Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 707
Filtrar
1.
BMC Palliat Care ; 20(1): 8, 2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33422058

RESUMO

BACKGROUND: Palliative care improves the quality of lives of patients and families affected by advanced illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country. METHODS: This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants. RESULTS: Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease. CONCLUSIONS: The symptom burden experienced by patients affected by advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.


Assuntos
Infecções por HIV/fisiopatologia , Determinação de Necessidades de Cuidados de Saúde , Neoplasias/fisiopatologia , Cuidados Paliativos , Qualidade de Vida , Insuficiência Renal Crônica/fisiopatologia , Tuberculose Resistente a Múltiplos Medicamentos/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pessoal Técnico de Saúde , Butão , Cognição , Feminino , Infecções por HIV/psicologia , Infecções por HIV/terapia , Humanos , Hepatopatias Alcoólicas/fisiopatologia , Hepatopatias Alcoólicas/psicologia , Hepatopatias Alcoólicas/terapia , Pneumopatias/fisiopatologia , Pneumopatias/psicologia , Pneumopatias/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Neoplasias/terapia , Enfermeiras e Enfermeiros , Médicos , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/psicologia , Traumatismos da Medula Espinal/terapia , Doente Terminal , Tuberculose Resistente a Múltiplos Medicamentos/psicologia , Tuberculose Resistente a Múltiplos Medicamentos/terapia , Adulto Jovem
2.
Rev. enferm. UERJ ; 28: e45261, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1146354

RESUMO

Objetivo: identificar o conhecimento e o enfrentamento do diabetes junto a pessoas com diabetes em diálise. Método: estudo transversal, realizado com pacientes com diabetes tipo 2. Os instrumentos utilizados foram o Diabetes Knowledge Scale Questionnaire (DKN-A) e o Diabetes Attitude Questionnaire (ATT-19). Resultados: participaram 71 pacientes, com idade média de 61,81±14,93 anos. A retinopatia diabética foi a complicação prevalente (81,69%); hipertensão arterial sistêmica foi a comorbidade (83,09%). A glicemia em jejum apresentou mediana de 152 (124-228,5) mg/dl e a hemoglobina glicada de 7,5 (6,42-8,27) mg/dl. O DKN-A apresentou escore médio de 7,84±2,55 pontos; seu item com maior número de acertos foi a conduta em caso de hipoglicemia; enquanto o com menor número de acertos foi em relação à cetonúria e substituições alimentares. O instrumento ATT-19 obteve média de 50,26±11,7 pontos. Conclusão: pessoas com diabetes, em diálise, apresentam conhecimento deficiente em relação ao diabetes, assim como baixo enfrentamento da doença.


Objective: to identify knowledge of, and coping with, diabetes mellitus among diabetics undergoing dialysis. Method: in this cross-sectional study of patients with type 2 diabetes, the instruments used were the Diabetes Knowledge Scale Questionnaire (DKN-A) and Diabetes Attitude Questionnaire (ATT-19). Results: mean age of the 71 participants was 61.81 ± 14.93 years. The most prevalent complication was diabetic retinopathy (81.69%), and the most prevalent comorbidity was systemic arterial hypertension (83.09%). Median fasting glycemia and glycated hemoglobin were 152 (124-228.5) mg/dl and 7,5 (6,42-8,27) mg/dl, respectively. Average DKN-A score was 7.84 ± 2.55; the highest success rate was on how to respond to hypoglycemia; the lowest was about ketones in urine and substitute foods. Mean ATT-19 score was 50.26 ± 11.7. Conclusion: the diabetics in dialysis showed deficient knowledge of diabetes and had negative attitudes to the disease.


Objetivo: identificar el conocimiento y el afrontamiento de la diabetes mellitus entre los diabéticos en diálisis. Método: en este estudio transversal de pacientes con diabetes tipo 2, los instrumentos utilizados fueron el Diabetes Knowledge Scale Questionnaire (DKN-A) y Diabetes Attitude Questionnaire (ATT-19). Resultados: la edad media de los 71 participantes fue de 61,81 ± 14,93 años. La complicación más prevalente fue la retinopatía diabética (81,69%) y la comorbilidad más prevalente fue la hipertensión arterial sistémica (83,09%). La mediana de la glucemia en ayunas y la hemoglobina glucosilada fueron 152 (124- 228,5) mg / dl y 7,5 (6,42-8,27) mg / dl, respectivamente. La puntuación promedio de DKN-A fue de 7,84 ± 2,55; la tasa de éxito más alta fue sobre cómo responder a la hipoglucemia; el más bajo fue sobre las cetonas en la orina y los alimentos sustitutos. La puntuación media de ATT-19 fue 50,26 ± 11,7. Conclusión: los diabéticos en diálisis mostraban un conocimiento deficiente de la diabetes y actitudes negativas hacia la enfermedad.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adaptação Psicológica , Atitude Frente a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Diálise Peritoneal/psicologia , Diabetes Mellitus Tipo 2/psicologia , Insuficiência Renal Crônica/psicologia , Autocuidado , Fatores Socioeconômicos , Perfil de Saúde , Brasil/epidemiologia , Educação em Saúde , Estudos Transversais , Inquéritos e Questionários , Diálise Peritoneal/enfermagem , Diabetes Mellitus Tipo 2/enfermagem , Insuficiência Renal Crônica/enfermagem
3.
Health Qual Life Outcomes ; 18(1): 266, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746855

