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1.
Nephrol Nurs J ; 46(6): 605-610, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31872991

RESUMO

Effective methodologies for teaching nursing students how to care for pediatric patients with end stage renal disease (ESRD) are not well described. Two teaching methodologies were compared using a mixed-methods approach: an at-home simulation group (three days simulating having ESRD: taking medications, eating a renal diet, nightly peritoneal dialysis), and a video group (children with ESRD and their families sharing their experiences). Data were collected via an anonymous online survey at course completion. Knowledge acquisition was assessed using psychometrically reliable multiple-choice questions; no statistically significant differences between the two groups were found, indicating both learned the material. Qualitative analysis found that both groups valued the assigned teaching method and that it deepened their learning. Students identified challenges that children with ESRD and their families are known to experience. Combining both teaching methods may ultimately be the most effective approach.


Assuntos
Falência Renal Crônica , Enfermagem Pediátrica , Estudantes de Enfermagem , Criança , Humanos , Falência Renal Crônica/enfermagem , Aprendizagem , Inquéritos e Questionários , Ensino
2.
Nephrol Nurs J ; 46(5): 485-495, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31566344

RESUMO

Globally, home dialysis prevalence has been declining relative to the increase in end stage renal disease and renal replacement therapy. The goal of this study was to identify international perceptions and practices. A web-based questionnaire was disseminated to nephrology nurses in 30 home dialysis-prevalent nations. Global telehealth use was low (23%), contrasting with 83% respondents agreeing telehealth would improve care. Only 31% of all programs enabled patient training outside of normal working hours (e.g., nights and weekends), and 31% of all program patients had some cost reimbursement, with a significant difference between U.S. and non-U.S. programs (U.S. 11%, non-U.S. 59%, 2 = 93.6, p < 0.0001). Significant differences in the need for monthly clinic visits (U.S. 72%, non-US 44%, 2 = 83.7, p < 0.0001) were also found. Telehealth provision and patient training flexibility is limited, and patient cost reimbursement is low. Increased telehealth, patient cost reimbursement, and flexible training models may promote home dialysis growth.


Assuntos
Atitude do Pessoal de Saúde , Hemodiálise no Domicílio/enfermagem , Falência Renal Crônica/enfermagem , Enfermagem em Nefrologia , Padrões de Prática em Enfermagem , Humanos , Internacionalidade , Inquéritos e Questionários
3.
Nephrol Nurs J ; 46(5): 497-508, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31566345

RESUMO

Fatigue is a subjective overwhelming feeling of tiredness at rest, exhaustion with activity, lack of energy that impedes daily tasks, lack of endurance, or a loss of vigor. Individuals with end stage renal disease (ESRD) experience a high rate and severity of fatigue. Symptom management of fatigue in this population is critical, since fatigue has been linked with lower quality of life and higher mortality rates. In this article, we present a definition and overview of fatigue, a review of factors contributing to fatigue, and ways to manage fatigue in individuals with ESRD.


Assuntos
Fadiga/etiologia , Falência Renal Crônica/complicações , Humanos , Falência Renal Crônica/enfermagem , Fatores de Risco
5.
Hu Li Za Zhi ; 66(4): 103-109, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31342507

RESUMO

Elderly patients with end stage renal disease (ESRD) frequently suffer from frailty, multiple comorbidities, and complications that greatly increase the mortality rate for this population. The irreversibility and variability of ESRD directly affect quality of life, which highlights the importance of gaining an early understanding of the preferences and expectations of these patients with regard to end-of-life care. This article describes a nursing experience that used ethical analysis to help an elderly ESRD patient and the dilemma faced by his family as to whether to sustain or withdraw hemodialysis. This article examines the uncertain trajectories of this disease and how to use shared decision making with the patient and his/her family to make the best decisions. A comprehensive assessment was conducted to identify the major health-related problems, to elicit the dilemmas faced in making the decision to sustain or end hemodialysis, and to understand the pain and suffering of the patient. Symptom control and comfort were identified as the most important goals of the patient, followed by building trust and rapport with his family. An analysis of the pros and cons of treatment was conducted using the 4-box ethical analysis developed by Josen, Siegler, and Winslade. The shared decision-making process was applied to help the patient express his expectations for his end-of-life care. While the health professionals considered that pain and suffering may influence the patient's decision, the patient found his connection between himself and others, self-value, and meaning of life through family love and support. A needs-based, flexible approach was adopted that established a continuous-care plan that was designed to provide the best care for the patient under a variety of possible scenarios while involving the family, which created a family-centered decision-making process that improved the quality of life of the elderly ESRD patient.


