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1.
Transplant Proc ; 51(6): 1822-1830, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31399167

RESUMO

OBJECTIVES: The aim of the study was to compare the effects of a physical activity program on daily physical activity and quality of life in kidney transplant (KTx) recipients and in patients with chronic kidney disease (CKD). MATERIALS AND METHODS: The study group consisted of 24 KTx recipients and 15 patients with stage 3 to 4 CKD. Habitual physical activity was monitored for 72 hours. Individualized structured programs of increased physical activity were prepared based on baseline physical performance. The measurements were repeated after 1 and 3 months. Participants completed the 36-item Short Form Health Survey questionnaire and an International Physical Activity Questionnaire at baseline and after 1, 2, and 3 months. RESULTS: Physical activity duration and total energy expenditure significantly increased after 3 months in both KTx recipients (from 126 ± 87 to 200 ± 132 min/d, P = .001, and from 1.73 ± 0.37 to 2.24 ± 0.59 cal/min, P < .001, respectively) and CKD patients (from 79 ± 78 to 129 ± 114 min/d, P < .001, and from 1.5 ± 0.5 to 1.92 ± 0.47 cal/min, P < .001, respectively). Short Form Health Survey total score and physical component scale score improved significantly in both groups. Mental component scale score increased significantly only in KTx patients. CONCLUSION: Increased physical activity induces similar beneficial effects on total and physical activity component of quality of life and habitual daily activity in CKD and KTx patients.


Assuntos
Terapia por Exercício/psicologia , Exercício , Transplante de Rim/reabilitação , Qualidade de Vida , Insuficiência Renal Crônica/reabilitação , Adulto , Terapia por Exercício/métodos , Feminino , Humanos , Transplante de Rim/psicologia , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/cirurgia , Inquéritos e Questionários , Transplantados/psicologia , Resultado do Tratamento
2.
Diabetes Metab Syndr ; 13(4): 2585-2591, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405680

RESUMO

BACKGROUND: Illness perceptions (IP) involve coping strategies and behavioural responses that can influence glycaemic control. Despite the importance of good glycaemic control, the majority of patients in Asia are not achieving glycaemic targets. An evaluation of IP in association with glycaemic control, medication adherence and chronic kidney disease (CKD) in Type 2 diabetes mellitus patients (T2DM) was carried out in an outpatient setting in Malaysia METHOD: A cross-sectional study was conducted using the Revised Illness Perception Questionnaire in a purposive sample of 384 T2DM patients. RESULTS: There were 55.7% females, median age was 58.2 years and median duration of diabetes was 13 years. The majority (79.4%) of patients had poor diabetes control (HbA1c ≥ 7.0%) and 39.6% of patients had low medication adherence. Patients with good glycaemic control had a higher Timeline Acute/Chronic and Emotional Representations score, hence they held the correct belief that diabetes is chronic and experienced negative emotions. Highly adherent patients had a higher Illness Coherence (χ2 = 21.385, p < 0.001) score but a lower Consequences (χ2 = 17.592, p < 0.001) and Emotional Representations (χ2 = 16.849, p < 0.001) score indicating good understanding and less negative perceptions of disease burden. Patients in a more advanced stage of CKD had a significantly higher Timeline Cyclical score (χ2 = 18.718, p = 0.001), believing that diabetes was unpredictable. CONCLUSION: Dimensions of IP have been shown to be significantly associated with the assessed variables, therefore intervention studies with education, support and counselling should be conducted in Asia with the ultimate aim of empowering patients through IP-targeted management.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Hiperglicemia/psicologia , Hipoglicemia/psicologia , Hipoglicemiantes/uso terapêutico , Adesão à Medicação/estatística & dados numéricos , Insuficiência Renal Crônica/psicologia , Idoso , Biomarcadores/análise , Estudos Transversais , Diabetes Mellitus Tipo 2/psicologia , Feminino , Seguimentos , Humanos , Hiperglicemia/epidemiologia , Hiperglicemia/prevenção & controle , Hipoglicemia/epidemiologia , Hipoglicemia/prevenção & controle , Malásia/epidemiologia , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Percepção , Prevalência , Prognóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/prevenção & controle , Inquéritos e Questionários
3.
J Natl Black Nurses Assoc ; 30(1): 21-28, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31465681