RESUMO

BACKGROUND: The prevalence of diabetes mellitus (DM) among patients with chronic kidney disease (CKD) has been increasing in recent years in China. This study aimed to evaluate the association between DM and health-related quality of life (HRQOL) in patients with CKD. METHODS: In our study, participants with CKD stage 1 to 4 from 39 centers in China were screened and enrolled. The Kidney Disease Quality of Life (KDQOL™-36) questionnaire was used to assess HRQOL. Participants were divided into a diabetic group and a non-diabetic group. Demographic data, clinical data, and HRQOL scores were compared between the two groups. Multivariable robust regression was used to analyze the factors related to HRQOL in CKD patients. RESULTS: A population of 2742 CKD patients was included in this study. CKD patients with DM were older and had lower education level, longer treatment periods and a higher prevalence of cardiovascular disease than CKD patients without DM (P < 0.05). HRQOL scores in the "symptoms and problems", "effects of kidney disease", and "SF-12 physical function" dimensions were significantly lower in the diabetic group than the non-diabetic group (86.88 ± 13.76 vs. 90.59 ± 10.75, 84.78 ± 14.86 vs. 87.28 ± 12.45, and 41.40 ± 9.77 vs. 45.40 ± 8.82, respectively, all P < 0.05). DM was negatively correlated with the symptoms and problems (regression coefficient for log transformed [175-score] = 0.010) and the SF-12 physical function dimension (regression coefficient = - 2.18) (all P < 0.05). CONCLUSION: HRQOL of diabetic patients with CKD was worse than that of non-diabetic patients with CKD. DM was an independent and negative factor affecting HRQOL in patients with CKD.


Assuntos
Diabetes Mellitus/psicologia , Qualidade de Vida , Insuficiência Renal Crônica/psicologia , Adulto , Idoso , Estudos de Casos e Controles , China/epidemiologia , Estudos de Coortes , Comorbidade , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Insuficiência Renal Crônica/epidemiologia
4.
BMC Public Health ; 20(1): 1079, 2020 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-32646400

RESUMO

BACKGROUND: Chronic kidney disease (CKD) is a common and growing health problem that requires adequate Knowledge by health care providers to reduce the progress of the disease. Thus, this study aimed to assess the care provider's Knowledge, attitude, and practices toward CKD. METHOD: A cross-sectional study conducted among 326 care providers at Jimma University Specialized hospital and three medium to higher clinics found in Jimma Town. Collected data entered into Epi-Data version 3.1 and exported to SPSS version 21 for windows for data analysis. Descriptive statistics and generalized linear modal used to analyze the data. RESULT: The mean age and service year of the participants were 29.68(±4.877) and 4.28(±4.561), respectively. The overall weighted Knowledge, attitude, and practice score of the study participant were 9.0971(8.77, 9.42), 2.53(2.4, 2.65), 10.14(9.94, 10.33) respectively. Over half of the care providers had the awareness to use eGFR to assess kidney function and patient referral to Nephrologists. Also, many care providers knew the five-stage of CKD and the risk factors of CKD, such as diabetes, long-term alcohol consumption, anemia, and cardiovascular disorders, respectively. Care providers had an understanding of late detection, and referral of CKD would increase kidney disease complications. Besides, 275(84.4%) of them are worried about treatment costs related to CKD. Over half of the care providers, 238(73.0%), believed that the Ethiopian ministry of health gave less attention to the problem. Furthermore, 234(71.8%) are interested in studying more on CKD management. Majority 256(78.5%), very likely or likely refer the patient to senior physician and Nephrologist. CONCLUSION: Care providers showed enough Knowledge, a favorable attitude, and practice toward CKD.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/psicologia , Adulto , Doenças Cardiovasculares , Comorbidade , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Universitários , Humanos , Testes de Função Renal , Masculino , Médicos/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Insuficiência Renal Crônica/terapia , Fatores de Risco
5.
Health Qual Life Outcomes ; 18(1): 207, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600360