Assuntos
Tomada de Decisões/ética , Análise Ética , Falência Renal Crônica/enfermagem , Diálise Renal , Suspensão de Tratamento/ética , Idoso , Feminino , Humanos , Masculino , Qualidade de Vida
6.
Enferm. nefrol ; 22(2): 124-128, abr.-jun. 2019. mapas
Artigo em Espanhol | IBECS | ID: ibc-186310

RESUMO

En España se ha conseguido gestionar la donación de órganos a lo largo de los últimos 30 años, de manera más efectiva que en el resto de los países. Aun así, no hemos alcanzado la autosuficiencia. La prevalencia de enfermedad renal en nuestro país para el año 2017 fue de 685 p.m.p. teóricamente el 22% de estos pacientes serán candidatos a trasplante renal, lo que supone una necesidad de 150 trasplantes renales p.m.p. En 2017, la lista de espera para trasplante renal albergaba a 7.211 pacientes, 3.269 consiguieron trasplantarse (332 de donante vivo), lo que suponen 70 trasplantes p.m.p. El porcentaje aumenta cuando hablamos de receptores jóvenes, ya que, el número de donantes mayores de 60 años supera el 50% del total. Así mismo, se observan notables diferencias en la distribución de actividad de trasplante renal de donante vivo por CCAA. Con la donación renal de vivo, se pretende atender mejor las necesidades de la lista de espera para trasplante, reducir los tiempos de espera en general y aumentar la oferta de una excelente opción terapéutica, con mejores resultados en supervivencia y rehabilitación para el paciente, siendo actualmente una opción muy segura también para los donantes. El abordaje de los pacientes con enfermedad renal crónica debe plantearse desde el punto de vista multidisciplinar (enfermeras, nefrólogos, psicólogos y cirujanos), destacando el papel clave de la enfermera como gestora de cuidados, por la influencia que ejerce en su educación sanitaria y en la orientación terapéutica que se proporciona desde las consultas de enfermedad renal avanzada


In Spain, organ donation has been managed over the last 30 years, more effectively than in the rest of the countries. Even so, we have not reached self-sufficiency, specifically in the case of kidney transplantation, there is still a negative balance between patients who annually enter the waiting list and organs available for transplantation. The prevalence of kidney disease in our country in 2017 was 685 donors per million population (p.m.p) theoretically 22% of these patients will be candidates for kidney transplantation, which means a need for 150 kidney transplants p.m.p. In 2017, the waiting list for kidney transplantation had 7,211 patients, 3,269 were transplanted (332 from living donor), which means 70 transplants p.m.p. The percentage increases in young recipients, since, the number of donors older than 60 years exceeds 50% of the total. There are also notable differences in the distribution of renal transplant activity from living donors by Autonomous Community. Kidney donation from living donors, aims to better meet the needs of the waiting list for transplant, reduce waiting times in general and increase the supply of an excellent therapeutic option, with better results in survival and rehabilitation for the patient, being currently a very safe option also for donors. The approach to patients with chronic kidney disease must be multidisciplinary (nurses, nephrologists, psychologists and surgeons), highlighting the key role of the nurse as manager of care, by the influence on their health education and therapeutic guidance, which it is provided from the consultations in advanced chronic kidney disease


Assuntos
Humanos , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Doadores Vivos/estatística & dados numéricos , Falência Renal Crônica/enfermagem , Obtenção de Tecidos e Órgãos/tendências , Programas Nacionais de Saúde/tendências
7.
Int J Palliat Nurs ; 25(3): 129-141, 2019 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-30892999

