Pub Date : 2019-07-01DOI: 10.33235/RSAJ.15.2.38-46
Allison Brown, Carol A. Jeffrey, D. Moyle
Background Laughter Yoga is a patient engagement strategy that promotes health and wellbeing through a structured group laughter therapy program or session. It is a cost-effective and accessible exercise that has been shown to improve mood, and reduce both stress and anxiety. Method The aim of this project was to evaluate the effectiveness of Laughter Yoga in improving wellbeing, in a cohort of people with kidney disease requiring haemodialysis. The study aimed to see an improvement in patient wellbeing. Wellbeing areas under consideration were general satisfaction with life and health, general feelings impacting on wellbeing, expectations in life, chronic pain and ability to relax/wind down. Sixteen patients on thrice-weekly haemodialysis participated in a weekly Laughter Yoga therapy session for four weeks. Results The intervention was evaluated using a non-validated pre- and post-survey. The survey showed the positive indicators for wellbeing increased. The general overall satisfaction with life and health perceptions saw an increase of the mean score from 6 to 7.8 and 4.7 to 6.8, respectively. The positive feelings that participants were asked to comment on revealed a mean score increase. The more challenging feelings that impact on wellbeing showed a mean score decrease. The questions completed about life expectations observed smaller mean score increases. Participants' scores on difficultly to wind down, difficulty with being able to relax and levels of chronic pain showed a mean score decrease. Conclusion The patients that engaged found Laughter Yoga to be a value-adding activity that supported their wellbeing.
{"title":"Laughter Yoga therapy in haemodialysis: one unit’s experience","authors":"Allison Brown, Carol A. Jeffrey, D. Moyle","doi":"10.33235/RSAJ.15.2.38-46","DOIUrl":"https://doi.org/10.33235/RSAJ.15.2.38-46","url":null,"abstract":"Background Laughter Yoga is a patient engagement strategy that promotes health and wellbeing through a structured group laughter therapy program or session. It is a cost-effective and accessible exercise that has been shown to improve mood, and reduce both stress and anxiety. Method The aim of this project was to evaluate the effectiveness of Laughter Yoga in improving wellbeing, in a cohort of people with kidney disease requiring haemodialysis. The study aimed to see an improvement in patient wellbeing. Wellbeing areas under consideration were general satisfaction with life and health, general feelings impacting on wellbeing, expectations in life, chronic pain and ability to relax/wind down. Sixteen patients on thrice-weekly haemodialysis participated in a weekly Laughter Yoga therapy session for four weeks. Results The intervention was evaluated using a non-validated pre- and post-survey. The survey showed the positive indicators for wellbeing increased. The general overall satisfaction with life and health perceptions saw an increase of the mean score from 6 to 7.8 and 4.7 to 6.8, respectively. The positive feelings that participants were asked to comment on revealed a mean score increase. The more challenging feelings that impact on wellbeing showed a mean score decrease. The questions completed about life expectations observed smaller mean score increases. Participants' scores on difficultly to wind down, difficulty with being able to relax and levels of chronic pain showed a mean score decrease. Conclusion The patients that engaged found Laughter Yoga to be a value-adding activity that supported their wellbeing.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42545046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.33235/RSAJ.15.2.64-70
G. Turner, S. Grace, C. Aggar, R. Rafferty
Aim The aim of this study was to critically review research literature investigating the role of practice nurses in the early identification and management of chronic kidney disease (CKD) in the general practice setting. Method An integrative review was performed to determine the extent to which the topic has been investigated. Quantitative and qualitative research papers were systematically located in peer-reviewed journals in electronic databases. Included papers were critically appraised using the relevant CASP appraisal tools. Findings There is a paucity of research investigating the role of practice nurses in the early identification and management of CKD in primary health care. Three articles published between 2013 and 2017 were identified: two quantitative studies and one qualitative study. One study from The Netherlands quantified positive outcomes of practice nurse-centred management of CKD in general practice. Conclusion Practice nurses may be effective in the early identification and management of CKD, including improving blood pressure control. Providing education to practice nurses appears to be a key factor in increasing practice nurses’ involvement in identification and management of CKD. Further research is warranted to see if the results are transferable to other jurisdictions.