RESUMO

BACKGROUND: Chronic kidney disease (CKD) leads to decreased quality of life (QOL) by increasing the risk of death during the progression of its pathogenesis. However, many factors can be improved to support QOL. This study aimed to assess QOL among CKD patients in Nepal and to determine the factors associated with their QOL. METHOD: A cross-sectional study was used for data collection. CKD cases receiving medical attention in the Bir Hospital in Mahaboudh, Kathmandu; Tribhuvan University Teaching Hospital in Maharajgunj, Kathmandu; Sumeru Hospital in Dhapakhel, Lalitpur; and Shahid Dharma Bhakta National Transplant Centre in Bhaktapur between August and October 2019 were invited to participate in the study. A validated questionnaire and the kidney disease quality of life short form (KDQOL-SF™ 1.3) were used to assess QOL. A questionnaire was completed by the researcher in face-to-face interviews. Logistic regression was used to detect the associations between variables at the significance level of α = 0.05. RESULTS: A total of 440 participants were recruited into the study: 56.59% were males, 74.32% were aged between 31 and 70 years, 25.68% were illiterate, and 82.95% were unemployed. The prevalence of good QOL among CKD in the domains of the physical component summary (PCS), mental component summary (MCS), and kidney disease component summary (KDCS) with and without hemodialysis were 53.64, 22.05, 21.28, and 13.19%, respectively. After controlling for all potential confounding factors, eight variables were found to be associated with good QOL in the domain of PCS: age, education, stage of CKD, hemodialysis, transporting oneself to a hospital, health insurance, medical expenses, and perceived lack of difficulty in handling medical expenses. Six variables were associated with good QOL in the domain of MCS after controlling for all potential confounding factors: residence, stage of CKD, transporting oneself to a hospital, health insurance, medical expenses, and perceived lack of difficulty in handling medical expenses. CONCLUSIONS: Public health interventions should be developed and implemented to improve QOL among CKD patients in Nepal by focusing on older female patients who have low education, live in rural areas and no health insurance.


Assuntos
Qualidade de Vida , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Adulto , Idoso , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal , Inquéritos e Questionários
6.
Niger J Clin Pract ; 23(7): 906-911, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620718

RESUMO

Background: The prevalence of chronic kidney disease (CKD) is increasing globally. Recently, the concept of Health-Related Quality of Life (HRQOL) is receiving attention as a measure of treatment outcome in addition to traditional morbidity and mortality rates. Objective: To assess the HRQOL of CKD patients stages 1-5 using the Kidney Disease Quality of Life questionnaire (KDQOL). Methodology: The study was a cross-sectional study of CKD patients at a teaching hospital in north-western Nigeria during the study period. The quality of life, sociodemographic, clinical, and laboratory variables were assessed using a pro forma and the KDQOL questionnaire during regular clinic visits/dialysis sessions. Age and sex-matched healthy volunteers without evidence of renal disease were recruited from the hospital environment into a comparison group. Results: A total of 150 subjects with CKD and 150 individuals in the comparison group completed the study with 77 males and 73 females for both groups. The mean ± standard deviation (SD) ages of the CKD and comparison group was 52.83 ± 14.21 and 52.43 ± 14.50 years, respectively. Subjects in the comparison group had higher physical composite summary (PCS) and mental composite summary (MCS) scores than individuals with CKD (P value < 0.05). Subjects with CKD showed a progressive decline in the scores of all HRQOL domains with advancing CKD stages (P value < 0.05). Conclusions: The results suggest that subjects with CKD have worse HRQOL domain scores when compared to the normal population and these scores progressively worsened with advancing CKD stages.


Assuntos
Nível de Saúde , Qualidade de Vida/psicologia , Diálise Renal , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Feminino , Voluntários Saudáveis , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Índice de Gravidade de Doença , Inquéritos e Questionários
7.
Enferm. clín. (Ed. impr.) ; 30(supl.5): 175-178, jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-196663

RESUMO

Anxiety is a psychological response that is often experienced by patients with chronic renal failure undergoing hemodialysis. The purpose of this study was to determine the effect of Dhikr therapy on anxiety levels in chronic kidney failure patients undergoing hemodialysis at RSUD Dr. Drajat Prawiranegara attack in 2019. This type of research is quasi-experimental without control, with 72 respondents selected using purposive sampling technique. The results of univariate analysis showed that in the first measurement before getting therapeutic intervention Dhikr most respondents condition that is anxious as many as 10 respondents (55.6%). After getting the Dhikr therapy intervention, the condition of the respondents' anxiety level experienced a change to a mild anxiety level of 9 (50%). The result of bivariate analysis is p value 0.000 with α<0.005, so it can be concluded that there is an effect of Dhikr therapy on the level of anxiety in patients with chronic renal failure undergoing hemodialysis at RSUD Dr. drajat prawiranegara attack in 2019. Further researchers are advised to examine the support of family relationships to the level of anxiety in patients with chronic renal failure in the hemodialysis room


No disponible


Assuntos
Humanos , Insuficiência Renal Crônica/enfermagem , Diálise Renal/métodos , Ansiedade/terapia , Terapia de Relaxamento/enfermagem , Transtornos de Ansiedade/terapia , Insuficiência Renal Crônica/psicologia , Indonésia , Inquéritos e Questionários
8.
Psicooncología (Pozuelo de Alarcón) ; 17(1): 149-164, ene.-jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-196989