RESUMO

BACKGROUND:: There is limited understanding of the symptoms that older people living with cancer, chronic obstructive pulmonary disease and chronic kidney disease experience during the last year of life in Thailand, in addition to their health service preferences. AIMS:: To survey the symptom experiences and health service preferences at the end of life of older people with chronic illnesses from the perspective of bereaved carers. METHODS:: The study used a retrospective post-bereavement approach to collect quantitative data. Purposive sampling was used to select 76 bereaved relatives of older people living with chronic illnesses who had died in the previous 5 to10 months. Telephone interviews and a translated version of the Views of Informal Carers-Evaluation Services (VOICES) questionnaire were conducted. Data were analysed using the statistical package SPSS version 17. FINDINGS:: The overall quality of care received by older people living with chronic diseases during the last three months of life was described as 'good' (36%). However, in comparing the quality of care from different settings, most of the subjects (63%) thought that the quality of care at home should be rated as 'poor'. During the last twelve months, 35% of the respondents rated pain and poor appetite as the main symptoms, while 25% described experiencing 'worry' related to being at the end of life. The severity of many symptoms increased during the last three months of life; 21% of carers recommended that pain caused the most suffering to their relatives at 'all times', when compared with other symptoms of end of life. Around 21-35% reported that their relatives 'sometimes' experienced worry, low mood, breathlessness and oedema. During the last three days of life, it was reported by 97% of respondents that their relatives spent all of their time in hospital, and no respondents reported that their relatives had died at home. CONCLUSION:: The study indicates that older people living with chronic diseases in Thailand are less likely to access specialist palliative care and are more likely to have poor symptom control at the end of life. It indicates that health services may not be meeting patients' needs and that there was clearly insufficient healthcare provision at home for older people to help them to manage their symptoms such as pain and breathlessness.


Assuntos
Doença Crônica/enfermagem , Preferência do Paciente , Idoso , Doença Crônica/psicologia , Feminino , Serviços de Saúde para Idosos , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Humanos , Entrevistas como Assunto , Falência Renal Crônica/enfermagem , Falência Renal Crônica/psicologia , Masculino , Neoplasias/enfermagem , Neoplasias/psicologia , Doença Pulmonar Obstrutiva Crônica/enfermagem , Doença Pulmonar Obstrutiva Crônica/psicologia , Tailândia
8.
J Nurs Res ; 27(4): e36, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30720548

RESUMO

BACKGROUND: Nonadherence to dietary and fluid restrictions, hemodialysis (HD), and medication treatment has been shown to increase the risks of hospitalization and mortality significantly. Sociodemographic and biochemical parameters as well as psychosocial conditions such as depression and anxiety are known to affect nonadherence in HD patients. However, evidence related to the relative importance and actual impact of these factors varies among studies. PURPOSE: The aim of this study was to identify the factors that affect nonadherence to dietary and fluid restrictions, HD, and medication treatment. METHODS: This descriptive study was conducted on 274 patients who were being treated at four HD centers in Turkey. The parameters used to determine nonadherence to dialysis treatment were as follows: skipping multiple dialysis sessions during the most recent 1-month period, shortening a dialysis session by more than 10 minutes during the most recent 1-month period, and Kt/V < 1.4. The parameters used to determine nonadherence to dietary and fluid restriction were as follows: serum phosphorus level > 7.5 mg/dl, predialysis serum potassium level > 6.0 mEq/L, and interdialytic weight gain > 5.7% of body weight. The Morisky Green Levine Medication Adherence Scale was performed to determine nonadherence to medication treatment. A patient was classified as nonadherent if he or she did not adhere to one or more of these indices. The Hospital Anxiety and Depression Scale was used to identify patient risk in terms of anxiety and depression. Logistic regression was used to determine the predictors of nonadherence. RESULTS: The nonadherence rate was 39.1% for dietary and fluid restrictions, 33.6% for HD, and 20.1% for medication. The risk of nonadherence to dietary and fluid restriction was found to be 4.337 times higher in high school graduates (95% CI [1.502, 12.754], p = .007). The risk of nonadherence to HD treatment was 2.074 times higher in men (95% CI [1.213, 3.546], p = .008) and 2.591 times higher in patients with a central venous catheter (95% CI [1.171, 5.733], p = .019). Longer duration in HD resulted in 0.992 times decrease in risk of nonadherence to treatment (95% CI [0.986, 0.998], p = .005). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Educational status, being male, having a central venous catheter, and having a short HD duration were found to be risk factors for nonadherence. Nurses must consider the patient's adherence to the dietary and fluid restrictions, HD, and medication treatment at each visit.


Assuntos
Transtorno Depressivo/psicologia , Falência Renal Crônica/psicologia , Cooperação do Paciente , Diálise Renal/psicologia , Dieta , Feminino , Humanos , Falência Renal Crônica/dietoterapia , Falência Renal Crônica/enfermagem , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Psicometria , Fatores Socioeconômicos , Turquia
9.
J Contin Educ Nurs ; 50(2): 59-60, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30694333

RESUMO

The potential for harm to patients related to initiation and maintenance of continuous dialysis therapy by the bedside nurse led to the development of a novel method to educate nurses new to the skill of continuous renal replacement therapy. [J Contin Educ Nurs. 2019;50(2):59-60.].


