Experiences of Patients with Chronic Kidney Disease and Their Family Members in an Advanced Practice Nurse-Led Counseling Service.

Chronic kidney disease (CKD) is a major health problem worldwide, but not enough is known about effective self-management interventions. In this qualitative study, we explore how outpatients with CKD Stages 1-5 (without renal replacement therapy) and their family members experienced an individually tailored CKD counseling service led by an advanced practice nurse (APN). Using thematic analysis, 10 pair interviews (N = 20) were conducted and analyzed stepwise. Findings revealed iterative processes along the course of the disease. Participants struggled with an incomprehensible diagnosis. An APN assisted them in their efforts to master CKD. The APN offered information, insights, and understanding. This support helped the families achieve a new outlook and filled some gaps in CKD care. Future development of the service should focus on slowing down CKD progression more effectively. Healthcare providers are encouraged to acknowledge the importance of ongoing guidance and the continuity of care in treating patients with CKD.

[How do family members of haemodialysis patients with dementia experience nursing care on a haemodialysis unit: a qualitative study]. / Wie Angehörige die pflegerische Betreuung von dialysepflichtigen Patientinnen und Patienten mit Demenz auf der Hämodialysestation erleben - Eine qualitative Studie.

BACKGROUND: Up to 70 % of dialysis patients over 55 years suffer from some degree of dementia. For a patient with dementia eventually agitated, staying at rest during the whole haemodialysis session could be difficult, which represents a real challenge for the haemodialysis team. Although relatives of patients with dementia or haemodialysis patients were described as care experts because of their support in everyday life, the perspective of relatives of haemodialysis patients with dementia has not yet been researched. AIM: The purpose of this qualitative study was to explore the experience of nursing care of relatives of haemodialysis patients with dementia in a haemodialysis unit. METHODS: Data were collected through eight interviews with relatives. Content analysis was used to analyse data. RESULTS: Relatives knew that the patients were in good hands with their nurses. Their own attendance of the dialysis sessions was of variable duration, frequency and regularity, and they were hardly involved in the care. Relatives and nurses rarely communicated regarding the patients' situation. Although relatives described symptoms of dementia, it was important for them to attest that the patients were still "mentally all right". CONCLUSIONS: Relatives of patients with dementia have diverse needs concerning their attendance during the therapy and the exchange of information with clinicians. Nurses should approach relatives and assess their individual needs to achieve a better collaboration.