{"title":"Investigating the role of practice nurses in the early identification and management of chronic kidney disease in the general practice setting: An integrative review","authors":"G. Turner, S. Grace, C. Aggar, R. Rafferty","doi":"10.33235/RSAJ.15.2.64-70","DOIUrl":"https://doi.org/10.33235/RSAJ.15.2.64-70","url":null,"abstract":"Aim The aim of this study was to critically review research literature investigating the role of practice nurses in the early identification and management of chronic kidney disease (CKD) in the general practice setting.\u0000Method An integrative review was performed to determine the extent to which the topic has been investigated. Quantitative and qualitative research papers were systematically located in peer-reviewed journals in electronic databases. Included papers were critically appraised using the relevant CASP appraisal tools.\u0000Findings There is a paucity of research investigating the role of practice nurses in the early identification and management of CKD in primary health care. Three articles published between 2013 and 2017 were identified: two quantitative studies and one qualitative study. One study from The Netherlands quantified positive outcomes of practice nurse-centred management of CKD in general practice.\u0000Conclusion Practice nurses may be effective in the early identification and management of CKD, including improving blood pressure control. Providing education to practice nurses appears to be a key factor in increasing practice nurses’ involvement in identification and management of CKD. Further research is warranted to see if the results are transferable to other jurisdictions.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43974394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.33235/RSAJ.15.2.53-63
Hyeyoung Ko, R. Jayasekara, C. Grech
Aim To review the effects of bioimpedance spectroscopy (BIS) to measure dry weight (DW) in haemodialysis (HD)patients when compared to clinical examination. Methods The review was conducted according to the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MasARI). Meta-analysis was performed using Review Manager 5 software. The search was limited to English language papers published from 2005 to 2017. A standard JBI three-step search strategy was used. We searched all quantitative studies from major databases for investigations of the BIS for measuring DW in HD patients. Results A total of four randomised controlled trials (RCTs) met the inclusion criteria. These studies all involved patients with end-stage kidney disease (ESKD) receiving HD and the comparison of BIS versus physician’s clinical judgement using cardiovascular parameters and mortality outcomes. The meta-analysis of BIS when compared with clinical judgement found no significant differences in the reduction of the mortality rate, hospitalisation rate or other cardiovascular parameters after 12 months of the intervention; only significant improvement in pre-dialysis systolic BP (WMD –5.41, 95% CI –9.00 to –1.82; p=0.003) was reported. However, individual RCTs found that BIS is an effective intervention for HD patients in the reduction of the mortality rate (HR 0.100, 95% CI, 0.013 to 0.805; p=0.04) after 2.5 years of the intervention. Conclusion The small number of participants and restricted participant selection criteria all has considerable impact with regard to generalising these findings to wider HD populations.
{"title":"Effectiveness of bioimpedance spectroscopy on dry weight (DW) measurement in haemodialysis patients: a systematic review","authors":"Hyeyoung Ko, R. Jayasekara, C. Grech","doi":"10.33235/RSAJ.15.2.53-63","DOIUrl":"https://doi.org/10.33235/RSAJ.15.2.53-63","url":null,"abstract":"Aim To review the effects of bioimpedance spectroscopy (BIS) to measure dry weight (DW) in haemodialysis (HD)patients when compared to clinical examination.\u0000Methods The review was conducted according to the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MasARI). Meta-analysis was performed using Review Manager 5 software. The search was limited to English language papers published from 2005 to 2017. A standard JBI three-step search strategy was used. We searched all quantitative studies from major databases for investigations of the BIS for measuring DW in HD patients.\u0000Results A total of four randomised controlled trials (RCTs) met the inclusion criteria. These studies all involved patients with end-stage kidney disease (ESKD) receiving HD and the comparison of BIS versus physician’s clinical judgement using cardiovascular parameters and mortality outcomes. The meta-analysis of BIS when compared with clinical judgement found no significant differences in the reduction of the mortality rate, hospitalisation rate or other cardiovascular parameters after 12 months of the intervention; only significant improvement in pre-dialysis systolic BP (WMD –5.41, 95% CI –9.00 to –1.82; p=0.003) was reported. However, individual RCTs found that BIS is an effective intervention for HD patients in the reduction of the mortality rate (HR 0.100, 95% CI, 0.013 to 0.805; p=0.04) after 2.5 years of the intervention.\u0000Conclusion The small number of participants and restricted participant selection criteria all has considerable impact with regard to generalising these findings to wider HD populations.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43474625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.33235/RSAJ.15.2.47-52
D. Fortnum, W. Bradshaw
