EDTNA/ERCA journal (English ed.)最新文献

The treatment schedule of the haemodialysis patient has many restrictions and the long-term haemodialysis patient's response to illness is characterised by various emotional reactions. Compliance with their medical regimens remains a significant problem which influences the progress of health and by extension quality of life. The preconceived idea that a patient's response to illness may influence his adherence to medical regimen led to this study. The main variables examined were the relationship between the patient's response to illness and compliance and the relationship between compliance and age, education and the length of time on haemodialysis.

This paper explains the development of protocols to aid in the care of patients following a combined kidney/pancreas transplant. With adequate planning of care, medical and nursing problems can be detected at an early stage thus ensuring immediate and appropriated action. We have found protocols to be invaluable in the care of these patients and the one which we developed on fluids and electrolytes is outlined in this paper.

The purpose of this paper is to describe the Master of Nursing (Renal) course that is offered to internal and distance education nephrology nurses in Australia. The challenging demand of offering this innovative curriculum will be discussed, and analysis of the first cohort of students will be made. Finally, future directions for renal nursing education will be discussed.

Patients requiring haemodialysis experience various problems, some of which are caused by the medical treatment. We explored various aspects of a haemodialysis patients life, to focus on the effects that their treatment had on their daily life. The aim of this study was "to know the life of the respondent, in order to improve the quality of the assistance." This pilot study allowed the staff to plan arrangements in order that the patient could pursue a "normal life".

The majority of doctors and nurses clearly recognise their responsibility to provide palliative care to the dying patient, and also the need for effective communication, counselling and support for this group of patients. This paper explores some of the issues preventing patient and significant others from being referred to the counselling service at this stage, and demonstrates that the nursing staff feel both inadequate and ill prepared to deliver quality care to the dying patient and use avoidance as a coping mechanism.

Stay.safe is a new PVC free double bag PD system that was introduced two years ago for CAPD. The system has been evaluated by three target groups, patients, nurses and physicians in 2 different studies. In the pilot study stay.safe was compared to the previous system and in the multi centre study, new patients judged stay.safe over a longer period of time. The pilot study showed better handling and function judgement by experienced patients of the new system compared to previous. In the multi centre study the overall satisfaction with the new system including use with disabled patients was very good and this high valuation was maintained over time.

Decline in residual renal function in CAPD patients often leads to reduced overall solute clearances. Inadequate dialysis has been linked to malnutrition and increased morbidity and mortality rates. Achieving dialysis adequacy targets is often difficult by the conventional method of increasing CAPD exchange volumes. In comparison, substantial increases in solute clearances can be achieved with the use of automated peritoneal dialysis with large fill volumes and an extra daytime exchange.

Deviations in ultrafiltration volume can cause various problems for patients undergoing a haemodialysis treatment. With the introduction of high flux dialysers, closed systems with volumetric fluid balancing became the systems of choice, because control of transmembrane pressure used previously is too inaccurate and unsafe to be used with such filters. In this article, a reliable and cost effective test method is described to increase the safety of a closed system. The test is carried out by simply analysing the dialysate pressure while the dialyser is isolated from the system for typically 7.2 seconds. No additional sensors and components other then a valve combination used to isolate the dialyser are required.

The patient, a chronic cannabis user, found it increasingly difficult to tolerate the side effects of the medication on her appearance. Rejection in the early post-transplant period meant that immunosuppression could not be further reduced. We were able to avoid a catastrophic self-initiated cut in immunosuppression, and withdrawal of steroids was carried out according to a schedule supervised by the clinic. Cellular rejection resulted and was treated with i.v. methyl prednisolone and conversion from cyclosporin micro-emulsion (Neoral, Novartis) to tacrolimus (Prograf, Fujisawa) and from azathioprine to mycophenolate mofetil (CellCept, Roche).

Adherence of individual treatment and personality dimension of locus of control was analysed. Evidence suggests that locus of control and other personality dimensions can influence adherence behaviour to treatment. The aim of this study was to examine the impact of social-clinical factors over personality dimensions and to provide empirical evidence of the relationship between internal locus of control experience and higher level of the compliance to treatment and diet. The results have shown the low level of adherence of patients to treatment and we found a tendency to correlate the dimension locus of internal control with adherence to treatment.