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1.
Nephrol Nurs J ; 46(5): 521-530, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31566347

RESUMO

This study was conducted to clarify and conceptualize the phenomenon of the resilience of patients on hemodialysis. Three phases of a hybrid model were applied. In the theoretical phase, a working definition of the resilience of patients on hemodialysis was developed via literature review. In the fieldwork phase, in-depth interviews were conducted with 10 patients. Qualitative data from the interviews were analyzed to find attributes of resilience for patients on hemodialysis. The final analytical phase interpreted and compared findings of the theoretical and fieldwork phases. The concept of the resilience of patients on hemodialysis was as a complex phenomenon possessing several dimensions and attributes, delineating how patients on hemodialysis perceive and overcome hemodialysis. This conceptualization could lead to demonstrating a theoretical construct of resilience of patients on hemodialysis.


Assuntos
Atitude Frente a Saúde , Diálise Renal/psicologia , Resiliência Psicológica , Humanos
2.
Transplant Proc ; 51(7): 2250-2253, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474290

RESUMO

BACKGROUND: Kidney transplantation (KT) is the optimal treatment for chronic end-stage renal failure. However, it is experiencing a huge delay in Morocco, and the lack of information on this alternative treatment could contribute to this delay. The purpose of our work is to evaluate the knowledge of hemodialysis (HD) on renal transplantation and to propose sensitization and information strategies. METHODS: This is a multicenter study conducted in 4 hemodialysis centers in Marrakesh from November to December 2017. An individual questionnaire was submitted to 310 patients concerning sociocultural status, willingness to be transplanted, the main benefits and risks of renal transplantation, knowledge of religious attitudes toward organ donation and transplantation, cost, and survival of the KT. RESULTS: Of the 310 patients, 56% were men, with a mean age of 49.43 ± 10.3 years. The mean duration of hemodialysis was 6.7 ± 5.3 years. Only 18% were in school, and 57% had moderate economic status. Of the 310 respondents, 71% said they wanted to be transplanted, and 15.5% believed that Islam was unfavorable by encouraging them to accept the fate that God chose for them. The rest were afraid of multiple complications and returning to dialysis. However, 41.7% thought transplantation was more expensive than hemodialysis. Only 65.8% believed that renal transplantation provided a better quality of life. CONCLUSIONS: Raising the awareness of hemodialysis patients and their families is essential to promote KT in Morocco.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Falência Renal Crônica/psicologia , Transplante de Rim/psicologia , Diálise Renal/psicologia , Adulto , Conscientização , Medo , Feminino , Humanos , Islamismo/psicologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Marrocos , Qualidade de Vida , Inquéritos e Questionários
3.
BMC Public Health ; 19(1): 1107, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412824

RESUMO

BACKGROUND: As the incidence and prevalence rates of end stage renal disease (ESRD) rise globally, a disproportionate increase has been observed in the elderly population. Singapore has the fifth highest incidence of treated ESRD worldwide, with the upward trend of ESRD being most apparent among those aged 70 years and older. Although it is well-documented that ESRD patients suffer an impaired quality of life compared to the general population, there is limited research focusing on the unique experiences and needs of elderly ESRD patients in Asian populations. To address the knowledge gap, this study seeks to explore the impact of ESRD and dialysis on the quality of life of elderly (≥70 years old) ESRD patients in Singapore and examine the coping strategies utilised by these patients. METHODS: This qualitative study involved semi-structured, in-depth interviews with 7 peritoneal dialysis patients, 5 haemodialysis patients, 4 patients on non-dialysis supportive care and 7 caregivers in Singapore. Interviews were conducted in English, Chinese, and Malay and fully transcribed. QSR NVivo 11 software was used for analysis. RESULTS: Participants reported that ESRD and dialysis had an impact on three highly interconnected areas of their quality of life: (a) biological/physical (general symptoms, neuromuscular problems, skin problems and poor sleep quality); (b) psychological (depressive symptoms, anxiety and fears, stress and negative self-perceptions); and (c) social (increased dependence on family and loss of social life). There were four key strategies that participants used to cope with these biopsychosocial challenges: (a) family support (financial, practical and emotional support); (b) religious/spiritual support (experiencing gratitude/contentment, the power of prayer and belonging to a faith community); (c) avoidance (cognitive avoidance and distraction techniques); and (d) acceptance (positive thinking and problem solving). CONCLUSIONS: This study has provided insights into the biopsychosocial impact of ESRD and dialysis, as well as cultural and religious factors that shape the experiences and coping mechanisms of elderly ESRD patients and caregivers in Singapore, which can be used to further the development and implementation of more holistic and person-centred services to help each patient achieve a better quality of life.