Assuntos
Competência Clínica/normas , Educação Continuada em Enfermagem/organização & administração , Falência Renal Crônica/terapia , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/normas , Segurança do Paciente/normas , Terapia de Substituição Renal/métodos , Adulto , Currículo , Feminino , Humanos , Falência Renal Crônica/enfermagem , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto
10.
BMC Nephrol ; 20(1): 2, 2019 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606135

RESUMO

BACKGROUND: This cluster randomised controlled trial set out to investigate the feasibility and acceptability of the "Combined Diabetes and Renal Control Trial" (C-DIRECT) intervention, a nurse-led intervention based on motivational interviewing and self-management in patients with coexisting end stage renal diseases and diabetes mellitus (DM ESRD). Its efficacy to improve glycaemic control, as well as psychosocial and self-care outcomes were also evaluated as secondary outcomes. METHODS: An assessor-blinded, clustered randomised-controlled trial was conducted with 44 haemodialysis patients with DM ESRD and ≥ 8% glycated haemoglobin (HbA1c), in dialysis centres across Singapore. Patients were randomised according to dialysis shifts. 20 patients were assigned to intervention and 24 were in usual care. The C-DIRECT intervention consisted of three weekly chair-side sessions delivered by diabetes specialist nurses. Data on recruitment, randomisation, and retention, and secondary outcomes such as clinical endpoints, emotional distress, adherence, and self-management skills measures were obtained at baseline and at 12 weeks follow-up. A qualitative evaluation using interviews was conducted at the end of the trial. RESULTS: Of the 44 recruited at baseline, 42 patients were evaluated at follow-up. One patient died, and one discontinued the study due to deteriorating health. Recruitment, retention, and acceptability rates of C-DIRECT were generally satisfactory HbA1c levels decreased in both groups, but C-DIRECT had more participants with HbA1c < 8% at follow up compared to usual care. Significant improvements in role limitations due to physical health were noted for C-DIRECT whereas levels remained stable in usual care. No statistically significant differences between groups were observed for other clinical markers and other patient-reported outcomes. There were no adverse effects. CONCLUSIONS: The trial demonstrated satisfactory feasibility. A brief intervention delivered on bedside as part of routine dialysis care showed some benefits in glycaemic control and on QOL domain compared with usual care, although no effect was observed in other secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients. TRIAL REGISTRATION NUMBER: Trial registered with the International Standard Randomised Controlled Trial (ISRCTN10546597). Registered 12 September 2016 (Retrospectively registered).


Assuntos
Nefropatias Diabéticas/terapia , Falência Renal Crônica/terapia , Entrevista Motivacional , Diálise Renal , Idoso , Ansiedade/etiologia , Depressão/etiologia , Nefropatias Diabéticas/enfermagem , Nefropatias Diabéticas/psicologia , Estudos de Viabilidade , Feminino , Hemoglobina A Glicada/análise , Metas , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/enfermagem , Falência Renal Crônica/psicologia , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Psicologia , Qualidade de Vida , Autocuidado , Autogestão , Método Simples-Cego , Fatores Socioeconômicos , Resultado do Tratamento
11.
Crit Care Clin ; 35(1): 61-73, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30447781

RESUMO

Renal complications are common following heart and/or lung transplantation and lead to increased morbidity and mortality. Renal dysfunction is also associated with increased mortality for patients on the transplant wait list. Dialysis dependence is a relative contraindication for heart or lung transplantation at most centers, and such patients are often listed for a simultaneous kidney transplant. Several factors contribute to the impaired renal function in patients undergoing heart and/or lung transplantation, including the interplay between cardiopulmonary and renal hemodynamics, complex perioperative issues, and exposure to nephrotoxic medications, mainly calcineurin inhibitors.


Assuntos
Cardiopatias/cirurgia , Transplante de Coração/efeitos adversos , Falência Renal Crônica/etiologia , Falência Renal Crônica/terapia , Pneumopatias/cirurgia , Transplante de Pulmão/efeitos adversos , Diálise Renal/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Enfermagem de Cuidados Críticos/normas , Feminino , Transplante de Coração/enfermagem , Humanos , Falência Renal Crônica/enfermagem , Transplante de Pulmão/enfermagem , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Fatores de Risco
12.
J Nurs Meas ; 26(3): 566-578, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30593578

RESUMO

BACKGROUND AND PURPOSE: In order to effectively evaluate self-efficacy, a valid and reliable instrument is clearly required. This study was conducted to assess the psychometric properties of the Persian version of the Exercise Self-Efficacy Scale (ESES) in hemodialysis patients. METHODS: There were 404 patients who completed the ESES. The face, content, and construct validity were evaluated. The reliability of the scale was measured using internal consistency and construct reliability. RESULTS: Construct validity determined one factor. The total variance was calculated at 48.13%. The confirmatory factor for the goodness-of-fit indices was χ2[(27, N = 202) = 106.70]. All the indices confirmed that the final model was a good fit. The convergent and divergent validity of the scale were regarded as being acceptable. The reliability of the scale was calculated as being over 0.7. CONCLUSIONS: Considering the established acceptability of the psychometric properties of the ESES, the Persian version of the scale can be reliably used for measuring self-efficacy in hemodialysis patients.


