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Self-care dialysis

Federica Picariello, Rona Moss-Morris, Iain C Macdougall, Sam Norton, Maria Da Silva-Gane, Ken Farrington, Hope Clayton, Joseph Chilcot
INTRODUCTION: Fatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients. METHODS: We aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue...
March 8, 2018: BMJ Open
Currie Moore, Rabiya Majeed-Ariss, Anuradha Jayanti, Sandip Mitra, Suzanne Skevington, Alison Wearden
OBJECTIVES: Despite home haemodialysis (HHD) being associated with significant health and psychosocial benefits, it remains an under-utilized dialysis modality for people with chronic kidney disease. Self-cannulation, where patients insert their own needles for dialysis, is a key component of HHD. Recent research suggests that the prospect of self-cannulation is a barrier for patients, but there is little research which examines why this is the case. The aim of this study was to explore male HHD patients' experiences and attitudes towards self-cannulation...
March 6, 2018: British Journal of Health Psychology
Thomas F X O'Donnell, Chloe Powell, Sarah E Deery, Jeremy D Darling, Kakra Hughes, Kristina A Giles, Grace J Wang, Marc L Schermerhorn
OBJECTIVE: Prior studies identified significant racial disparities as well as regional variation in outcomes of patients with peripheral artery disease (PAD). We aimed to determine whether regional variation contributes to these racial disparities. METHODS: We identified all white or black patients who underwent infrainguinal revascularization or amputation in 15 deidentified regions of the Vascular Quality Initiative between 2003 and 2017. We excluded three regions with <100 procedures...
February 16, 2018: Journal of Vascular Surgery
Jamal Saleh Al Wakeel, Mohammed A Al Ghonaim, Abdullah Aldohayan, Saira Usama, Saad Al Obaili, Ahmad R Tarakji, Mohammad Alkhowaiter
Our objective is to study the outcomes and complications of peritoneal dialysis (PD) including comparison of self-care PD with home-care assisted PD during a five-year period. A retrospective study of PD data at King Saud University-affiliated hospital in Riyadh from January 1, 2009, to December 31, 2013. One hundred and eleven patients were included (female 55%). The average age was 47.4 (1-83) years. Twenty-one (18.91%) patients were on continuous ambulatory PD and 90 (81.08%) on automated PD. The mean time on PD was 23...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Tian-Ying Chang, Yan Shan, Sai-Sai Liu, Song Xiao-Yue, Zheng-Yan Li, Li-Ping Du, Yan-Yan Li, Gao Douqing
AIM AND OBJECTIVE: To examine whether the information-motivation-behavioral skills (IMB) model could predict self-care behavior among Chinese peritoneal dialysis patients. BACKGROUND: Peritoneal dialysis is a treatment performed by patients or their caregivers in their own home. It is important to implement theory-based projects to increase the self-care of patients with peritoneal dialysis. The IMB model has been verified in diverse populations as a comprehensive, effective model to guide the design, implementation, and evaluation of self-care programs...
February 8, 2018: Journal of Clinical Nursing
Ladan Golestaneh
Hospitalizations drive up to 35% of the astronomical costs of care for patients on hemodialysis and are associated with poor outcomes. We describe outpatient care-sensitive categories of hospitalization risks in an effort to engage stakeholders and patients, as stakeholders, in mitigating hospitalizations. These categories include: (1) fluid (interdialytic weight gain (IDWG) and chronic volume status), (2) infection (vascular access and malnutrition/inflammation resilience), and c) psychosocial (poor social support, poor self-efficacy, and mood disorders) risks...
February 6, 2018: Seminars in Dialysis
Denise Neumann, Juliane Lamprecht, Maxi Robinski, Wilfried Mau, Matthias Girndt
Background: Social relationships are important determinants of health-related outcomes for patients with chronic conditions. However, the effects of social networks and social support on health outcomes of dialysis patients in different treatment modalities have been under studied. Methods: We surveyed peritoneal dialysis (PD) and haemodialysis (HD) patients in the Choice of Renal Replacement Therapy project about their social relationships and health-care outcomes at baseline and 1-year follow-up...