Assuntos
Adaptação Psicológica , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Diálise Renal/psicologia , Idoso , Idoso de 80 Anos ou mais , Cuidadores/psicologia , Feminino , Saúde Holística , Humanos , Masculino , Assistência Centrada no Paciente , Pesquisa Qualitativa , Qualidade de Vida , Singapura
4.
G Ital Nefrol ; 36(4)2019 Jul 24.
Artigo em Italiano | MEDLINE | ID: mdl-31373463

RESUMO

People with a chronic kidney condition can live with their disease for several years, during which the illness becomes "an integral aspect of life" and requires "an arduous and continuous process of adaptation at multiple levels: cognitive, emotional and physical". Often, communicating with doctors is not helpful to these patients in understanding what is happening and reorganizing their lives, as ineffective communication strategies are employed. It is in fact necessary to overcome obstacles such as the use of incomprehensible technical language, ambiguity, the lack of communication training and the abundance of stressful situations. Chronically ill patients have the right to be informed in a simple, clear and impartial way about their condition and its possible treatments; this information will help them manage their kidney disease, "accept" it and find the motivation to adhere to medical prescriptions over time.


Assuntos
Barreiras de Comunicação , Nefrologia , Relações Enfermeiro-Paciente , Relações Médico-Paciente , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Esgotamento Profissional , Comunicação , Humanos , Acontecimentos que Mudam a Vida , Educação de Pacientes como Assunto , Insuficiência Renal Crônica/terapia
5.
BMC Psychol ; 7(1): 49, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337443

RESUMO

BACKGROUND: Nowadays there is a growing interest in exploring causes of fatigue symptoms and the possible linked aspects in patients with Chronic Kidney Disease (CKD) receiving hemodialysis (HD) treatment. Inflammatory processes were demonstrated to influence motivational systems functioning in chronic conditions. However, there is a lack of connection between quantitative motivational systems measure and patients self-report motivational and fatigue issue. Thus, the aim of this study was to identify an association between HD patients reward mechanisms, fatigue severity and psychosocial variables emerging from semi-structured interviews. METHODS: Interviews were held for a sample of ninety-four patients (54 males, 40 females; Mage = 62.98 ± 17.94; dialytic mean age in months = 76.55 ± 84.89) receiving chronic HD treatment and consequently analyzed by means of quantitative and qualitative analysis. Behavioral motivation systems reflecting inhibition/approach tendency to rewards were measured by Behavioral Inhibition/Activation System (BIS/BAS) scale and the fatigue severity experienced by HD patients was measured with the Fatigue Severity Scale. Scale results were correlated to psychosocial variables and topics derived from the semi-structured interviews. RESULTS: Findings highlight the presence of two effects: one related to the Behavioral Activation System (BAS) as a protective factor against the HD treatment pervasive consequences; the other one deals with the self-reported levels of fatigue that seemed to significantly interfere with patients' daily life, as a function of gender. CONCLUSIONS: Such results encourage the use of a mixed method approach to understand the complexity of the subjective experience of patients' facing chronic disease and treatments.


Assuntos
Atitude Frente a Saúde , Fadiga/psicologia , Entrevista Psicológica/métodos , Qualidade de Vida/psicologia , Diálise Renal/psicologia , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Recompensa , Fatores de Risco , Autorrelato
7.
Hu Li Za Zhi ; 66(4): 29-39, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342499