Context The latest KHA-CARI guidelines provide recommendations on screening for and management of blood-borne viruses (BBV) and multi-resistant organisms (MRO). The Guidelines comprise almost 80 pages, and include detailed practical advice related to clinical infection prevention, management considerations, and the working party’s evidence sourcing methodologies. Objectives To outline the format and content of the guidelines, summarising key points as relevant to nursing practice within haemodialysis units. To review the key points in the guidelines in regard to standard precautions, routine and enhanced surveillance screening, management of patients with positive results for BBV and MRO, environmental and equipment use and cleaning, use of personal protective equipment, and suggestions for clinical care. To highlight how the guidelines can support a dialysis unit in meeting relevant standards in the accreditation process. Key findings The KHA-CARI guidelines governing infection control in Australian and New Zealand haemodialysis units are detailed and evidence-based, and if adopted within an appropriate clinical governance framework, provide a comprehensive approach toward unit-based infection control that supports compliance with a number of the eight Australian National Safety and Quality Health Service (NSQHS) standards. Patient-centred care and implementation impact is a key focus of the guidelines, although they highlight limitations imposed by gaps in evidential knowledge. Conclusion The KHA-CARI infection control guidelines provide a high-quality, evidence-focused and detailed review of recommendations in regard to preventing and managing BBV and MRO infections in dialysis units. They align with NSQHS accreditation standards.
{"title":"KHA-CARI guidelines: infection control for haemodialysis units — a summary review","authors":"D. Fortnum, W. Bradshaw","doi":"10.33235/RSAJ.15.2.47-52","DOIUrl":"https://doi.org/10.33235/RSAJ.15.2.47-52","url":null,"abstract":"Context The latest KHA-CARI guidelines provide recommendations on screening for and management of blood-borne viruses (BBV) and multi-resistant organisms (MRO). The Guidelines comprise almost 80 pages, and include detailed practical advice related to clinical infection prevention, management considerations, and the working party’s evidence sourcing methodologies.\u0000Objectives To outline the format and content of the guidelines, summarising key points as relevant to nursing practice within haemodialysis units. To review the key points in the guidelines in regard to standard precautions, routine and enhanced surveillance screening, management of patients with positive results for BBV and MRO, environmental and equipment use and cleaning, use of personal protective equipment, and suggestions for clinical care. To highlight how the guidelines can support a dialysis unit in meeting relevant standards in the accreditation process.\u0000Key findings The KHA-CARI guidelines governing infection control in Australian and New Zealand haemodialysis units are detailed and evidence-based, and if adopted within an appropriate clinical governance framework, provide a comprehensive approach toward unit-based infection control that supports compliance with a number of the eight Australian National Safety and Quality Health Service (NSQHS) standards.\u0000Patient-centred care and implementation impact is a key focus of the guidelines, although they highlight limitations imposed by gaps in evidential knowledge.\u0000Conclusion The KHA-CARI infection control guidelines provide a high-quality, evidence-focused and detailed review of recommendations in regard to preventing and managing BBV and MRO infections in dialysis units. They align with NSQHS accreditation standards.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42902162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Peritonitis is the leading cause of technique failure among peritoneal dialysis (PD) patients. The study aimed to examine the microbiological characteristics of PD-related peritonitis in a tertiary hospital in Singapore. Methods A retrospective, cross-sectional study was performed at Singapore General Hospital (SGH). Data of patients diagnosed with PD-related peritonitis from January 2011 to December 2014 were collected. Microbiological characteristics of PD-related peritonitis were reported using descriptive statistics. Results A total of 377 episodes of peritonitis occurred in 247 patients. The average peritonitis rate in the centre was 0.23 episodes per patient year. There were 118 (31.2%) Gram-positive, 98 (26.0%) Gram-negative, 58 (15.4%) polymicrobial, 16 (4.2%) fungal, 2 (0.5%) mycobacterium and 85 (22.6%) culture-negative, PD-related peritonitis episodes. The three main Gram-positive micro-organisms isolated from peritoneal fluid cultures were Coagulase-negative Staphylococcus aureus (CoNS) (n=70, 17.6%), Streptococcus spp. (n=52, 13.1%) and Enterococcus spp. (n=28, 7.1%), while the three main Gram-negative isolates were Escherichia coli (n=50, 12.6%), Klebsiella spp. (n=46, 11.6%) and Enterobacter spp. (n=27, 6.8%). Candida parapsilosis (n=9, 1.9%) was the commonest fungus identified. Only 33 (47.1%) CoNS strains were sensitive to cefazolin, which was used in the institution for empiric coverage of Gram-positive micro-organisms in PD-peritonitis. All Streptococcus strains were sensitive to cefazolin (n=52). The majority of Escherichia coli (n=38, 76%), Klebsiella spp. (n=37, 80.4%) and Enterobacter spp. (n=18, 66.7%) strains were sensitive to gentamicin, the empiric antibiotic used for coverage of Gram-negative micro-organisms. Conclusions Our findings highlight the importance of regular monitoring of micro-organisms and their antimicrobial sensitivities in determining appropriate, centre-specific empirical antibiotics.