RESUMO

OBJETIVOS: El objetivo de este trabajo es estudiar las propiedades psicométricas de un cuestionario multidimensional de adaptación a la enfermedad para pacientes con enfermedad renal en diálisis (CMAE-RD). MÉTODOS: Esta herramienta está diseñada para ser administrada por un profesional de la psicología en forma de entrevista semiestructurada y fue diseñado a partir de un cuestionario previo para pacientes oncohematológicos. Un total de 113 pacientes en hemodiálisis fueron entrevistados mediante el CMAE-RD y completaron dos cuestionarios adicionales con propósitos de validación: el HADS (para evaluar ansiedad y depresión) y el CDRISC-2 (para evaluar resiliencia). RESULTADOS: La consistencia interna para las áreas del CMAE-RD estuvo comprendida entre 0,53 y 0,70, y se obtuvieron evidencias de validez relacionada con un criterio externo y concurrente especialmente para las áreas que evaluaban el grado en que el paciente está informado y su estado de ánimo. CONCLUSIONES: CMAE-RD presenta niveles adecuados de fiabilidad y validez, siendo una herramienta útil desde el punto de vista clínico, pues permite evaluar las necesidades y recursos de los pacientes, guiando la intervención psicológica


OBJECTIVES: The present study aims to explore the psychometric properties of a multidimensional questionnaire to assess adaptation to illness in patients with end stage renal disease under hemodialysis (CMAE-RD for its Spanish acronym). METHODS: This instrument was developed to be administered by a psychologist as a semi structured interview and it was adapted from a previous questionnaire for patients with oncohaematologic diseases. A total of 113 patients receiving hemodialysis treatment were interviewed with the CMAE-RD and completed two additional questionnaires with validation purposes: the HADS (to assess anxiety and depression) and the CDRISC-2 (to assess resilience). RESULTS: Internal consistency scores for the areas of the CMAE-RD was comprised between.53 and.70. Evidences of validity related to an external criterion and concurrent validity were obtained for the areas which assess the level of information of the patient and their emotional state. CONCLUSIONS: We conclude that the CMAE-RD shows adequate levels of reliability and validity, being a useful measurement tool from the standpoint of health care, as it allows psychologist the needs and resources of renal patients, providing guidance for psychological intervention


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Inquéritos e Questionários , Adaptação Psicológica , Diálise Renal/psicologia , Depressão/psicologia , Ansiedade/psicologia , Fatores Socioeconômicos , Psicometria
9.
Health Qual Life Outcomes ; 18(1): 106, 2020 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-32326945

RESUMO

INTRODUCTION: The current epidemic of chronic kidney disease (CKD) in Sri Lanka is ascribed to the exponential increase in the number of CKD patients, which cannot be attributed to any known etiology (CKDu). The aim of this study is to describe the health related quality of life (HRQOL) and the associated factors among CKD/CKDu patients in a rural district in Sri Lanka. METHODS: A community based cross-sectional study included 1174 CKD/CKDu patients. Kidney Disease Quality of Life-Short Form was used to assess the HRQOL, while Centre for Epidemiologic Studies Depression Scale, General Health Questionnaire (GHQ) 12 and CKD Symptom Index - Sri Lanka were used to assess presence of depression, psychological distress and symptom burden respectively. Three summary scores; kidney disease (KDSC), physical (PCS) and mental (MCS) are derived from Kidney Disease Quality of Life-Short Form (KDQOL-SF™). RESULTS: Mean age of the study population was 58.3 years (standard deviation (SD) 10.7). Median KDSC (58.4; inter-quartile range (IQR) 54.2-63.4), was higher than the median scores of PCS (35.0; IQR 26.2-41.9) and MCS (58.4; IQR 54.2-63.4). Multiple linear regression revealed low income, advanced stages of CKD, symptom burden, being positive for depression and psychological distress were significantly associated with low HRQOL. CONCLUSION: The HRQOL of the CKD patients in this rural Sri Lankan population was found to be poor. Superior socio-economic status, less physical and psychological symptom burden were found to be independently associated with better HRQOL. Periodical screening of the CKD patients for depression and psychological distress and measures to alleviate symptom burden seem to be important to improve the HRQOL of these patients.


Assuntos
Depressão/epidemiologia , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/epidemiologia , Adulto , Idoso , Estudos Transversais , Depressão/diagnóstico , Depressão/psicologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/psicologia , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Sri Lanka/epidemiologia
10.
Health Qual Life Outcomes ; 18(1): 85, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228619