RESUMO

BACKGROUND: Taiwan has the highest incidence and prevalence of dialysis in the world. The literature suggests that severity of depression at the beginning of dialysis treatment is an independent predictor of survival. Depression significantly worsens the condition of chronic renal disease patients, with the adverse consequences of depression including increased mortality and hospitalization rates as well as poor compliance and quality of life. Given the importance of this problem, providing safe and effective information and good nursing care to dialysis patients is urgently needed. PURPOSE: The purpose of this study was to explore the effects of implementing health promotion education groups on self-perceived depression, hope, and quality of life in dialysis patients. METHODS: Dialysis patients who met the study criteria and had provided consent to participate in the health promotion education group were randomly assigned to either the treatment group (20 persons) or the control group (20 persons). In the control group, routine dialysis treatment and nursing care were maintained. In addition to receiving routine dialysis treatment and nursing care, the experimental group participated in health promotion education group activities for 90 minutes, twice a week for a total of 8 sessions. The quantitative data from both groups and the qualitative data analysis of the experimental group were used to assess the effects of the intervention. RESULTS: The results showed that the intervention had significantly improved self-perceived depression, hope, and quality of life in the experimental group. The participants indicated that the health promotion education group had helped them learn to adapt to their physical conditions, change their mindset, learn to regard happiness as the purpose of life, and maintain hope and increase mutual support in the face of difficulties. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study demonstrated that the cross-disciplinary integrated care provided through health promotion education groups is able to significantly improve depression, hope, and quality of life in dialysis patients. Thus, health promotion education groups arranged by the case management nurses for dialysis patients have the potential to promote mental health and quality of life in these patients. Therefore, continuing education is recommended to strengthen the awareness and knowledge of dialysis case management nurses with regard to applying integrated cross-disciplinary care in health promotion education groups and to promoting the implementation of these groups in the holistic care of dialysis patients.


Assuntos
Depressão/prevenção & controle , Processos Grupais , Promoção da Saúde/métodos , Esperança , Educação de Pacientes como Assunto/métodos , Qualidade de Vida , Diálise Renal/psicologia , Humanos , Diálise Renal/enfermagem , Taiwan
8.
Sao Paulo Med J ; 137(2): 137-147, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31314874

RESUMO

BACKGROUND: Depression and anxiety are the most prevalent psychological disorders among end-stage renal disease patients and are associated with various conditions that result in poorer health outcomes, e.g. reduced quality of life and survival. We aimed to investigate the prevalences of depression and anxiety among patients undergoing renal replacement therapy. DESIGN AND SETTING: Cross-sectional study in Belo Horizonte, Brazil. METHODS: Patients' depression and anxiety levels were assessed using the Beck Inventory. The independent variables were the 36-Item Short-Form Health Survey (SF-36), Charlson Comorbidity Index and Global Subjective Assessment, along with sociodemographic and clinical characteristics. RESULTS: 205 patients were included. Depression and anxiety symptoms were detected in 41.7% and 32.3% of dialysis patients and 13.3% and 20.3% of transplantation patients, respectively. Lower SF-36 mental summary scores were associated with depression among transplantation patients (odds ratio, OR: 0.923; 95% confidence interval, CI: 0.85-0.99; P = 0.03) and dialysis patients (OR: 0.882; 95% CI: 0.83-0.93; P ≤ 0.001). Physical component summary was associated with depression among dialysis patients (OR: 0.906; 95% CI: 0.85-0.96; P = 0.001). Loss of vascular access (OR: 3.672; 95% CI: 1.05-12.78; P = 0.04), comorbidities (OR: 1.578; 95% CI: 1.09-2.27; P = 0.01) and poorer SF-36 mental (OR: 0.928; 95% CI: 0.88-0.97; P = 0.002) and physical (OR: 0.943; 95% CI: 0.89-0.99; P = 0.03) summary scores were associated with anxiety among -dialysis patients. CONCLUSIONS: Depression and anxiety symptoms occurred more frequently among patients undergoing dialysis. Quality of life, comorbidities and loss of vascular access were associated factors.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Falência Renal Crônica/terapia , Transplante de Rim/psicologia , Qualidade de Vida/psicologia , Diálise Renal/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Falência Renal Crônica/psicologia , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
9.
Arch Pediatr ; 26(5): 263-267, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31278026

RESUMO

INTRODUCTION: Chronic kidney disease (CKD) is a potentially life-threatening condition leading to various psychosocial problems associated with different treatment modalities in addition to their medical advantages and disadvantages. The aim of this study was to evaluate the psychiatric morbidity in children with CKD in terms of different treatment modalities in comparison to healthy peers. In addition, parental attitudes and psychiatric symptoms in this group of mothers were examined. POPULATION AND METHODS: A matched cohort study including 66 children with CKD (21 renal transplantation, 27 dialysis, 18 conservative treatment) and 37 healthy age- and sex-matched controls were evaluated. Children filled out the Children's Depression Inventory, the State-Trait Anxiety Inventory, and the Parental Attitude Scale, and the mothers filled out the Symptom Checklist-90-R. The Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version was used for psychiatric diagnosis. RESULTS: The overall depression scores in children and the mothers' overall symptom severity index were significantly higher in the CKD group: 40.9% of children in the CKD group were diagnosed with a psychiatric disorder, while the corresponding figure for the control group was 16.2%. The in-group comparison of the CKD group failed to detect any significant difference between the three treatment modalities. CONCLUSION: The results support the findings of research showing that CKD has high psychiatric morbidity. It is important to include psychosocial and psychiatric assessments in the evaluation processes of different treatment modalities in CKD.