RESUMO

African-Americans have the highest rates of chronic kidney disease due to type 2 diabetes (T2DM-CKD) and of progression to end-stage renal disease. The purpose of this study was to describe African-American's perceptions of T2DM-CKD: specifically, perceptions of cause, risk, severity, self-management of T2DM-CKD before and after diagnosis, and overall effect on their lives. Informed by the Common Sense Model of Illness, a cross-sectional qualitative study using purposive sampling was conducted. Findings were that participants did not take T2DM seriously until they had CKD and they also had misperceptions about the cause of T2DM. Participants believed that a family history of diabetes meant nothing could prevent a T2DM onset. In addition, participants viewed primary care providers as not explicitly informing them of their status/risks regarding CKD. The study results identified factors among African-Americans that contribute to the T2DM-CKD progression. This may enhance primary care providers' ability to educate African-Americans, which may lead to more accurate perceptions.


Assuntos
Afro-Americanos/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Insuficiência Renal Crônica/etnologia , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/etnologia , Humanos , Pesquisa Qualitativa , Insuficiência Renal Crônica/psicologia
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.
Estud. Interdiscip. Psicol ; 10(2): 80-96, ago.2019. tab
Artigo em Português | LILACS | ID: biblio-1025745

RESUMO

O objetivo do estudo foi buscar evidências de validade baseadas na relação com variáveis externas para a Escala Baptista de Depressão Versão Hospital-Ambulatório (EBADEP-HOSP-AMB). Participaram 210 pacientes renais crônicos em hemodiálise, com idades entre 18 e 82 anos (M=53,40; DP=14,40), sendo 112 (53,3%) do sexo masculino. Foram aplicados um questionário sociodemográfico/saúde, juntamente com a EBADEP-HOSP-AMB, a Escala Hospitalar de Ansiedade e Depressão (HADS) e a Escala de Pensamentos Depressivos (EPD). As aplicações ocorreram de forma individual durante as sessões de hemodiálise. Foi verificada a relação entre os instrumentos além de possíveis diferenças de média em função das variáveis sociodemográficas. Os principais resultados indicaram correlações significativas de magnitudes moderadas a altas entre os instrumentos. Também foi observado que as mulheres e aqueles que relataram ter diagnóstico de depressão obtiveram escores mais elevados na maioria das escalas apresentando mais sintomatologia depressiva e pensamentos depressivos, bem como ansiedade (AU).


The purpose of the study was to seek validity evidence based on the relationship with external variables for the Hospital-Ambulatory Depression Baptist Scale (EBADEPHOSP-AMB). A total of 210 chronic kidney patients undergoing hemodialysis, aged 18-82 years (M=53.40, SD=14.40), 112 (53.3%) males participated. A sociodemographic/health questionnaire was applied, along with the EBADEP-HOSPAMB, the Hospital Anxiety and Depression Scale (HADS) and the Depressive Thoughts Scale (EPD). The applications occurred individually during the hemodialysis sessions. The relationship between the instruments was verified, besides possible differences of mean according to the sociodemographic variables. The main results indicated significant correlations of moderate to high magnitudes between the instruments. It was also observed that women and those who reported having a diagnosis of depression scored higher on most scales presenting more depressive symptomatology and depressive thoughts as well as anxiety (AU).