{"title":"Microbiological characteristics of peritoneal dialysis-related peritonitis in an Asian\u0000tertiary hospital 2011–2014","authors":"Mui Hian Sim","doi":"10.33235/RSAJ.15.1.5-10","DOIUrl":"https://doi.org/10.33235/RSAJ.15.1.5-10","url":null,"abstract":"Background\u0000Peritonitis is the leading cause of technique failure among peritoneal dialysis (PD) patients. The study aimed to examine the microbiological characteristics of PD-related peritonitis in a tertiary hospital in Singapore.\u0000Methods\u0000A retrospective, cross-sectional study was performed at Singapore General Hospital (SGH). Data of patients diagnosed with PD-related peritonitis from January 2011 to December 2014 were collected. Microbiological characteristics of PD-related peritonitis were reported using descriptive statistics.\u0000Results\u0000A total of 377 episodes of peritonitis occurred in 247 patients. The average peritonitis rate in the centre was 0.23 episodes per patient year. There were 118 (31.2%) Gram-positive, 98 (26.0%) Gram-negative, 58 (15.4%) polymicrobial, 16 (4.2%) fungal, 2 (0.5%) mycobacterium and 85 (22.6%) culture-negative, PD-related peritonitis episodes.\u0000The three main Gram-positive micro-organisms isolated from peritoneal fluid cultures were Coagulase-negative Staphylococcus aureus (CoNS) (n=70, 17.6%), Streptococcus spp. (n=52, 13.1%) and Enterococcus spp. (n=28, 7.1%), while the three main Gram-negative isolates were Escherichia coli (n=50, 12.6%), Klebsiella spp. (n=46, 11.6%) and Enterobacter spp. (n=27, 6.8%). Candida parapsilosis (n=9, 1.9%) was the commonest fungus identified.\u0000Only 33 (47.1%) CoNS strains were sensitive to cefazolin, which was used in the institution for empiric coverage of Gram-positive micro-organisms in PD-peritonitis. All Streptococcus strains were sensitive to cefazolin (n=52). The majority of Escherichia coli (n=38, 76%), Klebsiella spp. (n=37, 80.4%) and Enterobacter spp. (n=18, 66.7%) strains were sensitive to gentamicin, the empiric antibiotic used for coverage of Gram-negative micro-organisms.\u0000Conclusions\u0000Our findings highlight the importance of regular monitoring of micro-organisms and their antimicrobial sensitivities in determining appropriate, centre-specific empirical antibiotics.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47559518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.33235/RSAJ.15.1.19-25
R. Krishnasamy
Background: The rate of multidrug-resistant organisms (MDRO) colonisation in dialysis populations has increased over time. This study aimed to assess the effect of contact precautions and isolation on quality of life and mood for haemodialysis (HD) patients colonised with MDRO. Methods: Patients undergoing facility HD completed the Kidney Disease Quality of Life (KDQOL–SFTM), Beck Depression Inventory (BDI) and Personal Wellbeing-Index Adult (PWI-A). Patients colonised with MDRO were case-matched by age and gender with patients not colonised. Results: A total of 16 MDRO-colonised patients were matched with 16 controls. Groups were well matched for demographics and co-morbidities, other than a trend for older dialysis vintage in the MDRO group [7.2 years (interquartile range 4.6–10.0) compared to 3.2 (1.4–7.6) years, p=0.05]. Comparing MDRO-positive with negative patients, physical (30.5±10.7 vs. 34.6±7.3; p=0.2) and mental (46.5±11.2 vs. 48.5±12.5; p = 0.6) composite scores were not different between groups. The MDRO group reported poorer sleep quality (p=0.01) and sleep patterns (p=0.05), and lower social function (p=0.02). BDI scores were similar (MDRO-positive 10(3.5–21.0) vs. MDRO-negative 12(6.5–16.0), p=0.6). PWI-A scores were also similar in both groups; however, MDRO patients reported lower scores for “feeling safe”, p=0.03. Conclusion: While overall scores of quality of life and depression were similar between groups, the MDRO group reported poorer outcomes in sleep and social function. A larger cohort and qualitative interviews may give more detail of the impact of contact precautions and isolation on HD patients. The necessity for contact precautions for different MDRO needs consideration.
