Barriers and facilitators in self-care and management of chronic kidney disease in dialysis patients: A systematic review of qualitative studies.

AIM: To identify and synthesise qualitative studies on barriers and facilitators perceived by dialysis patients in relation to self-care and disease management. DESIGN: Systematic review of qualitative studies. DATA SOURCES: Qualitative study articles were extracted from PUBMED, MEDLINE, COCHRANE, WEB OF SCIENCE (WOS), CINAHL PsycINFO and EMBASE and electronic journals of the Spanish Society of Nephrology and Spanish Society of Nephrological Nursing until May 2022. Studies on barriers and/or facilitators affecting self-care and disease management expressed by people undergoing haemodialysis or peritoneal dialysis were included. REVIEW METHODS: The SPICE (Setting, Perspective, Intervention, Comparison and Evaluation) strategy was used to develop issues and subissues through the thematic synthesis of the qualitative findings. GRADE-CERQual was used to evaluate the articles. RESULTS: From 172 articles, 15 qualitative articles about barriers and facilitators perceived by patients concerning self-care and disease management were finally included. Identified eight facilitators and four barriers. CONCLUSION: Patients perceived a significant number of barriers and facilitators. It is possible to identify which aspects facilitate self-management of their disease and to understand that the processes are individualised. This is why therapeutic strategies should be designed to foster the participation and empowerment of the person in the management of the disease. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Identifying the barriers and facilitators concerning the management of chronic kidney disease furnishes us with knowledge for individualised clinical practice and improved care processes. IMPACT: This review is the first to synthesise barriers and facilitators in haemodialysis patients about the management of their disease and treatment. The results enable the proposal of improvements in the training of healthcare personnel, clinical practice guidelines and action protocols to improve the daily life and management of the disease by patients. No patient or public contribution due to this is a systematic review.

Impact of Service-Learning educational interventions on nursing students: An integrative review.

BACKGROUND: Service learning is an innovative educational approach that enables nursing students to directly participate and engage in the community while providing them and the community with benefits. OBJECTIVES: To summarise the evidence from service learning activities for nursing students, the educational and non-educational benefits derived through implementing this methodology, and the participating students' perceptions. DESIGN: An integrative review including qualitative, quantitative, and mixed methods designs was conducted. DATA SOURCES: The articles were identified through a systematic search in the following electronic databases: PubMed, Cochrane Library Plus, Scopus, CINAHL Complete (EBSCOHost), and Education Source (EBSCOHost). REVIEW METHODS: The search for studies was conducted in December 2020 using the following search terms: "Service learning", "Service-learning partnership", "Nursing", "Benefits" and "Intervention". RESULTS: A total of 22 articles were included. A positive relationship was found between the nursing students participating in service learning programmes and the acquisition of educational benefits, such as theoretical and practical learning, communication skills, and teamwork, and non-educational benefits, such as empathy, questioning prejudices, and commitment. In addition, a wide variety of activities and interventions were found to have been implemented using this academic approach, as well as a positive evaluation by the participating students. CONCLUSIONS: Service learning programmes with the active participation of nursing students generate benefits for both them and the community. First, these interventions receive positive evaluations from participating students. Furthermore, the interventions developed using service learning are varied and require motivation and creativity to implement them. However, there is a need for more experimental studies and the use of larger samples in service learning programmes.