El objetivo del estudio fue buscar evidencias de validez basadas en la relación con variables externas para la Escala Baptista de Depresión Versión Hospital-Ambulatorio (EBADEP-HOSP-AMB. Participaron un total de 210 pacientes renales crónicos en hemodiálisis, con edades entre 18 y 82 años (M=53,40; DP=14,40), siendo 112 (53,3%) del sexo masculino. Se aplicó un cuestionario sociodemográfico / salud, junto con EBADEP-HOSP-AMB, la Escala Hospitalaria de Ansiedad y Depresión (HADS) y la Escala de Pensamientos Depresivos (EPD). Los cuestionarios fueron aplicados de forma individual durante las sesiones de hemodiálisis. Se verificó la relación entre los instrumentos además de posibles diferencias de promedio en función de las variables sociodemográficas. Los principales resultados indicaron correlaciones significativas de magnitudes moderadas a altas entre los instrumentos. También se observó que las mujeres y aquellos que reportaron tener diagnóstico de depresión obtuvieron puntuaciones más altas en la mayoría de las escalas presentando más sintomatología depresiva y pensamientos depresivos, así como ansiedad (AU.


Assuntos
Reprodutibilidade dos Testes , Estudos de Validação , Testes Neuropsicológicos , Depressão/diagnóstico , Insuficiência Renal Crônica/psicologia
6.
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
7.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(3): 367-372, 2019 Jun 30.
Artigo em Chinês | MEDLINE | ID: mdl-31282331

RESUMO

Objective To describe the status of hope,self-efficacy,and self-management in patients with chronic kidney disease(CKD)(stages 1-3)and to explore the interactions between these three variables.Methods Herth Hope Index,self-efficacy scale,and CKD self-management instrument were used to evaluate the patients with CKD(stages 1-3)in PUMC Hospital(n=153). Structural equation modeling was used to establish the structural equation model of hope,self-efficacy,and self-management.Results The median score of hope was 40.0(36.0,44.5),and 85.0% of patients were in higher level of hope. The median score of self-efficacy was 8.3(7.1,9.4)and the overall score of self-management was 89.0±13.4. There were no significant differences in level of hope and self-management among patients with different age,gender,marital status,educational level,course of disease,and CKD stages(all P>0.05). Age and marriage status were significantly associated with self-efficacy. Self-efficacy was significantly higher in >65 years group than in other age groups(P<0.05)and was significantly higher in married group than in single group(P<0.05).The level of hope had direct effect on self-efficacy(ß=0.67,P<0.05)and self-management(ß=0.46,P<0.05).Conclusions The levels of hope,self-efficacy,and self-management are high in patients with CKD(stages 1-3). Hope directly affects the self-efficacy and self-management of these patients.


Assuntos
Esperança , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Autoeficácia , Autogestão , Humanos
8.
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
9.
Nephrol Nurs J ; 46(3): 277-290, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31199095

RESUMO

The purpose of this study was to explore how illness perceptions, specifically intrusiveness, impact individuals with chronic kidney disease living with dialysis therapy and kidney transplants, and to determine the relationships among illness perceptions, symptoms, coping, and quality of life (QoL). Forty-two individuals on dialysis and with renal transplants completed an online survey. We found strong relationships between illness intrusiveness, symptom scores, and QoL. Illness intrusiveness was highly disruptive to one's financial situation, health, and work. Intrusiveness was also significantly related to individual symptoms, especially tiredness, feelings of well-being, and sleep. Correlations between intrusiveness and QoL were significant. Emotion-focused coping strategies were also significantly associated with intrusiveness. Health professionals can target illness perceptions, symptom burden, and coping strategies to enhance QoL.


Assuntos
Qualidade de Vida , Insuficiência Renal Crônica , Adaptação Psicológica , Humanos , Diálise Renal , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/psicologia , Inquéritos e Questionários
10.
BMC Med ; 17(1): 98, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-31109328