January 23, 2018: Nephrology, Dialysis, Transplantation
Hidekazu Iida, Noriaki Kurita, Shino Fujimoto, Yuka Kamijo, Yoshitaka Ishibashi, Shingo Fukuma, Shunichi Fukuhara
PURPOSE: To prevent peritoneal dialysis (PD)-related infection, components of self-catheter care have been emphasized. However, studies on the effectiveness of home recording for the prevention of PD-related infections are limited. This study aimed to examine the association between keeping home records of catheter exit site and incidence of PD-related infections. METHODS: Home record books were submitted by patients undergoing PD. The proportion of days on which exit-site home recording was carried out for 120 days (0-100%) was obtained...
January 18, 2018: International Urology and Nephrology
Rupesh Raina, Joseph Wang, Vinod Krishnappa, Maria Ferris
The transition from pediatric to adult medical services is an important time in the life of an adolescent or young adult with a renal transplant. Failure of proper transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis. The aim of this study was to conduct a systematic review and survey to assess the challenges and existing practices in transition of renal transplant recipient children to adult services, and to develop a transition protocol. We conducted a literature review and performed a survey of pediatric nephrologists across the United States to examine the current state of transition care...
January 16, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Claudiana Pase, Andréia Dias Mathias, Clotilde Druck Garcia, Clarissa Garcia Rodrigues
BACKGROUND: Falling ill represents a traumatic experience especially in adolescence, since in addition to the moments of ambiguity and contradictions that this period brings, there is coping with the disease. Renal transplantation provides a better quality of life but the dependence on dialysis is replaced by the greater responsibility of self-care. With advances in technology, contemporary communication methods are a strategic mechanism for the approximation of the adolescent and the multiprofessional team...
January 9, 2018: JMIR Research Protocols
Hidehiro Sugisawa, Yumiko Shimizu, Tamaki Kumagai, Hiroaki Sugisaki, Seiji Ohira, Toshio Shinoda
The present study examined the performance level and its related factors on the process of case management for disabled patients on hemodialysis. Case management performance was evaluated at three stages: patient assessment, making a care plan, and monitoring/evaluation. Candidates for targeting the factors relating to performance included four dimensions: nursing care level, physical malfunction, cognitive malfunction, and barriers to service were used as patient factors; the period of case management for the patient and the knowledge of dialysis emerged as case manager factors; work load was included as an organizational factor; and community resources for these services and communication with surrounding persons were included as system factors...
December 28, 2017: Therapeutic Apheresis and Dialysis
Michelle Sophie Keller, Hannah J Park, Maria Elena Cunningham, Joshua Eleazar Fouladian, Michelle Chen, Brennan Mason Ross Spiegel
BACKGROUND: Virtual reality (VR) technology provides an immersive environment that enables users to have modified experiences of reality. VR is increasingly used to manage patients with pain, disability, obesity, neurologic dysfunction, anxiety, and depression. However, public opinion regarding the use of VR in health care has not been explored. Understanding public opinion of VR is critical to ensuring effective implementation of this emerging technology. OBJECTIVE: This study aimed to examine public opinion about health care VR using social listening, a method that allows for the exploration of unfiltered views of topics discussed on social media and online forums...
December 19, 2017: Journal of Medical Internet Research
Xiuzhu Gu, Kenji Itoh
OBJECTIVES: This study from Japan extracted performance measures for dialysis unit management and investigated their characteristics from professional views. METHODS: Two surveys were conducted using self-administered questionnaires, in which dialysis managers/staff were asked to rate the usefulness of 44 performance indicators. A total of 255 managers and 2,097 staff responded. RESULTS: Eight performance measures were elicited from dialysis manager and staff responses: these were safety, operational efficiency, quality of working life, financial effectiveness, employee development, mortality, patient/employee satisfaction and patient-centred health care...