RESUMO

BACKGROUND: One-third of adults with diabetes in the United States have chronic kidney disease (CKD), and 19% of them have eye complications (ECs). However, little is known about the Health-related Quality of Life (HRQoL) of adults with both of these diabetes-related complications. Therefore, the purpose of this study is to examine differences in the HRQoL, mental health, and healthcare utilization of adults with diabetes who have CKD, ECs, both or neither. METHODS: A cross-sectional study design was implemented using data from multiple panels (2009-2015) of the Medical Expenditure Panel Survey. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. The HRQoL, mental health, and healthcare utilization of four mutually exclusive groups: 1) diabetes with both CKD and ECs; 2) diabetes with CKD only; 3) diabetes with ECs only, and 4) diabetes with neither CKD nor ECs were compared. In all analyses, adults with neither CKD nor ECs were the reference group. RESULTS: There were 8415 adults with diabetes who met the inclusion criteria. Approximately, 75% of the study sample had neither CKD nor ECs, 13.3% had ECs only, 5.7% had CKD only, and 5.5% had both CKD and ECs. In the adjusted analyses, adults with both CKD and/or ECs complications exhibited significantly lower HRQoL compared to those with neither CKD nor ECs. Mental illness and psychological distress were higher among adults with both CKD and ECs compared to those with neither CKD nor ECs. Furthermore, adults with CKD and/or ECs had higher polypharmacy, inpatient and emergency services use compared to those with neither CKD nor ECs. CONCLUSIONS: The results indicate that the presence of both CKD and/or ECs was negatively associated with poor HRQoL, poor mental health, higher psychological distress and healthcare utilization in adults with diabetes. The findings emphasize the need for routine assessment and treatment for diabetes-related CKD and/or ECs complications to improve the quality of care for individuals with diabetes.


Assuntos
Complicações do Diabetes/psicologia , Oftalmopatias/psicologia , Qualidade de Vida , Insuficiência Renal Crônica/psicologia , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Complicações do Diabetes/complicações , Oftalmopatias/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Insuficiência Renal Crônica/complicações , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
11.
Qual Life Res ; 29(7): 1817-1827, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32124263

RESUMO

PURPOSE: Chronic kidney disease (CKD) affects over 10% of the global population. Health-related quality of life (HRQoL) has been identified as a reliable indicator for assessing the effectiveness of treatment in chronic patients, and resilience as a predictor of low levels of stress and higher QoL. The aim of this research is to identify the relationship between HRQoL, resilience, perceived stress, and the different sociodemographic and clinical routine variables of advanced chronic kidney disease (ACKD). METHODS: Multicenter, cross-sectional, and correlational study with 155 ACKD patients in the Valencian Community (Spain). The measures for the study included the Kidney Disease Quality of Life 36 (KDQOL-36), the Perceived Stress Scale 10 (PSS10), and the Connors-Davidson Resilience Scale (CD-RISC). To identify the variables with predictive power over the scales and subscales of the KDQOL-36, multiple regression analyses were performed. RESULTS: Average participants' age was 67.39, 68.4% were male, 29% diabetic, and 83.2% had undergone arteriovenous vascular access placement with a Charlson Comorbidity Index of 6 (SD = 2.09). The regression models identified that age and resilience explained up to 26.8% of the variance of the KDQOL-36 total score. As for the physical component of QoL, comorbidity with other clinical conditions, resilience, and the presence of diabetes explained 32.1% of its variance. CONCLUSIONS: Resilience was identified as one of the most important predictors of HRQoL. Thus, the development of interventions aiming to improve the level of resilience may have a positive impact over the quality of life of patients with CKD.


Assuntos
Qualidade de Vida/psicologia , Diálise Renal/métodos , Insuficiência Renal Crônica/terapia , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Insuficiência Renal Crônica/psicologia , Projetos de Pesquisa
12.
Health Psychol ; 39(6): 509-518, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32202823

RESUMO

OBJECTIVE: The purpose of this study was to evaluate associations between executive functioning and caregiver adherence monitoring with objective antihypertensive medication adherence over 24 months in adolescents with chronic kidney disease (CKD). METHODS: Adolescents (N = 97, 11-20 years old) with CKD taking antihypertensive medication and their caregivers were recruited from three pediatric nephrology clinics. At baseline, adolescents and caregivers reported on adolescents' executive functioning and caregivers reported on their adherence monitoring. Antihypertensive medication adherence was objectively assessed via electronic monitoring at baseline and every 6 months after for 24 months. Associations between executive functioning, caregiver monitoring, and longitudinal adherence were evaluated with linear mixed models. RESULTS: Up to 38% of adolescents had elevated executive functioning scores indicating more severe impairments, with rates varying by scale and reporter (adolescent vs. caregiver). Caregiver monitoring showed a significant, negative association with adherence, but adolescents' executive functioning was not significantly associated with adherence. Neither variable was associated with the rate of change in adherence over time. CONCLUSIONS: Given that adolescents' executive functioning was not associated with antihypertensive medication adherence or changes in adherence over time, adherence to daily pill-form medications may involve less cognitive effort than more complex medical regimens. Higher levels of caregiver monitoring were unexpectedly associated with lower adherence levels. This unanticipated finding may reflect increased caregiver monitoring efforts when faced with adolescents' medication nonadherence, but this finding warrants further investigation. Adolescents with CKD who are nonadherent may benefit from medication adherence-promoting strategies beyond increasing caregiver monitoring. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Cuidadores/psicologia , Função Executiva/fisiologia , Adesão à Medicação/psicologia , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem
13.
Enferm. clín. (Ed. impr.) ; 30(supl.3): 10-13, mar. 2020.
Artigo em Inglês | IBECS | ID: ibc-196101