RESUMO

BACKGROUND: Acute kidney injury (AKI) is a recognized complication of pediatric severe malaria, but its long-term consequences are unknown. METHODS: Ugandan children with cerebral malaria (CM, n = 260) and severe malaria anemia (SMA, n = 219) or community children (CC, n = 173) between 1.5 and 12 years of age were enrolled in a prospective cohort study. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to retrospectively define AKI and chronic kidney disease (CKD). Cognitive testing was conducted using the Mullen Scales of Early Learning in children < 5 and Kaufman Assessment Battery for Children (K-ABC) second edition in children ≥ 5 years of age. RESULTS: The prevalence of AKI was 35.1%, ranging from 25.1% in SMA to 43.5% in CM. In-hospital mortality was 11.9% in AKI compared to 4.2% in children without AKI (p = 0.001), and post-discharge mortality was 4.7% in AKI compared to 1.3% in children without AKI (p = 0.030) corresponding to an all-cause adjusted hazard ratio of 2.30 (95% CI 1.21, 4.35). AKI was a risk factor for short- and long-term neurocognitive impairment. At 1 week post-discharge, the frequency of neurocognitive impairment was 37.3% in AKI compared to 13.5% in children without AKI (adjusted odds ratio (aOR) 2.31 [95% CI 1.32, 4.04]); at 1-year follow-up, it was 13.3% in AKI compared to 3.4% in children without AKI (aOR 2.48 [95% CI 1.01, 6.10]), and at 2-year follow-up, it was 13.0% in AKI compared to 3.4% in children without AKI (aOR 3.03 [95% CI 1.22, 7.58]). AKI was a risk factor for CKD at 1-year follow-up: 7.6% of children with severe malaria-associated AKI had CKD at follow-up compared to 2.8% of children without AKI (p = 0.038) corresponding to an OR of 2.81 (95% CI 1.02, 7.73). The presenting etiology of AKI was consistent with prerenal azotemia, and lactate dehydrogenase as a marker of intravascular hemolysis was an independent risk factor for AKI in CM and SMA (p < 0.0001). In CM, AKI was associated with the presence and severity of retinopathy (p < 0.05) and increased cerebrospinal fluid albumin suggestive of blood-brain barrier disruption. CONCLUSIONS: AKI is a risk factor for long-term neurocognitive impairment and CKD in pediatric severe malaria.


Assuntos
Lesão Renal Aguda/epidemiologia , Transtornos Cognitivos/epidemiologia , Malária/complicações , Malária/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Lesão Renal Aguda/complicações , Lesão Renal Aguda/psicologia , Criança , Pré-Escolar , Transtornos Cognitivos/etiologia , Estudos de Coortes , Feminino , Mortalidade Hospitalar , Humanos , Lactente , Malária/patologia , Malária/psicologia , Malária Cerebral/complicações , Malária Cerebral/epidemiologia , Masculino , Prevalência , Estudos Prospectivos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/psicologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Uganda/epidemiologia
11.
Rev Med Chil ; 147(2): 153-160, 2019 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-31095162

RESUMO

BACKGROUND: Physical activity may improve quality of life in patients with chronic kidney disease. AIM: To assess the relationship between physical activity and quality of life in patients with Chronic Kidney Disease. MATERIAL AND METHODS: The Kidney Disease Quality of Life-36 (KDQOL-36) and the International Physical Activity questionnaire were answered by 130 patients with chronic kidney disease (74 women, 80 receiving renal substitution therapy). Sociodemographic variables were recorded. RESULTS: Patients on renal substitution therapy with a time lapse since diagnosis of 0 to 6 months had higher levels of physical activity than those with longer time lapses (51.4 ± 12.5 and 34.6 ± 8.1 minutes respectively). Disease burden scores were lower among patients with renal substitution therapy. There was a direct correlation between levels of vigorous and moderate physical activity and the physical functioning dimension in the quality of life questionnaire for patients with more than 19 months of disease. The dimension general physical health was significantly associated with physical activity in women and patients with 7 to 18 months of diagnosis. The dimension disease burden was associated with physical activity in women, patients not receiving substitution therapy and those with 7 to 18 months of diagnosis. CONCLUSIONS: Moderate and vigorous physical activity is directly related to the dimensions physical functioning, the general perception of physical health and inversely related with the dimension burden of disease.


