. Next, the expert panel undertook a consensus building process involving face-to-face meetings and online discussion to refine the indicators. Lastly indicator confirmation was undertaken using a 5-point rating scale involving delegates at a major conference.

Results

The initial indicator proposal, based on evidence and clinical experience, identified 65 potential indicators (20 structural, 22 process and 23 outcome). The consensus process involved discussion and negotiation to reduce the potential indicators to 28 (eight structural, 12 process and eight outcome). Confirmation involved 25 nurses with all 28 indicators supported (all > 3.5/5). Indicators highly supported were patient satisfaction, fluid balance assessment, peritoneal dialysis catheter exit-site, clinical signs measurement, peritonitis investigation, peritoneal dialysis catheter complications referral and infection rates.

Conclusion

Following further validity, reliability and feasibility testing, these nursing sensitive indicators can be used to measure the quality of peritoneal dialysis nursing care provided for patients and families.

背景:护理敏感指标是一种衡量病人护理中最受护士行为影响的方面的方法。尽管存在护理敏感指标,但这些指标在很大程度上不适合衡量腹膜透析护理实践。目的:本项目旨在共同开发一套腹膜透析护理敏感指标。设计:根据Donabedian质量框架(结构、过程、结果),采用多国合作生产共识设计。参与者和测量:首先,由7名专业人士组成的专家小组从临床专业知识和审查同行评审的文章和临床指南中提出了潜在的指标。接下来,专家小组开展了建立共识的过程,包括面对面会议和在线讨论,以完善指标。最后,采用一项涉及一次主要会议代表的5点评分表进行指标确认。结果:初步指标提案基于证据和临床经验,确定了65个潜在指标(20个结构指标,22个过程指标和23个结果指标)。协商一致进程涉及讨论和谈判,以将潜在指标减少到28项(8项结构性指标、12项进程指标和8项结果指标)。确认涉及25名护士,所有28项指标均得到支持(均为bb0 3.5/5)。患者满意度、体液平衡评估、腹膜透析导管退出部位、临床体征测量、腹膜炎调查、腹膜透析导管并发症转诊和感染率均得到高度支持。结论:这些护理敏感指标经过进一步的效度、信度和可行性检验,可用于衡量腹膜透析患者及家属护理质量。
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引用次数: 0
Exploring Haemodialysis Nurses' Perceptions on Kidney Replacement Therapy Modality Education: A Framework Analysis 血液透析护士对肾脏替代治疗方式教育的认知:框架分析。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-01-24 DOI: 10.1111/jorc.70002
Elke Jaibeeh Barah, Jennifer Jackson

Background

Many people with kidney failure start and remain on in-centre haemodialysis treatment despite evidence of improved outcomes with home dialysis. To make an informed modality decision patients must receive frequent, high-quality modality education. This education is inconsistent in the in-centre haemodialysis setting, where patients spend the most time with nurses while receiving haemodialysis treatments.

Objectives

The aim of this study was to examine in-centre haemodialysis nurses' perceptions around modality education for patients receiving in-centre haemodialysis using the COM-B model of behaviour change.

Design

We used framework analysis as a research method, applying the COM-B model as a theoretical framework to understand nurses' perceptions of modality education.

Participants

We interviewed 13 in-centre haemodialysis nurses in a single province in Canada.

Approach

We completed semi-structured interviews via Zoom, which ranged from 30 to 60 min.

Findings

Participants reported knowledge deficits, lack of experience or exposure to other dialysis modalities, and lack of resources to support modality education practices. In-centre haemodialysis nurses reported some factors that enhanced modality education, including strong nurse–patient therapeutic relationships and previous experience in other dialysis modalities.

Conclusions

Nurses could have a role in modality education but had different views on what this role should be. Nurses faced barriers in modality education such as knowledge deficits, a lack of experience with home modalities, and limited patient teaching resources. Factors that favoured modality education were strong nurse–patient relationships and previous experience with other modalities.