Assuntos
Tratamento Conservador/psicologia , Transplante de Rim/psicologia , Transtornos Mentais/etiologia , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Adolescente , Adulto , Atitude Frente a Saúde , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Mães/psicologia , Escalas de Graduação Psiquiátrica , Insuficiência Renal Crônica/terapia , Fatores de Risco
10.
Qual Life Res ; 28(11): 3117-3135, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31350653

RESUMO

PURPOSE: End-stage renal disease patients' experience of care is an integral part of the assessment of the quality of the care provided at hemodialysis centers and is needed to promote patient choice, quality improvement, and accountability. The purpose of this study is to evaluate the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS®) survey and its equivalence in different age, gender, race, and education subgroups. METHODS: The ICH-CAHPS survey was administered to 1454 patients from 32 dialysis facilities. For the characteristics compared, the sample had 756 participants younger than 65 years old, 739 men, 516 Black, 567 White, and 970 with less than high school diploma. Three different patient experience constructs were studied including nephrologist's communication and caring, quality of care and operations, and providing information to patients. We used item response theory analysis to examine the possibility of differential item functioning (DIF) by patient age, gender, race, and education separately after controlling for the other DIF characteristics and additional confounding variables including survey mode, mental, and general health status as well as duration on dialysis. RESULTS: The three constructs studied were unidimensional and no major DIF was observed on the composites. Some non-equivalences were observed when confounders were not controlled for, suggesting that such covariates can be important factors in understanding the possibility of disparity in patients' experience. CONCLUSIONS: The ICH-CAHPS is a promising survey to elicit hemodialysis patients' experience that has good psychometric properties and provides a standardized tool for assessing age, gender, race, or education disparity.


Assuntos
Pesquisas sobre Serviços de Saúde/métodos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Falência Renal Crônica/terapia , Psicometria/métodos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Diálise Renal/psicologia , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Pessoal de Saúde/normas , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Qualidade de Vida/psicologia
11.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 908-913, jul.-set. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005706

RESUMO

Objetivo: avaliar a qualidade de vida de pessoas adultas com doença renal crônica em tratamento hemodialítico. Método: estudo descritivo, realizado em um município localizado no noroeste do estado do Paraná, Brasil. Os dados foram coletados no segundo semestre de 2016, utilizando instrumento adaptado e validado para avaliação da qualidade de vida de pessoas com deficiência renal crônica. Foi utilizado o teste de kruskal-wallis para tratamento das variáveis. Resultado: as dimensões genéricas com melhor avaliação foram o bem-estar emocional e o funcionamento físico. A dimensão função social foi a pior avaliada. Nas dimensões específicas, o papel profissional, a satisfação com a assistência e o sono obtiveram as melhores avaliações. A função cognitiva, a função sexual, o suporte e a qualidade da interação social foram as piores avaliadas. Conclusão: o estudo sinaliza a importância de intervenções multiprofissionais para melhora do suporte e qualidade de interação social, função cognitiva e sexual de pessoas em tratamento hemodialítico


Objective: evaluate the quality of life of adults with chronic kidney disease undergoing hemodialysis. Method: descriptive study, carried out in a municipality located in the northwest of the state of Paraná, Brazil. Data were collected in the second half of 2016, using an instrument adapted and validated to evaluate the quality of life of people with chronic renal failure. The kruskal-wallis test was used to treat the variables. Result: the generic dimensions with the best evaluation were emotional well-being and physical functioning. The social function dimension was the worst evaluated. In the specific dimensions the professional role, satisfaction with the assistance and the sleep, obtained the best evaluations. Cognitive function, sexual function, support and quality of social interaction were the worst evaluated. Conclusion: the study indicates the importance of multiprofessional interventions to improve the support and quality of social interaction, cognitive and sexual function of people on hemodialysis