Assuntos
Exercício/psicologia , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/psicologia , Adulto , Estudos Transversais , Diagnóstico Tardio/estatística & dados numéricos , Substituição de Medicamentos/estatística & dados numéricos , Exercício/fisiologia , Feminino , Humanos , Masculino , Insuficiência Renal Crônica/terapia , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários
12.
Qual Life Res ; 28(9): 2481-2489, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31123881

RESUMO

PURPOSE: The aim of this study was to evaluate if health and oral health status of children and adolescents with different stages of CKD are associated with their health-related quality of life (HRQoL), oral health-related quality of life (OHRQoL) and socioeconomic and demographic conditions. METHODS: One hundred children and adolescents with CKD were age and gender matched to 100 individuals without CKD (mean age ± SD = 13.04 ± 2.57). Oral health was characterised by means of gingival bleeding index (GBI), plaque index (PI), the decayed, missing, and filled teeth (DMFT) index and the developmental enamel defect (DED) index. All children and adolescents answered two Peds QL® instruments (general and oral health scales). RESULTS: Comparing the mean scores of HRQoL and OHRQoL between groups, we observed that CKD group demonstrated worse perceptions when compared to non-CKD group. Multiple linear regression analysis with bootstrap estimation of variance (1000 replications) showed association between dental caries experience (p < 0.001), gingival inflammation (p < 0.001) and diagnosis of CKD (p = 0.027) with the OHRQoL and between physical and the emotional domain of HRQoL, when moderate/severe gingival inflammation and hypoplasia were present. CONCLUSION: The implementation of public policies that contemplate the early dental preventive intervention in CKD children and adolescents should occur aiming to improve their oral health, once oral manifestations can directly affect the aspects of the HRQoL and OHRQoL of these individuals.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Nível de Saúde , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/psicologia , Adolescente , Criança , Estudos Transversais , Demografia , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Feminino , Humanos , Masculino , Índice Periodontal
13.
Qual Life Res ; 28(8): 2081-2090, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30937731

RESUMO

PURPOSE: Quality-of-life is poor in end-stage kidney disease; however, the relationships between earlier stages of chronic kidney disease (CKD) and are poorly understood. This study explored longitudinal quality-of-life changes in a community-based CKD cohort and assessed associations between CKD and quality-of-life over time, and between baseline quality-of-life and CKD outcomes. METHODS: We used the Australian diabetes, obesity and lifestyle study-a nationally representative, prospective cohort with data collected at baseline, year 5 and year 12-to examine the relationships between CKD stage, quality-of-life and outcomes. Linear mixed regression, cox proportional hazards, Kaplan-Meier and competing risks analyses were used. RESULTS: Of 1112 participants with CKD and baseline quality-of-life data, the physical component summary (PCS) score was significantly lower than for the general population (p = 0.01 age and sex adjusted), while the mental component summary (MCS) score was no different (p = 0.9 age and sex adjusted). In our unadjusted mixed effects model, more advanced kidney disease was associated with lower PCS and higher MCS at baseline (p < 0.001 and p < 0.01, respectively); however, this effect was no longer significant after adjustment for demographic and clinical variables. The rate of decline in PCS over the period of follow-up was greatest for those with more advanced kidney disease (p < 0.001 in unadjusted model, p = 0.007 in adjusted model). There was no association between change in MCS over the period of follow-up and severity of kidney disease in either the unadjusted or adjusted model (p = 0.7 and p = 0.1, respectively). Lower PCS, but not MCS, was associated with increased cardiovascular and increased all-cause mortality even after adjustment for key demographic and clinical variables (p < 0.001). CONCLUSIONS: Physical, but not mental, quality-of-life is significantly impaired in CKD, and continues to decline with disease progression.


Assuntos
Nível de Saúde , Falência Renal Crônica/psicologia , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/psicologia , Adulto , Idoso , Austrália , Estudos de Coortes , Diabetes Mellitus/patologia , Progressão da Doença , Feminino , Humanos , Falência Renal Crônica/terapia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Insuficiência Renal Crônica/terapia
14.
Clin Exp Nephrol ; 23(8): 1031-1038, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31030309