RESUMO

OBJECTIVE: The objective was to describe the experience of patients in self-managing. METHOD: Phenomenology design was used in this study. Fifhteen of families who have family member which undergoing hemodialysis were recruited as participants. In-depth interviews were conducted at April to July 2018 to explore of the experiences of family in patients' self-managing. Data were analyzed using Colaizzi. RESULT: We found four themes of patients'self-management which reported by their family. There themes were (1) having positive and negative views on life changes after undergoing hemodialysis, (2) spirit for undergoing the process of hemodialysis, (3) controlling the activity and (4) limitation of food while undergoing hemodialysis and patient's expectations during hemodialysis. CONCLUSION: Self-management of patients who receive hemodialysis includes self-management in physical form (controlling activities and food restrictions) and psychological (views on life changes and life zest)


No disponible


Assuntos
Humanos , Autocuidado/métodos , Diálise Renal/enfermagem , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/enfermagem , Insuficiência Renal Crônica/psicologia , Autocuidado/psicologia
14.
Nephrol Nurs J ; 47(1): 67-98, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083438

RESUMO

Chronic kidney disease (CKD) diagnosis is often associated with stress, depression, and major lifestyle changes. The aim of this qualitative study was to explore patients' experiences of living with CKD. A non-random purposeful sampling strategy was used to recruit 10 patients with CKD undergoing hemodialysis, from a tertiary care hospital in Crete, Greece. Semi-structured, face-to-face interviews were conducted with open-ended questions aiming to assess different aspects of their life after CKD diagnosis. Four main themes were revealed portraying participants' experience, including facing a new reality, 2) confronting changes, 3) finding ways to cope, and 4) continuing life.


Assuntos
Adaptação Psicológica , Insuficiência Renal Crônica/psicologia , Grécia , Humanos , Pesquisa Qualitativa , Diálise Renal , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia , Centros de Atenção Terciária
15.
J Relig Health ; 59(1): 277-288, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30673996

RESUMO

Spirituality is an important part of practice of the healthcare providers. Spiritual therapy is important for patients with chronic and end-stage diseases such as end-stage renal disease due to changes in physical, mental, social and spiritual needs. Promotion of spiritual well-being, self-esteem and self-efficacy is very important for these patients. The aim of this study was to determine the effectiveness of spiritual therapy on spiritual well-being, self-esteem and self-efficacy in patients on hemodialysis. The quasi-experimental research design was pre-posttest with the control group. The statistical population was the patients on hemodialysis in Governmental Hospital of Shahid Mostafa in Ilam, Iran, in 2015. Twenty-four patients were entered to the study by convenience sampling. They were divided into experimental and control groups randomly. Twelve 60-min sessions of spiritual therapy were held for the experimental group twice a week. The tools included spiritual well-being scale of Paloutzian and Ellison, Self Esteem Inventory of Cooper Smith and Self-Efficacy Scale of Sherer. Data were analyzed by SPSS software through descriptive and inferential statistics (analysis of covariance). p Values < 0.05 were considered significant. Results indicated that the scores in the experimental group changed in spiritual health from 39.32 ± 3.38 to 43.40 ± 2.82, in self-esteem from 42.65 ± 2.61 to 45.90 ± 3.88 and in self-efficacy from 40.99 ± 2.19 to 44.65 ± 2.58 which was significant compared with the control group (p = 0.01). Spiritual therapy can be used as an effective intervention to improve spiritual well-being, self-esteem and self-efficacy in patients on hemodialysis. This intervention is directed to holistic care. It can be done by interdisciplinary participation in caring and psychological teams.


Assuntos
Qualidade de Vida/psicologia , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Autoimagem , Autoeficácia , Terapias Espirituais/métodos , Espiritualidade , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/terapia , Resultado do Tratamento
16.
Clin Exp Nephrol ; 24(1): 63-72, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31544220

RESUMO

BACKGROUND: Depression is common in chronic kidney disease (CKD) patients and associated with significant increase in morbidity and mortality. In recent years, a relationship between vitamin D deficiency and depression has been shown. The aim of this study is to investigate the relationship between 25-hydroxy (OH) vitamin D and depression in hemodialysis patients. METHODS: A total of 140 patients were included in the study. Hamilton depression scale (HAM-D) was completed by all patients. 25(OH) vitamin D levels were compared between patients with and without depressive symptoms. RESULTS: Patients who had depressive symptoms had significantly lower 25(OH) vitamin D levels (13.70 [24.3-8.25] vs. 18.20 [29.2-11.7] ng/mL, p = 0.016). HAM-D score showed significant association with gender (p = 0.011) and 25(OH) vitamin D level (p = 0.011). Univariate logistic regression analysis showed that males had lower risk of depression by a ratio of 61.1% (OR 0.389, p = 0.012) and vitamin D-deficient patients had 2.88 times greater risk of depression compared to non-deficient patients (OR 2.885, p = 0.013). Multivariate logistic regression analysis showed that males had 53.7% less risk of depression (OR 0.463, p = 0.046) and vitamin D-deficient patients had 2.39 times greater risk of depression (OR 2.397, p = 0.047). When evaluated by gender, univariate logistic regression analysis showed that 25(OH) vitamin D and other variables were not associated with depression in females (p > 0.05), while only vitamin D level had a significant effect on depression in males (OR 8.207, p = 0.008). CONCLUSIONS: We found a significant association between vitamin D level and depressive symptoms in hemodialysis patients. When analyzed according to gender, this association was found to stand independent of other variables only in males.