December 14, 2017: Journal of Renal Care
Kathryn Havas, Clint Douglas, Ann Bonner
Purpose: The provision of self-management support (SMS) for people with earlier stages (1-4) of chronic kidney disease (CKD) can improve patient outcomes and extend time to dialysis. However, attempts to deliver such support have often not taken patient preferences into account. After the development, implementation, and quantitative evaluation of the person-centered CKD-SMS intervention, the aim of this study was to investigate participant experiences and perceptions of the program, as well as to seek suggestions to improve future SMS attempts...
2017: Patient Preference and Adherence
Dorothy Wong, Shen Cao, Heather Ford, Candice Richardson, Dmitri Belenko, Evan Tang, Luca Ugenti, Eleanor Warsmann, Amanda Sissons, Yalinie Kulandaivelu, Nathaniel Edwards, Marta Novak, Madeline Li, Istvan Mucsi
BACKGROUND: Collecting patient reported outcome measures (PROMs) via computer-based electronic data capture system may improve feasibility and facilitate implementation in clinical care. We report our initial experience about the acceptability of touch-screen tablet computer-based, self-administered questionnaires among patients with chronic kidney disease (CKD), including stage 5 CKD treated with renal replacement therapies (RRT) (either dialysis or transplant). METHODS: We enrolled a convenience sample of patients with stage 4 and 5 CKD (including patients on dialysis or after kidney transplant) in a single-centre, cross-sectional pilot study...
December 6, 2017: BMC Nephrology
Konstadina Griva, Mooppil Nandakumar, Jo-An H Ng, Kevin F Y Lam, Hayley McBain, Stanton P Newman
BACKGROUND: Poor adherence to treatment is common in hemodialysis patients. However, effective interventions for adherence in this population are lacking. Small studies of behavioral interventions have yielded improvements, but clinical effectiveness and long-term effects are unclear. STUDY DESIGN: Multicenter parallel (1:1) design, blinded cluster-randomized controlled trial. SETTING & PARTICIPANTS: Patients undergoing maintenance hemodialysis enrolled in 14 dialysis centers...
March 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Dinesh Bansal, Vijay Kher, Krishan Lal Gupta, Debasish Banerjee, Vivekanand Jha
INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care...
November 25, 2017: Journal of Vascular Access
Silvia Barrios, María Isabel Catoni, María Cecilia Arechabala, Eugenia Palma, Yolanda Ibacache, Joanna Richard
BACKGROUND: Knowing nurses' workload in hemodialysis units allows a better organization of human resources. AIM: To determine nurses' workload according to dependence and risk profiles of patients undergoing chronic hemodialysis. MATERIAL AND METHODS: One hundred fifty one patients from five hemodialysis units were selected and categorized in terms of dependence and risk using the instrument "Care according to dependence and risk in hemodialysis (CUDYR-DIAL)...
July 2017: Revista Médica de Chile
Robyn Levine, Karina Javalkar, Meaghan Nazareth, Richard A Faldowski, Maria Diaz-Gonzalez de Ferris, Sarah Cohen, Jessica Cuttance, Stephen R Hooper, Eniko Rak
PURPOSE: Low health literacy adversely affects health outcomes in adults with chronic kidney disease. The current study examined associations between limited/inadequate health literacy and health services utilization among adolescents and young adults (AYA) with chronic or end-stage kidney disease (CKD or ESKD). DESIGN AND METHODS: This was a retrospective cohort study that enrolled patients from both the pediatric- and adult-focused nephrology clinics of a major university hospital...
October 31, 2017: Journal of Pediatric Nursing
Dominic M Taylor, Simon Fraser, Chris Dudley, Gabriel C Oniscu, Charles Tomson, Rommel Ravanan, Paul Roderick
Background: Limited health literacy affects 25% of people with chronic kidney disease (CKD), and may reduce self-management skills resulting in poorer clinical outcomes. By disproportionately affecting people with low socio-economic status and non-white ethnicity, limited health literacy may promote health inequity. Methods: We performed a systematic review of quantitative studies of health literacy and clinical outcomes among adults with CKD. Results: A total of 29 studies (13 articles; 16 conference abstracts) were included...
November 20, 2017: Nephrology, Dialysis, Transplantation
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