Assuntos
Exercício , Falência Renal Crônica/psicologia , Psicometria , Autoeficácia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Humanos , Falência Renal Crônica/enfermagem , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Diálise Renal , Reprodutibilidade dos Testes , Inquéritos e Questionários
13.
Rev Lat Am Enfermagem ; 26: e3091, 2018 Nov 29.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-30517579

RESUMO

OBJECTIVE: to analyze the impact of an educational and motivational intervention for patients with a chronic kidney disease, undergoing hemodialysis treatment, on the control of fluid intake during interdialytic periods. METHOD: a quasi-experimental, non-randomized clinical trial with patients from a Nephrological Unit of the State of São Paulo. Participants were included in two groups: Control Group with 106 patients and Intervention Group with 86 patients, totaling 192 participants. The used intervention was an educational and motivational video to control liquid intake, based on the Bandura's Theory. The measure of control of water intake was the percentage of lost weight, also considered the variable outcome of the research. For the data analysis, descriptive analyses and regression analysis of the Inflated Beta Model were used. RESULTS: patients who participated in the intervention had a decrease in the pattern of weight gain in interdialytic periods, with a 3.54 times more chance of reaching the goal of 100% of weight loss when compared to participants from the control group. CONCLUSION: the educational and motivational intervention was effective in reducing the percentage of weight loss in patients undergoing hemodialysis. Brazilian Clinical Trials Registry (ReBEC) under the opinion RBR-4XYTP6.


Assuntos
Hidratação/métodos , Educação em Saúde , Falência Renal Crônica/prevenção & controle , Motivação , Água/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ingestão de Líquidos , Feminino , Humanos , Falência Renal Crônica/enfermagem , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Diálise Renal , Insuficiência Renal Crônica/complicações , Ganho de Peso , Adulto Jovem
14.
Nurs Clin North Am ; 53(4): 511-519, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30388977

RESUMO

Chronic kidney disease (CKD) is a most challenging diagnosis for patients and their health care teams. Detection is often delayed because of the insidious nature of kidney failure and symptoms experienced by patients. It is not until later in the disease progression that laboratory test values begin to display values indicative of actual renal damage. Patients are then presented with life-changing alternatives that affect their work, lifestyle, relationships, and well-being. Therapies currently used in CKD and end-stage renal disease are described depicting choices patients have in maintaining and perhaps arresting some aspects of CKD.


Assuntos
Falência Renal Crônica/terapia , Humanos , Falência Renal Crônica/enfermagem , Diálise Peritoneal , Diálise Renal
15.
Nurs Clin North Am ; 53(4): 521-529, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30388978

RESUMO

Current donor pool utilization is unable to meet the high demand for kidney transplants. Donor pool expansion using expanded-criteria donors and dual kidney transplantation are viable options. Advances in diagnosing antibody-mediated rejection and targeting immunosuppression increase long-term transplantation success. Further exploration of minimally invasive surgical techniques, kidney bioengineering, and artificial-implantable renal devices hold promise for the future.


Assuntos
Falência Renal Crônica/terapia , Transplante de Rim , Humanos , Imunossupressão , Falência Renal Crônica/enfermagem , Procedimentos Cirúrgicos Minimamente Invasivos , Procedimentos Cirúrgicos Robóticos , Doadores de Tecidos
16.
Nurs Clin North Am ; 53(4): 551-567, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30388981

RESUMO

Progressive glomerular damage can occur as a result of various etiologic factors including infections, medications, diseases, and autoimmune disorders. This article discusses the clinical management of the leading conditions associated with glomerular disease, including glomerulosclerosis, diabetic nephropathy, focal segmental glomerulosclerosis, and membranous nephropathy. Glomerular damage and disease progression may lead to end stage renal disease. Clinical management is individualized, as based on causative factors and clinical manifestations, with the overall goal of limiting glomerular damage. Collaborative and comprehensive care is imperative to improving patient outcomes.