Assuntos
Afeto , Depressão/psicologia , Diálise Renal , Insuficiência Renal Crônica/terapia , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/psicologia , Medição de Risco , Fatores de Risco , Fatores Sexuais , Resultado do Tratamento , Turquia/epidemiologia , Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/epidemiologia , Adulto Jovem
17.
J Ren Care ; 46(1): 13-24, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31621197

RESUMO

BACKGROUND: Individual responsibility and self-care are seen as ways to overcome some of the challenges for long-term health care provision. Patients are being encouraged to take an active role in their health care. Access to health information via a web-based, patient-facing portal is an innovative way to engage in self-care. PatientView is one such portal, which was developed to allow patients with kidney disease access to parts of their health record. It was thought that the use of PatientView would improve self-care activity but there was little evidence to support this claim. OBJECTIVE: To gain an understanding of how patients with kidney disease use PatientView in their self-care practice. PARTICIPANTS: Six users and four non-users of PatientView. DESIGN: Qualitative, semi-structured interviews and participant observation. APPROACH: A practice-based approach was used to collect qualitative data to better understand how patients use PatientView in daily life to enable self-care. Participants were invited to "show the researcher" how they use PatientView and to describe how they translated the information into actions of self-care. Inductive analysis was used to identify themes. RESULTS: The analysis identified four key themes, which were non-linear inter-related. Patients engage with PatientView because it supports ways of knowing that are of direct importance to self-care activity. Patients interact with PatientView and translate the information they gain from using it into actions that support self-care. A consequence of engaging with PatientView is that patients can involve their family more in their care and this helps to reduce the burden on health care professionals. CONCLUSION: Patient interactions with PatientView are inter-related, multi-dimensional and differ according to the individual's positioning within a continuum of care. Nonetheless, these interactions can be captured and doing so provides a basis for understanding of how patients create and sustain opportunities for care through information technology.


Assuntos
Aplicativos Móveis/normas , Participação do Paciente , Insuficiência Renal Crônica/psicologia , Autocuidado/psicologia , Humanos , Entrevistas como Assunto/métodos , Aplicativos Móveis/estatística & dados numéricos , Satisfação do Paciente , Pesquisa Qualitativa , Insuficiência Renal Crônica/terapia , Autocuidado/estatística & dados numéricos
18.
Nephrol Dial Transplant ; 35(7): 1211-1218, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-30541108

RESUMO

BACKGROUND: The longitudinal association between low education and chronic kidney disease (CKD) and its underlying mechanisms is poorly characterized. We therefore examined the association of low education with incident CKD and change in kidney function, and explored potential mediators of this association. METHODS: We analysed data on 6078 participants from the community-based Prevention of Renal and Vascular End-stage Disease study. Educational level was categorized into low, medium and high (< secondary, secondary/equivalent, > secondary schooling, respectively). Kidney function was assessed by estimating glomerular filtration rate (eGFR) by serum creatinine and cystatin C at five examinations during ∼11 years of follow-up. Incident CKD was defined as new-onset eGFR <60 mL/min/1.73 m2 and/or urinary albumin ≥30 mg/24 h in those free of CKD at baseline. We estimated main effects with Cox regression and linear mixed models. In exploratory causal mediation analyses, we examined mediation by several potential risk factors. RESULTS: Incident CKD was observed in 861 (17%) participants. Lower education was associated with higher rates of incident CKD [low versus high education; hazard ratio (HR) (95% CI) 1.25 (1.05-1.48), Ptrend = 0.009] and accelerated eGFR decline [B (95% CI) -0.15 (-0.21 to -0.09) mL/min/1.73 m2/year, Ptrend < 0.001]. The association between education and incident CKD was mediated by smoking, potassium excretion, body mass index (BMI), waist-to-hip ratio (WHR) and hypertension. Analysis on annual eGFR change in addition suggested mediation by magnesium excretion, protein intake and diabetes. CONCLUSIONS: In the general population, we observed an inverse association of educational level with CKD. Diabetes and the modifiable risk factors smoking, poor diet, BMI, WHR and hypertension are suggested to underlie this association. These findings provide support for targeted preventive policies to reduce socioeconomic disparities in kidney disease.