{"title":"Contact precautions for colonisation with multidrug-resistant organisms and haemodialysis patient quality of life and mood: a pilot case-control study","authors":"R. Krishnasamy","doi":"10.33235/RSAJ.15.1.19-25","DOIUrl":"https://doi.org/10.33235/RSAJ.15.1.19-25","url":null,"abstract":"Background: The rate of multidrug-resistant organisms (MDRO) colonisation in dialysis populations has increased over time. This study aimed to assess the effect of contact precautions and isolation on quality of life and mood for haemodialysis (HD) patients colonised with MDRO.\u0000Methods: Patients undergoing facility HD completed the Kidney Disease Quality of Life (KDQOL–SFTM), Beck Depression Inventory (BDI) and Personal Wellbeing-Index Adult (PWI-A). Patients colonised with MDRO were case-matched by age and gender with patients not colonised.\u0000Results: A total of 16 MDRO-colonised patients were matched with 16 controls. Groups were well matched for demographics and co-morbidities, other than a trend for older dialysis vintage in the MDRO group [7.2 years (interquartile range 4.6–10.0) compared to 3.2 (1.4–7.6) years, p=0.05]. Comparing MDRO-positive with negative patients, physical (30.5±10.7 vs. 34.6±7.3; p=0.2) and mental (46.5±11.2 vs. 48.5±12.5; p = 0.6) composite scores were not different between groups. The MDRO group reported poorer sleep quality (p=0.01) and sleep patterns (p=0.05), and lower social function (p=0.02). BDI scores were similar (MDRO-positive 10(3.5–21.0) vs. MDRO-negative 12(6.5–16.0), p=0.6). PWI-A scores were also similar in both groups; however, MDRO patients reported lower scores for “feeling safe”, p=0.03.\u0000Conclusion: While overall scores of quality of life and depression were similar between groups, the MDRO group reported poorer outcomes in sleep and social function. A larger cohort and qualitative interviews may give more detail of the impact of contact precautions and isolation on HD patients. The necessity for contact precautions for different MDRO needs consideration.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42507254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antimicrobial stewardship programs and renal units in 2019 and beyond","authors":"","doi":"10.33235/rsaj.15.1.4","DOIUrl":"https://doi.org/10.33235/rsaj.15.1.4","url":null,"abstract":"","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45156400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.33235/RSAJ.15.1.26-33
Annette Bezzant
Pregnancy occurring in the setting of chronic kidney disease requires timely care co-ordination to promote best outcomes. When multiple other co-morbidities exist, the need for strong and effective communication links become essential to supporting best outcomes. The role of the nurse practitioner or advanced practice nurse is well suited to supporting the needs of the pregnant woman and her family, especially when dialysis is required. This paper explores the role of the nurse practitioner during a rare clinical scenario. Clinical considerations, including co-ordination, monitoring and management of intensive renal, diabetic, obstetric, ophthalmic and complex psychosocial care are discussed. The importance of multidisciplinary collaboration, incorporating medical, nursing and allied health professionals from each specialty area underpins the case presented in this educational supplement.