Objetivo: evaluar la calidad de vida de personas adultas con enfermedad renal crónica en tratamiento hemodialítico. Método: estudio descriptivo, realizado en un municipio ubicado en el noroeste del estado de Paraná, Brasil. Los datos fueron recolectados en el segundo semestre de 2016, utilizando un instrumento adaptado y validado para evaluar la calidad de vida de las personas con deficiencia renal crónica. Se utilizó la prueba de kruskal-wallis para el tratamiento de las variables. Resultado: las dimensiones genéricas con mejor evaluación fueron el bienestar emocional y el funcionamiento físico. La dimensión de la función social fue la peor evaluada. En las dimensiones específicas el papel profesional, satisfacción con la asistencia y el sueño, obtuvieron las mejores evaluaciones. La función cognitiva, función sexual, soporte y calidad de la interacción social, fueron las peores evaluadas. Conclusión: el estudio señala la importancia de intervenciones multiprofesionales para mejorar el soporte y calidad de la interacción social, función cognitiva y sexual de las personas en tratamiento hemodialítico


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Qualidade de Vida , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Equipe de Assistência ao Paciente , Cuidados de Enfermagem
12.
Holist Nurs Pract ; 33(4): 222-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192834

RESUMO

The aim of this study was to examine the effect of the application of lavender oil on fatigue and anxiety levels in patients undergoing hemodialysis treatment. This randomized controlled study was conducted with 60 patients (30 patients in intervention group, 30 patients in control group) in a province located in southeastern Turkey. After the patients in both groups were informed about the study, a questionnaire, the Fatigue Severity Scale, and the Beck Anxiety Inventory were applied to the patients. In the intervention group, a statistically significant difference was found between pretest and posttest scores of the Fatigue Severity Scale (t = 7.177, P = .001) and the Beck Anxiety Inventory (t = 10.371, P = .001). Mean scores of fatigue and anxiety decreased significantly following aromatherapy and also fatigue and anxiety levels declined. Lavender aromatherapy can be applied as an effective nursing intervention to reduce fatigue and anxiety of patients with chronic renal failure and undergoing hemodialysis treatment.


Assuntos
Ansiedade/terapia , Aromaterapia/normas , Fadiga/terapia , Diálise Renal/efeitos adversos , Adulto , Idoso , Ansiedade/etiologia , Ansiedade/psicologia , Aromaterapia/métodos , Fadiga/etiologia , Fadiga/psicologia , Feminino , Humanos , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Óleos Voláteis/administração & dosagem , Óleos Voláteis/uso terapêutico , Óleos Vegetais/administração & dosagem , Óleos Vegetais/uso terapêutico , Diálise Renal/psicologia , Inquéritos e Questionários , Turquia
13.
Int Urol Nephrol ; 51(7): 1249-1260, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31161521

RESUMO

PURPOSE: Patients with end-stage renal disease (ESRD) seem to have a negative attitude towards physical activity, which is mainly favored by the lack of counseling provided by the medical and nursing staff. The aim of this study was to investigate the attitudes of both ESRD patients and medical staff on the participation and promotion of physical activity and identify the obstacles that discourage patients' involvement in intervention programs. STUDY DESIGN: Subjective assessment questionnaires and the International Physical Activity Questionnaire were administrated to hemodialysis patients and medical staff, to investigate the association between patient's barriers to physical activity, the total intensity level of physical activity, and attitudes of both ESRD patients and medical staff on the participation and promotion of physical activity. RESULTS: A total of 103 ESRD patients (61 men, 59.2%), 20 nephrologists (12 men, 60.0%), and 72 nurses (61 women, 84.7%) participated in the study. Most commonly reported patient's barriers were fatigue on dialysis (97.4%) and non-dialysis days (55.1%). Healthcare staff showed positive attitude towards renal rehabilitation exercise programs. However, most of physicians (85.0%) and nurses (83.3%) did not have previous experience with interventional exercise rehabilitation programs. Binary logistic regression revealed significant association between patients' inactivity, demographic data, and barriers towards physical activity, such as fatigue and pain in dialysis and non-dialysis days (p < 0.05), family's and physician's concern (p < 0.05), too many medical problems (p < 0.05), the fear of getting hurt (p = 0.01), and unwillingness for exercise (p < 0.05). Interestingly, healthcare staff's negative attitudes toward patient's physical activity seem to be strongly associated with patient's inactivity status. CONCLUSION: Healthcare staff negative attitudes and multiple related barriers especially fatigue on dialysis and non-dialysis days, towards ESRD patient's physical activity, suppress desire for exercise and active patients' status, leading them to abstain from it.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Terapia por Exercício , Exercício , Falência Renal Crônica , Participação do Paciente/psicologia , Diálise Renal , Adulto , Aconselhamento , Exercício/fisiologia , Exercício/psicologia , Terapia por Exercício/métodos , Terapia por Exercício/psicologia , Fadiga/etiologia , Fadiga/psicologia , Feminino , Humanos , Falência Renal Crônica/psicologia , Falência Renal Crônica/reabilitação , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Nefrologistas/psicologia , Recursos Humanos de Enfermagem/psicologia , Diálise Renal/efeitos adversos , Diálise Renal/métodos , Diálise Renal/psicologia , Comportamento Sedentário
14.
J Clin Nurs ; 28(21-22): 4004-4011, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31240768