Assuntos
Escolaridade , Conhecimentos, Atitudes e Prática em Saúde , Insuficiência Renal Crônica/epidemiologia , Adulto , Índice de Massa Corporal , Feminino , Taxa de Filtração Glomerular , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/psicologia , Fatores de Risco , Relação Cintura-Quadril
19.
J Psychosom Res ; 128: 109869, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31739085

RESUMO

OBJECTIVE: Depression is the most common mental disorder in patients with chronic kidney disease (CKD), and previous studies have found that: (a) depression can accelerate the progression of CKD; and (b) depression is an independent risk factor for hospitalization and death among patients with CKD. Therefore, the objective of the current study was to investigate the prevalence of depression in Chinese patients with CKD, and to identify variables associated with depression. METHODS: The study analyzed baseline data from a multicenter prospective cohort study of Chinese patients with chronic kidney disease (the C-STRIDE study). In all, 2995 participants in CKD stages 1 to 4 who completed a survey of depressive symptoms were included in the analyses. Depressive symptoms were assessed by the Zung Self-Rating Depression Scale (ZSDS). A ZSDS ≥50 was used as the cut-off score for the presence of depressive symptoms. Multivariable logistic regression was used to identify variables associated with depression. RESULTS: The mean estimated glomerular filtration rate (eGFR) in the study sample was 51.59±29.49 ml/min/1.73 m2. The prevalence of depressive symptoms was 37.8% and increased significantly with CKD stage. Being female, a higher level of education, a low income, a larger economic impact of disease cost, comorbid cardiovascular disease, anemia, and impaired physical ability were independently associated with depressive symptoms. CONCLUSION: Our study revealed that depressive symptoms were common among patients with CKD in China. Sociodemographic variables and the clinical characteristics of disease severity were strongly associated with depressive symptoms.


Assuntos
Depressão/epidemiologia , Insuficiência Renal Crônica/complicações , Adulto , Idoso , China , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/psicologia , Fatores de Risco
20.
Am J Kidney Dis ; 75(6): 868-878, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31879215

RESUMO

RATIONALE & OBJECTIVE: Health-related quality of life (HRQoL) is a major outcome measure increasingly used in patients with chronic kidney disease (CKD). We evaluated the association between different stages of CKD and the physical and mental health domains of HRQoL. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: 2,693 outpatients with moderate (stage 3, estimated glomerular filtration rate [eGFR], 30-60mL/min/1.73m2) or advanced (stages 4-5, estimated glomerular filtration rate<30mL/min/1.73m2, not on kidney replacement therapy [KRT]) CKD under the care of a nephrologist at 1 of 40 nationally representative facilities, 1,658 patients with a functioning kidney transplant, 1,251 patients on maintenance dialysis randomly selected from the national Renal Epidemiology and Information Network registry, and 20,574 participants in the French Decennial Health Survey, representative of the general population. PREDICTOR: Severity of kidney disease (moderate CKD, advanced CKD, maintenance dialysis as KRT, and functioning kidney transplant as KRT), compared with a sample of the general population. OUTCOMES: HRQoL scores assessed using the Medical Outcomes Study 36-Item Short Form Health Survey or the Kidney Disease Quality of Life 36 scale. ANALYTICAL APPROACH: Age- and sex-standardized (to the general population) prevalence of poor or fair health status was estimated for each study kidney disease group. Analysis of variance was used to estimate adjusted differences in mean physical and mental health scores between the kidney disease subgroups and the general population. RESULTS: Mean age was 67.2±12.6 (SD) years for patients with non-KRT-requiring CKD, 69.3±17.7 years for dialysis patients, and 55.3±14.2 years for those with functioning kidney transplants; 60% were men. Age- and sex-standardized health status was perceived as fair or poor in 27% of those with moderate CKD,>40% of those with advanced CKD or receiving dialysis, 12% with a functioning transplant, and 3% of the general population sample. HRQoL physical scores (adjusted for age, sex, education, obesity, and diabetes) were significantly lower in patients in all CKD subgroups than in the general population. For patients receiving dialysis, the magnitude of the difference in physical score versus the general population exceeded 4.5 points, the minimal clinically important difference for this score in this study; for both kidney transplant recipients and patients with advanced CKD, the magnitude of the difference was close to this threshold. For mental score, only dialysis patients had a score that differed from that of the general population by more than the minimal clinically important difference. LIMITATIONS: Cross-sectional study design for each subpopulation. CONCLUSIONS: This study highlights the degree to which perceived physical health is lower in the setting of CKD than in the general population, even in the absence of kidney failure, and calls for greater attention to CKD-related quality of life.


Assuntos
Autoavaliação Diagnóstica , Transplante de Rim/psicologia , Qualidade de Vida , Insuficiência Renal Crônica , Terapia de Substituição Renal/psicologia , Estudos Transversais , Feminino , França/epidemiologia , Taxa de Filtração Glomerular , Nível de Saúde , Humanos , Transplante de Rim/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Distribuição Aleatória , Sistema de Registros , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Terapia de Substituição Renal/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...