Assuntos
Nefropatias Diabéticas/terapia , Glomerulosclerose Segmentar e Focal/terapia , Falência Renal Crônica/terapia , Nefropatias Diabéticas/enfermagem , Glomerulosclerose Segmentar e Focal/enfermagem , Humanos , Falência Renal Crônica/enfermagem
17.
Nurs Clin North Am ; 53(4): 579-588, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30388983

RESUMO

Understanding the physiology of the kidney and the pathophysiology of common complications of chronic kidney disease (CKD) is essential. The rise of CKD across the United States demands that nurses be prepared to care for these patients. Cardiovascular complications, anemia, and bone formation issues are the most common complications. Approximately 30 million people (15% of adults) are reported to have CKD. By 2020 there will be a 14.4% increase in the prevalence of CKD, and by 2030, the increase will be up by 16.7%. Nurses are integral to providing care that can slow or halt the progression of CKD.


Assuntos
Falência Renal Crônica/terapia , Anemia/complicações , Doenças Cardiovasculares/complicações , Diabetes Mellitus Tipo 2/complicações , Humanos , Hipertensão/complicações , Falência Renal Crônica/complicações , Falência Renal Crônica/enfermagem
18.
Nurs Clin North Am ; 53(4): 589-600, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30388984

RESUMO

This article provides an overview of the psychosocial issues faced by those with renal disease. The article discusses the physiologic connection between anxiety, depression, and pain-symptoms commonly seen in renal disease and other chronic illnesses. The application of integrative medicine or nonallopathic medicine and its role in the management of anxiety, depression, and pain are presented. Also presented is evidence surrounding several frequently used nonallopathic modalities appropriate for incorporation into a comprehensive management regimen for renal patients to reduce symptom burden. The article concludes with a discussion on the role of palliative care in treatment decisions for renal patients.


Assuntos
Adaptação Psicológica , Falência Renal Crônica/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/enfermagem , Transtorno Depressivo/psicologia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/enfermagem , Manejo da Dor , Cuidados Paliativos
19.
Saudi J Kidney Dis Transpl ; 29(4): 755-765, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30152410

RESUMO

There has been a rapid increase in the incidence of chronic kidney disease and those requiring renal replacement therapy. Managing these patients requires a multidisciplinary team approach. Clinical nurse specialists (CNS's) play a vital role in ensuring the highest quality care is delivered in a cost-effective manner. There is an acute shortage of CNS' in the Middle East and other developing countries. Development of the CNS's role necessitates comprehensive training programs in conjunction with multi-stakeholder acceptance. This article hereby addresses the various steps in developing such a role as facilitating nurses to work to their full professional and academic potential ensures best practice.


Assuntos
Falência Renal Crônica/enfermagem , Papel do Profissional de Enfermagem , Hospitalização , Humanos , Modelos de Enfermagem
20.
Rev Gaucha Enferm ; 38(3): e66789, 2018 Mar 12.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29538608

RESUMO

OBJECTIVE: To validate interventions and nursing activities proposed by the Nursing Interventions Classification for patients with acute renal failure or acute chronic renal disease in hemodialysis therapy with the Excess Fluid Volume and Risk for Imbalanced Fluid Volume nursing diagnoses. METHODS: Validation of content with 19 expert nurses from a university hospital. The data collection was made from September to November 2011 through instruments that contained the interventions and nursing activities in study. The data analysis considered the average of scores obtained in the validation process. RESULTS: The Fluid Management was validated as a priority intervention (mean ≥ 0.8), with eight main activities for the Excess Fluid Volume nursing diagnosis and eight for the Risk for Imbalanced Fluid Volume nursing diagnosis. CONCLUSION: The validated intervation of the Fluid Management enables the monitoring of the hydric balance and facilitates the prevention of complications, which are important activities in the nursing care of the patients in hemodialysis therapy.


Assuntos
Diálise Renal/enfermagem , Lesão Renal Aguda/enfermagem , Lesão Renal Aguda/terapia , Feminino , Unidades Hospitalares de Hemodiálise , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Falência Renal Crônica/enfermagem , Falência Renal Crônica/terapia , Masculino , Diagnóstico de Enfermagem , Diálise Renal/efeitos adversos , Especialidades de Enfermagem , Equilíbrio Hidroeletrolítico , Desequilíbrio Hidroeletrolítico/etiologia , Desequilíbrio Hidroeletrolítico/enfermagem , Desequilíbrio Hidroeletrolítico/prevenção & controle
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