移植前血液透析:生活经验

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL International Journal of Noncommunicable Diseases Pub Date : 2023-04-01 DOI:10.4103/jncd.jncd_34_23
Priya, D. Kenwar, M. Dutta
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引用次数: 0

摘要

终末期肾病(ESRD)是一个快速增长的全球性健康问题,其中肾脏损害是不可逆转的。在世界范围内,血液透析是最常见的肾脏替代疗法,它可以延长寿命,但不是最终的治愈方法,同时,这种治疗方式有多种并发症,使这些患者的生活变得痛苦。关于患者教育、副作用和血液透析并发症的文献很多,但很少有人尝试了解透析患者的生活经历。材料与方法:采用现象学研究设计,探讨血液透析患者的生活体验。采用有目的的抽样技术,纳入了在移植前阶段进行血液透析至少6个月的成人(60岁)移植后患者。数据通过半结构化访谈收集,定量数据采用描述性统计,定性数据采用Colaizzi方法进行分析。结果:内科诊断以不明原因慢性肾小球肾炎最为常见,常见的合并症为高血压。根据被试的逐字记录,经过数据分析,共提取出5个主题和13个副主题。出现的主要主题是与疾病和透析相关的问题、情绪动荡、经济负担、社会孤立和生活方式的变化。结论:经血液透析治疗的ESRD患者存在生理障碍、情绪困扰和经济负担。社会孤立、经济拮据和生活方式改变是患者面临的主要挑战。专业人员需要以共情的态度对待血液透析患者,以尽量减少他们的痛苦。
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Pretransplant hemodialysis: Lived experiences
Introduction: End-stage renal disease (ESRD) is a rapidly increasing global health problem where the kidney damage is irreversible. Worldwide, hemodialysis is the most common kidney replacement therapy which increases longevity but is not the ultimate cure, and at the same time, there are multiple complications associated with this treatment modality making life miserable for these patients. Plenty of literature is available on patient education, side effects, and complications of hemodialysis, but very few attempts have been made to understand patients' experiences living on dialysis. Materials and Methods: A phenomenological research design was adopted to explore lived experiences of patients on hemodialysis. Using purposive sampling technique, adult (60 years) posttransplant patients who had hemodialysis at least for 6 months during pretransplantation phase were enrolled. Data were collected through semi-structured interviews, analyzed using descriptive statistics for quantitative and Colaizzi's method for qualitative data. Results: The most common medical diagnosis was unknown chronic glomerulonephritis, and the prevalent comorbid condition was hypertension. Based on participants' verbatim, total 5 themes and 13 subthemes were extracted after data analysis. The main themes emerged were disease- and dialysis-associated problems, emotional turmoil, financial burden, social isolation, and changes in lifestyle. Conclusion: The present study concluded that ESRD patients on haemodialysis experienced physiological disturbances, emotional distress and financial burden. Social isolation, financial constraints, and changes in lifestyle were major challenges faced by patients. Professionals need empathic attitude to deal with patients on hemodialysis to minimize their sufferings.
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