RESUMO

BACKGROUND: The type of lifestyle guidance that is effective for preventing development of chronic kidney disease (CKD) is unknown. Here, we aim to investigate the effects of a participatory structured group education (SGE) program on the development of CKD in a population-based study. METHODS: We retrospectively analyzed 1060 adult special health check-up examinees with CKD. Examinees with an estimated glomerular filtration rate (eGFR) from 50 to 60 mL/min/1.73 m2 and/or proteinuria 1+ were encouraged to attend an SGE program. The SGE program included participatory small group discussions on the attendees' remaining risk factors. The primary outcome of this study was the change in eGFR per year. RESULTS: The changes in eGFR in examinees who attended the SGE program (n = 209, + 2.9 mL/min/1.73 m2 [95% confidence interval (CI) + 1.9 to + 3.9]) significantly improved compared with control (n = 383, + 1.2 mL/min/1.73 m2 [95% CI + 0.5 to + 1.9], p = 0.006). Attending an SGE program was independently and positively related to the changes in eGFR at 1 year after attendance, after adjusting for classical covariates (ß = 1.55 [95% CI 0.37-2.73], p = 0.01). Attending an SGE program was effective for the examinees with a lower eGFR compared with those with only proteinuria. CONCLUSIONS: Our SGE program showed the beneficial effects of preventing the development of CKD, independent of classical factors. The type of SGE program that is more effective for preventing development of CKD should be investigated in a long-term analysis.


Assuntos
Processos Grupais , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto/métodos , Participação do Paciente , Proteinúria/terapia , Insuficiência Renal Crônica/prevenção & controle , Comportamento de Redução do Risco , Idoso , Progressão da Doença , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/fisiopatologia , Masculino , Fatores de Proteção , Proteinúria/diagnóstico , Proteinúria/fisiopatologia , Proteinúria/psicologia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/psicologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
15.
Artigo em Inglês | MEDLINE | ID: mdl-31018581

RESUMO

Diabetes and hypertension are the two major causes of chronic kidney disease (CKD). Epidemiological studies have found poor knowledge about the CKD among the general population. Hence, this study aimed to assess the awareness of CKD among type 2 diabetes mellitus (T2DM) patients in India. Patients with confirmed T2DM were included in the study. Patients receiving dialysis or with a history of a kidney transplant were excluded. A validated questionnaire was used to assess knowledge about CKD. Demographic characteristics were presented using descriptive statistics and trends in groups were calculated using the chi-square test. Statistical analysis was performed using SAS v9.4. A total of 323 patients completed the study. The mean age of the patients was 56 ± 11.25 years, and 51.7% were female. Only 33.43% of the patients correctly identified diabetes and hypertension as risk factors for CKD, while 44.27% were aware of the kidney's function. Statistically significant associations were observed between kidney disease knowledge and education status (p = 0.004), socioeconomic status (p = 0.000), and income status (p = 0.003). No association was observed between the knowledge about CKD and age, gender, hypertension stages, CKD stages, duration of diabetes as well as hypertension and co-morbidities. Based on the results of this study, we found poor knowledge of CKD among Indian T2DM patients. The government should start a CKD awareness programme to deal with this rising co-morbid condition.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Conhecimento , Insuficiência Renal Crônica/psicologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Conscientização , Comorbidade , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Fatores de Risco , Inquéritos e Questionários
16.
Rev Bras Enferm ; 72(2): 541-551, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017220

RESUMO

OBJECTIVE: Identify and analyze existing evidence regarding the benefits of spirituality and / or religiosity in patients with Chronic Kidney Disease. METHOD: Integrative review carried out through consultation of databases: Latin American and Caribbean Literature in Health Sciences, Scientific Electronic Library Online, US National Library of Medicine and Scopus. The following descriptors were used: chronic kidney disease, spirituality and religion. Primary articles published by December 2017 were included. RESULTS: Twenty-six articles were selected, from which four thematic categories emerged: benefits as a modality of coping, perception of quality of life, mental health and improvement of renal function after transplantation. CONCLUSION: Benefits included those related to situational coping modalities, such as the strengthening of hope, social support and coping with pain; those related to mental health, such as the lower risk of suicide and fewer depressive symptoms; improvement in the perception of quality of life and in renal function after transplantation.