{"title":"Pregnancy, diabetes and end-stage kidney disease: Complex care co-ordination\u0000for a rare clinical scenario","authors":"Annette Bezzant","doi":"10.33235/RSAJ.15.1.26-33","DOIUrl":"https://doi.org/10.33235/RSAJ.15.1.26-33","url":null,"abstract":"Pregnancy occurring in the setting of chronic kidney disease requires timely care co-ordination to promote best outcomes. When multiple other co-morbidities exist, the need for strong and effective communication links become essential to supporting best outcomes. The role of the nurse practitioner or advanced practice nurse is well suited to supporting the needs of the pregnant woman and her family, especially when dialysis is required. This paper explores the role of the nurse practitioner during a rare clinical scenario. Clinical considerations, including co-ordination, monitoring and management of intensive renal, diabetic, obstetric, ophthalmic and complex psychosocial care are discussed. The importance of multidisciplinary collaboration, incorporating medical, nursing and allied health professionals from each specialty area underpins the case presented in this educational supplement.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47234131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-15DOI: 10.33235/RSAJ.15.1.11-18
A. Esterman
Background: Treatment non-adherence may be prevalent in patients requiring haemodialysis (HD). Health literacy plays an important role in self-management. However, most research has only assessed basic literacy skills in the haemodialysis cohort. Aim: To determine the association between a multidimensional concept of health literacy and self-reported treatment adherence in HD patients. Method: A cross-sectional survey was undertaken with 42 maintenance HD patients from two South Australian dialysis centres. The Functional, Communicative and Critical Health Literacy (FCCHL) tool was used to assess health literacy. Treatment adherence was measured using a self-report tool developed by the researchers. Results: Higher overall health literacy was associated with increased adherence to food (OR 3.66; 95% CI 1.08–12.43; p=0.038), fluid (OR 4.92; 95% CI 1.13–21.35; p=0.033) and medications (OR 11.88; 95% CI 2.26–62.44; p=0.003). Conclusion: Interventions should be designed to facilitate a multidimensional concept of health literacy to assist patients to follow treatment recommendations.
背景:治疗不依从可能在需要血液透析(HD)的患者中普遍存在。健康素养在自我管理中发挥着重要作用。然而，大多数研究只评估了血液透析队列的基本读写能力。目的:确定多维健康素养概念与HD患者自我报告的治疗依从性之间的关系。方法:对来自南澳大利亚两个透析中心的42例维持性HD患者进行横断面调查。使用功能、交流和关键健康素养(FCCHL)工具评估健康素养。使用研究人员开发的自我报告工具来测量治疗依从性。结果:总体健康素养的提高与饮食依从性的增加相关(OR 3.66;95% ci 1.08-12.43;p=0.038)，液体(OR 4.92;95% ci 1.13-21.35;p=0.033)和药物(OR 11.88;95% ci 2.26-62.44;p = 0.003)。结论:干预措施的设计应促进健康素养的多维概念，以帮助患者遵循治疗建议。
{"title":"The effect of health literacy on treatment adherence in maintenance haemodialysis patients: a cross-sectional study","authors":"A. Esterman","doi":"10.33235/RSAJ.15.1.11-18","DOIUrl":"https://doi.org/10.33235/RSAJ.15.1.11-18","url":null,"abstract":"Background: Treatment non-adherence may be prevalent in patients requiring haemodialysis (HD). Health literacy plays an important role in self-management. However, most research has only assessed basic literacy skills in the haemodialysis cohort.\u0000Aim: To determine the association between a multidimensional concept of health literacy and self-reported treatment adherence in HD patients.\u0000Method: A cross-sectional survey was undertaken with 42 maintenance HD patients from two South Australian dialysis centres. The Functional, Communicative and Critical Health Literacy (FCCHL) tool was used to assess health literacy. Treatment adherence was measured using a self-report tool developed by the researchers.\u0000Results: Higher overall health literacy was associated with increased adherence to food (OR 3.66; 95% CI 1.08–12.43; p=0.038), fluid (OR 4.92; 95% CI 1.13–21.35; p=0.033) and medications (OR 11.88; 95% CI 2.26–62.44; p=0.003).\u0000Conclusion: Interventions should be designed to facilitate a multidimensional concept of health literacy to assist patients to follow treatment recommendations.","PeriodicalId":42629,"journal":{"name":"Renal Society of Australasia Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43675916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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