RESUMO

PURPOSE: We conducted a cross-sectional investigation of health-related quality of life (HRQOL) among maintenance haemodialysis (MHD) patients, and determined important predictive factors of HRQOL in these patients. METHODS: Psychological factors were evaluated with the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI) and the General Self-Efficacy Scale (GSES). HRQOL was evaluated with the EQ-5D. Laboratory data (albumin, haemoglobin and C-reactive protein) were collected for medical evaluation. We also collected participants' demographic data, including gender, age, et al. This study was in compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. RESULTS: The mean EQ-5D score was 0.86 ± 0.12, mean HADS-anxiety score was 5.27 ± 3.41, mean HADS-depression score was 5.29 ± 3.58, mean PSQI score was 7.00 ± 4.23 and mean GSES score was 6.86 ± 2.03. Participants' mean haemoglobin was 108.18 ± 16.45 g/L, mean albumin was 41.80 ± 4.61 g/L and mean C-reactive protein was 8.88 ± 18.50 mg/L. HRQOL was negatively correlated with HADS-anxiety (r = -0.390, p < 0.001), HADS-depression (r = -0.385, p < 0.001), PSQI (r = -0.285, p < 0.001) and C-reactive protein (r = -0.198, p = 0.034). HRQOL was positively correlated with GSES (r = 0.205, p = 0.007). Age (p < 0.001), anxiety (p < 0.001), depression (p = 0.002), and postdialysis unemployment (p < 0.001) were independent risk factors for HRQOL. CONCLUSION: Different health interventions should be implemented to improve patients' HRQOL. RELEVANCE TO CLINICAL PRACTICE: The results will provide evidence for establishing healthcare interventions to maintain or improve HRQOL among this patient population.


Assuntos
Qualidade de Vida , Diálise Renal/psicologia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
15.
Licere (Online) ; 22(02): 331-352, junho.2019. ilus, tab
Artigo em Português | LILACS | ID: biblio-1010184

RESUMO

Este estudo descreve e analisa a rotina de trabalho de um programa de recreação e ginástica para pacientes com insuficiência crônica renal. O tipo de trabalho desenvolvido foi a pesquisa-ação empírica. Um questionário-diagnóstico foi aplicado a 85 sujeitos adultos em hospital situado em Maringá-PR. No estudo foram utilizados diferentes tipos de instrumentos de coleta: 1) Questionário SF 36 de qualidade de vida; 2) Entrevistas semiestruturadas; e 3) Registro fotográfico. Os resultados apresentam e discutem o cotidiano e a rotina do hospital e os procedimentos necessários para desenvolvimento de atividades em sala de hemodiálise. Em conclusão, este estudo caracterizou as necessidades dos pacientes, as dificuldades encontradas na implantação do programa e estratégias desenvolvidas para intervenção.


The current study describes and analyzes the routine of the recreation and exercise program in chronic renal failure patients. The type of research was empirical action research. The diagnostic questionnaire was applied to 85 adults in a hospital of Maringá-PR. This study also used other different types of instruments: 1) SF 36 quality of life questionnaire; 2) Semi-structured interviews and 3) Photographic record. The results presented and discussed the routine of the hospital and the necessary procedure for activities development in the hemodialysis room. In conclusion, this study was characterized the patients needs and the difficulties of implementation and development of the intervention program.