Assuntos
Adaptação Psicológica , Insuficiência Renal Crônica/psicologia , Espiritualidade , Adulto , Feminino , Humanos , Masculino , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/complicações
17.
J Ren Care ; 45(2): 74-82, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30938078

RESUMO

BACKGROUND: Chronic Kidney Disease (CKD) is exacerbated by depression and confers significant healthcare costs. Whilst adverse impacts may be mitigated by physical activity, many patients with CKD remain physically inactive, with this physical inactivity potentially influenced by how CKD is appraised. OBJECTIVES: The study aims to explore the relationship between physical activity, depression and illness representations in CKD. METHODS: Patients with CKD but not requiring dialysis completed the Revised Illness Perception Questionnaire (IPQ-R), Beck Depression Inventory (BDI-II) and Short-Form International Physical Activity Questionnaire (IPAQ-SF). Demographic information was obtained via medical records. Correlation and regression analyses were conducted to determine the relationship of illness representations with levels of physical activity. Moderation and mediation analyses were performed to investigate the role of depression in any relationship between illness representations and physical activity levels. RESULTS: Seventy respondents, 60 % male, with a mean age of 60 ± 16 years, took part in the study. Of illness representation dimensions, personal control was positively associated with levels of physical activity whilst timeline cyclical (a subscale of the IPQ-R relating to patient beliefs about the nature of their illness) was a significant predictor. Severity of depression was neither a moderator nor a mediator of illness representations and levels of physical activity. CONCLUSION: Facets of illness representations had significant relationships with levels of physical activity. Future research concerning the development and validation of psychological interventions based on an illness representations framework for patients with CKD not requiring dialysis is proposed. The efficacy of such interventions could be then evaluated using a randomised controlled method.


Assuntos
Depressão/complicações , Exercício/psicologia , Insuficiência Renal Crônica/psicologia , Adulto , Idoso , Atitude Frente a Saúde , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Insuficiência Renal Crônica/complicações , Inquéritos e Questionários
18.
J Am Soc Nephrol ; 30(4): 664-677, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30898870

RESUMO

BACKGROUND: Patient-reported outcome measures that are more practical and clinically useful are needed for patients with CKD. We compared a new CKD-specific quality-of-life impact scale (CKD-QOL) with currently used measures. METHODS: Patients (n=485) in different treatment groups (nondialysis stages 3-5, on dialysis, or post-transplant) completed the kidney-specific CKD-QOL and Kidney Disease Quality of Life-36 (KDQOL-36) forms and the generic SF-12 Health Survey at baseline and 3 months. New items summarizing quality of life (QOL) impact attributed to CKD across six QOL domains yielded single impact scores from a six-item static (fixed-length) form and from computerized adaptive tests (CATs) with three to six items. Validity tests compared the CKD-QOL, KDQOL-36 (Burden, Effects, and Symptoms/Problems subscales), and generic SF-12 measures across groups in four tests of clinical status and clinician assessment of change (CKD-specific tests), and number of comorbidities. ANOVA was used to test for group mean differences, variances in each measure explained by groups, and relative validity (RV) in comparison with the referent KDQOL-36 Burden subscale. RESULTS: KDQOL-36 and CKD-QOL measures generally discriminated better than generic SF-12v2 measures. The pattern of variances across CKD-specific tests comparing validity favored CKD-QOL two-fold over KDQOL-36. Two RV test results confirmed CKD-QOL improvements over the referent KDQOL scale. Results for static and CAT CKD-QOL forms were similar. SF-12 Physical and KDQOL-36 Symptoms scores worsened with increasing comorbid condition counts. CONCLUSIONS: Overall, compared with the KDQOL-36, the new approach to summarizing CKD-specific QOL impact performed better across multiple tests of validity. CAT surveys were more efficient than static surveys.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Insuficiência Renal Crônica , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Relações Interpessoais , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Diálise Renal , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Adulto Jovem
19.
BMC Health Serv Res ; 19(1): 199, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-30922299