背景:许多肾衰竭患者开始并坚持中心血液透析治疗,尽管有证据表明家庭透析改善了结果。为了做出明智的模式决策,患者必须接受频繁、高质量的模式教育。这种教育在中心血液透析环境中是不一致的,在中心血液透析环境中,患者在接受血液透析治疗时与护士相处的时间最多。目的:本研究的目的是使用行为改变的COM-B模型来检查中心血液透析护士对接受中心血液透析患者的模式教育的看法。设计:我们采用框架分析作为研究方法,采用COM-B模型作为理论框架来了解护士对模式教育的看法。参与者:我们在加拿大的一个省采访了13名中心血液透析护士。方法:我们通过Zoom完成了半结构化的访谈,时间从30到60分钟不等。研究结果:参与者报告知识不足,缺乏经验或接触其他透析方式,以及缺乏支持模式教育实践的资源。中心血液透析护士报告了一些增强模式教育的因素,包括牢固的护患治疗关系和以前在其他透析模式中的经验。结论:护士在德育教育中可以发挥作用,但对应发挥的作用有不同的认识。护士在模式教育方面面临障碍,如知识不足,缺乏家庭模式的经验,以及有限的病人教学资源。支持模式教育的因素是牢固的护患关系和以前使用其他模式的经验。
{"title":"Exploring Haemodialysis Nurses' Perceptions on Kidney Replacement Therapy Modality Education: A Framework Analysis","authors":"Elke Jaibeeh Barah,&nbsp;Jennifer Jackson","doi":"10.1111/jorc.70002","DOIUrl":"10.1111/jorc.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many people with kidney failure start and remain on in-centre haemodialysis treatment despite evidence of improved outcomes with home dialysis. To make an informed modality decision patients must receive frequent, high-quality modality education. This education is inconsistent in the in-centre haemodialysis setting, where patients spend the most time with nurses while receiving haemodialysis treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to examine in-centre haemodialysis nurses' perceptions around modality education for patients receiving in-centre haemodialysis using the COM-B model of behaviour change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We used framework analysis as a research method, applying the COM-B model as a theoretical framework to understand nurses' perceptions of modality education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>We interviewed 13 in-centre haemodialysis nurses in a single province in Canada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We completed semi-structured interviews via Zoom, which ranged from 30 to 60 min.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Participants reported knowledge deficits, lack of experience or exposure to other dialysis modalities, and lack of resources to support modality education practices. In-centre haemodialysis nurses reported some factors that enhanced modality education, including strong nurse–patient therapeutic relationships and previous experience in other dialysis modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nurses could have a role in modality education but had different views on what this role should be. Nurses faced barriers in modality education such as knowledge deficits, a lack of experience with home modalities, and limited patient teaching resources. Factors that favoured modality education were strong nurse–patient relationships and previous experience with other modalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047163","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
Nurses' Perception and Insight Into Uremic Pruritus in Patients With Chronic Kidney Disease on Dialysis: A Survey-Based Study 护士对慢性肾病透析患者尿毒症性瘙痒的认知与洞察:一项基于调查的研究。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-01-24 DOI: 10.1111/jorc.70003
Maria Pia Zito, Cinzia Fabbri, Francesca Del Grosso, Francesco Barci, Giuseppe Ferraro, Gessica De Pascale, Giovanna Santapaola, Mara Canzi, Valerio Neiviller, Alessandro Pizzo

Background

Uremic pruritus is a quite common condition among patients with chronic kidney disease. Symptom severity and patterns are variable.

Aim

To assess how nurses in the field of nephrology perceive the issue of uremic pruritus in dialysis patients and the relevance of this condition.

Design

A qualitative survey-based study.

Participants

Nurses working in the field of nephrology.

Methods

Nurses were administered an online survey with a 10-item survey (5 on socio-demographics, 5 specific to nephrology). Responses were reported in descriptive form and response rates.

Results

The study involved 185 nurses working in the field of nephrology, most of which were over the age of 40, and 39% had over 20 years of experience. Most perceived that uremic pruritus has decreased over the years thanks to better dialysis methods and that it is currently independent of the type of dialysis. Fifty-two percent estimate pruritus affects half or more of patients, and 47.6% that it affects only a minority. 75% estimate moderate-to-severe uremic pruritus involves between 1 and 3 cases every 10 patients (40.5% estimating ≤3/10 patients and 34.6% ≤1/10 patients), and 25% it affects at least half of patients. 41% estimate that more than half the patients do not find relief from PU to prevent it from impairing their quality of life.

Conclusions

The results highlight a large divergence in the perception of uremic pruritus among nurses. While this evidence the need for greater awareness on uremic pruritus, this also suggests a privileged role for nurses in detecting uremic pruritus occurrence and properly referring patients to nephrologist.

背景:尿毒症性瘙痒是慢性肾脏疾病患者的常见症状。症状的严重程度和模式各不相同。目的:评估肾内科护士如何看待透析患者尿毒症性瘙痒的问题及其相关性。设计:基于定性调查的研究。参与者:在肾脏学领域工作的护士。方法:对护士进行10项在线调查(社会人口统计学5项,肾脏病学5项)。调查结果以描述性的形式和回复率进行报告。结果:本研究共涉及185名从事肾脏病学领域工作的护士,其中大多数年龄在40岁以上,39%的护士工作经验在20年以上。大多数人认为,由于更好的透析方法,尿毒症瘙痒多年来有所减少,目前与透析类型无关。52%的人估计瘙痒会影响一半或更多的患者,47.6%的人认为瘙痒只影响少数人。75%的患者估计每10例患者中有1至3例出现中度至重度尿毒症瘙痒(40.5%的患者估计≤3/10例,34.6%的患者估计≤1/10例),25%的患者至少有一半受到影响。41%的人估计,超过一半的患者没有从PU中得到缓解,以防止它损害他们的生活质量。结论:结果显示护士对尿毒症瘙痒的认知存在很大差异。虽然这表明需要提高对尿毒症瘙痒的认识,但这也表明护士在发现尿毒症瘙痒的发生和适当地将患者转介给肾病科医生方面具有特殊作用。
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引用次数: 0
Chronic Kidney Disease Symptoms: The Informal Caregiver's Experience 慢性肾脏疾病症状:非正式照顾者的经验。
IF 1.5 4区 医学 Q3 NURSING Pub Date : 2025-01-20 DOI: 10.1111/jorc.70007
Malene Deele
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引用次数: 0
期刊
Journal of renal care
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