Assuntos
Humanos , Qualidade de Vida , Terapias Complementares , Exercício , Saúde Mental , Diálise Renal/efeitos adversos , Diálise Renal/psicologia , Insuficiência Renal Crônica , Fluxo de Trabalho , Pacientes Internados , Relações Interpessoais , Atividades de Lazer , Relações Enfermeiro-Paciente
16.
Health Qual Life Outcomes ; 17(1): 78, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053092

RESUMO

BACKGROUND: Older patients with end-stage renal disease (ESRD) have experienced diminished quality of life and debilitating symptoms. Conservative management may be a potential treatment option. Currently, limited studies have been conducted about the main outcome of conservative management, including quality of life, symptoms and sleep quality. The aim of this systematic review was to examine the quality of life, symptoms and sleep quality of elderly patients with ESRD undergoing conservative management. METHODS: Evidence-based medicine database (JBI and Cochrane) and original literature database (PubMed, Medline, EMbase, Web of Science) were searched up to March 12, 2018. The quality of included papers was evaluated with the Newcastle-Ottawa Scale. RESULTS: Eight studies met the inclusion criteria. The total of 1229 patients were involved with an average age of 60.6 ~ 82 years. Patients choosing conservative management were older and more functionally impaired compared to those opting for dialysis. 55% patients undergoing conservative management had stable or improved quality of life and symptoms in prospective cohort study. However, the results revealed that there were no significant differences in quality of life and symptom between conservative management and renal replacement therapy. Only one study assessed quality of life of older patients using SF-36, with a lower score in physical health subscale of conservative management patients than those of renal replacement therapy. Although more than 40% of the patients had poor sleep quality, no significant difference was found between conservative management and renal replacement therapy. Sleep disorders were associated with fatigue and other symptoms. CONCLUSIONS: Although there is a limited literature, conservative management is likely to improve quality of life and alleviate symptoms of end-stage renal disease patients with considerable clinical implications mainly in elderly patients. Future study should pay more attention to the various treatment outcomes of conservative management, providing abundant evidence.


Assuntos
Tratamento Conservador/psicologia , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Fadiga/etiologia , Humanos , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Diálise Renal/psicologia , Transtornos do Sono-Vigília/etiologia , Resultado do Tratamento
17.
BMC Public Health ; 19(1): 531, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31072378

RESUMO

BACKGROUND: Even though depression is one of the most common psychiatric disorders, it is under-recognized in hemodialysis (HD) patients. Existing literature does not provide enough information on evaluation of predictors of depression among HD patients. The objective of the current study was to determine the prevalence and predictors of depression among HD patients. METHODS: A multicenter prospective follow-up study. All eligible confirmed hypertensive HD patients who were consecutively enrolled for treatment at the study sites were included in the current study. HADS questionnaire was used to assess the depression level among study participants. Patients with physical and/or cognitive limitations that prevent them from being able to answer questions were excluded. RESULTS: Two hundred twenty patients were judged eligible and completed questionnaire at the baseline visit. Subsequently, 216 and 213 patients completed questionnaire on second and final follow up respectively. The prevalence of depression among patients at baseline, 2nd visit and final visit was 71.3, 78.2 and 84.9% respectively. The results of regression analysis showed that treatment given to patients at non-governmental organizations (NGO's) running HD centers (OR = 0.347, p-value = 0.039) had statistically significant association with prevalence of depression at final visit. CONCLUSIONS: Depression was prevalent in the current study participants. Negative association observed between depression and hemodialysis therapy at NGO's running centers signifies patients' satisfaction and better depression management practices at these centers.


Assuntos
Falência Renal Crônica/psicologia , Qualidade de Vida/psicologia , Diálise Renal/psicologia , Índice de Gravidade de Doença , Adulto , Idoso , Depressão/epidemiologia , Feminino , Seguimentos , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Prevalência , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-31126041