RESUMO

BACKGROUND: Frequent hospitalizations and dependency on technology and providers place individuals with chronic kidney disease (CKD) at high risk for multiple safety events. Threats to their safety may be physical, emotional, or psychological. This study sought to explore patient safety from the perspectives and experiences of patients with CKD in acute care settings, and to describe willingness to report incidents utilizing an existing safety reporting system. METHODS: This study was conducted using a qualitative interpretive descriptive approach. Face to face interviews were conducted with 30 participants at their bedside during their current hospital admission. The majority of the participants were 50 years or older, of which 75% had a confirmed diagnosis of end stage renal disease with the remainder at stages 3 or 4 of CKD. Eighty percent of the participants were either on hemo- or peritoneal dialysis. RESULTS: Participants expected to receive safe care, to be taken care of, and to be cared for. Safety threats included: sharing a room with patients who were on precautions; lack of cleanliness; and roommates perceived to be threatening. The concepts of being taken care of and being cared for constituted the safety threats identified within the interpersonal environment. Participants felt taken care of when their physical needs are met and cared for when their psychological and emotional needs are met. There was a general lack of awareness of the presence of a safety reporting system that was to be accessible to patients and families by telephone. There was also an overall unwillingness to report perceived safety incidents, although participants did distinguish between speaking up and reporting. CONCLUSIONS: A key finding was the unwillingness to report incidents using the safety reporting system. Fear of reprisals was the most significant reporting impediment expressed. Actively inviting patients to speak up may be more effective when combined with a psychologically safe environment in order to encourage the involvement of patients in patient safety. System-wide organizational changes may be necessary to mitigate emotional and physical harm for this client population.


Assuntos
Segurança do Paciente , Satisfação do Paciente , Insuficiência Renal Crônica/terapia , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Emoções , Medo , Feminino , Hospitalização , Humanos , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/psicologia , Telefone , Adulto Jovem
20.
J Ren Care ; 45(2): 93-101, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30825408

RESUMO

BACKGROUND: Self-management of chronic kidney disease (CKD) is crucial for health outcomes. OBJECTIVES: This study was conducted to demonstrate the effect of a self-management programme based on Bandura's self-efficacy theory offered to patients receiving peritoneal dialysis (PD) on behavioural changes regarding hand-washing/mask-wearing and self-efficacy level. DESIGN: In this study, the pretest-posttest design was used without a control group. METHODS: The sample of the study consisted of 30 patients who were receiving peritoneal dialysis. At the first interview conducted with patients, patients were given a Questionnaire Form on Socio-Demographic and Disease Characteristics and the Self-efficacy Scale. Following the 6-month self-management programme; the self-efficacy scale was applied again and the effectiveness of the self-management programme was evaluated by re-asking the questions on hand-washing and mask-wearing behaviours, and the two questions on the presence of peritonitis and leucocyte abnormality. The self-management programme in question in this study was comprised of multidisciplinary team collaboration, telephone contact, clinic interviews, use of reminders, training intervention based on Bandura's self-efficacy theory and enhancement of self-efficacy. RESULTS: A statistically significant difference was found between the pre-intervention and post-intervention self-efficacy scale mean scores of patients (t: -4,396, p < .001). CONCLUSIONS: In this study, it was found that the self-management programme based on Bandura's self-efficacy theory caused a positive change in the hand-washing/ mask-wearing behaviours of patients and that it improved the self-efficacy level.


Assuntos
Fidelidade a Diretrizes/normas , Desinfecção das Mãos/normas , Equipamento de Proteção Individual/normas , Autogestão/psicologia , Adulto , Idoso , Feminino , Humanos , Masculino , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Diálise Peritoneal/instrumentação , Diálise Peritoneal/métodos , Equipamento de Proteção Individual/estatística & dados numéricos , Projetos Piloto , Avaliação de Programas e Projetos de Saúde/métodos , Psicometria/instrumentação , Psicometria/métodos , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Autoeficácia , Autogestão/métodos , Autogestão/estatística & dados numéricos , Inquéritos e Questionários
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