RESUMO

Hemodialysis patients perform little physical activity. We formulated a hypothesis that some factors, i.e., frailty, medical and functional factors, psychological factors, quality of life, awareness of recommendations, and sociodemographic factors influence the decisions of taking up physical activity. This prospective study comprised 72 dialysis patients aged 57.8 ± 16.0 ( x ¯ ± SD; in the range of 19-87 years of age). The following research tools were used: an interview about awareness of the physical activity recommendations, the Canadian Study of Health and Aging Scale (CSHA-CFS), scales for the assessment of functional status, State-Trait Anxiety Inventory (STAI), Acceptance of Illness Scale (AIS), and the questionnaire of Kidney Disease Quality of Life (KDQOL-SF 1.3). The majority of patients diagnosed with frailty did not follow the physical activity recommendations (79.3%). Quality of life was better in active patients compared to inactive patients, especially in the domains of sleep and physical performance. The severity of trait anxiety was significantly higher in patients who did not follow the recommendations compared to patients who adhered to physical activity recommendations (46.0 ± 10.5 vs. 40.0 ± 8.2; p = 0.021 ). The likelihood of adherence decreased by 1% after each subsequent month of dialysis (odds ratio = 0.99; 95% confidence interval = 0.972-0.999; p = 0.047 ). Adherence was most limited by frailty. Adherence to recommendations on physical activity was affected by: motivation, lower levels of trait anxiety, and better quality of life. Age modified the effect of awareness and acceptance of the disease on adherence to physical activity recommendations.


Assuntos
Ansiedade/psicologia , Terapia por Exercício/psicologia , Exercício/psicologia , Fragilidade/psicologia , Nefropatias/terapia , Qualidade de Vida/psicologia , Diálise Renal/psicologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Canadá , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
19.
Rev Bras Enferm ; 72(2): 314-320, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017191

RESUMO

OBJECTIVE: To translate and adapt the Patient Perceptions of Hemodialysis Scale (PPHS) to the Brazilian context. METHOD: A methodological study, in which the stages of initial translation, synthesis of translations, back translation, evaluation by an expert committee and pre-test of the PPHS were performed. RESULTS: Two initial translations by independent translators, experienced in the health area and fluent in English. Subsequently, the synthesis of the translations was carried out, and this synthesis was back translated to the original language (American English).The translated and back-translated versions were evaluated by an expert committee made up of six PhD experts from the health area. The judges' evaluations resulted in content validity indexes for each item of the scale, and 7 of the 36 items had to be revised. Subsequently, a pretest was carried out with 20 participants, who considered the instrument intelligible. CONCLUSION: The PPHS is adequately translated and adapted to Brazilian Portuguese.


Assuntos
Pacientes/psicologia , Percepção , Psicometria/normas , Diálise Renal/normas , Adulto , Brasil , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Diálise Renal/métodos , Diálise Renal/psicologia , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tradução
20.
PLoS One ; 14(4): e0216045, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31034497

RESUMO

BACKGROUND: The hemodialysis regimen is an inevitable and mandatory treatment for patients with end-stage renal disease (ESRD). During the dialysis journey, patients may experience maladaptation in terms of sleep disturbances, depressive symptoms, and reduced health-related quality of life (HRQOL). Psychosocial resources such as social support may have beneficial influences on health outcomes, but studies have rarely analyzed the integrated relationships among risk factors which include pain, sleep disturbances, duration since diagnosis and various health outcomes in Taiwan. This study aimed to bridge this gap by investigating the relationships among related risk factors, social support, sleep disturbances, depressive symptoms, and HRQOL, which is composed of physical quality of life (PQOL) and mental quality of life (MQOL), in ESRD patients. METHOD: A correlational design was used, and 178 patients aged 20 years or older were recruited via convenience sample. The relationships among the risk factors, the mediators, depressive symptoms, PQOL, and MQOL were analyzed using structural equation modeling. RESULTS: The findings showed that more than 70% of the participants reported poor sleep quality, and 32% reported depressive symptoms. When participants had greater pain and more sleep disorders, they were more likely to be depressed. When participants had more appraisal support; they had better PQOL and fewer depressive symptoms. Overall, the structural equation model explained 31.8% of the variance in self-reported depressive symptoms, 29.4% of the variance in PQOL, and 5.7% of the variance in MQOL. Moreover, appraisal support enhanced PQOL and reduced depressive symptoms by exerting its two mediating effects on sleep disturbances. CONCLUSION: Our findings indicate that patients with ESRD who have more social support have better PQOL and MQOL and fewer depressive symptoms than those with less social support.


Assuntos
Depressão/psicologia , Qualidade de Vida/psicologia , Diálise Renal/psicologia , Transtornos do Sono-Vigília/psicologia , Apoio Social , Depressão/epidemiologia , Humanos , Falência Renal Crônica/psicologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
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