The relationship between illness perceptions and fluid-control adherence among Chinese hemodialysis patients: a cross-sectional study.

Fluid-control adherence was important for hemodialysis (HD) patients, and while significant correlations between treatment adherence and illness perceptions have been found, there is limited research that explored the relationship between illness perceptions and fluid-control adherence. We sought to assess illness perceptions and fluid-control adherence and to explore the relationship between them among Chinese hemodialysis patients. A cross-sectional study of 253 Chinese HD patients was conducted. We recorded sociodemographic and disease characteristics, Revised Illness Perception Questionnaire (IPQ-R) responses, Fluid Control in Hemodialysis Patients Scale (FCHPS) scores and the interdialytic weight gain (IDWG). The total FCHPS score of hemodialysis patients was of a moderate level, and 45.85% hemodialysis patients' IDWG exceeded 3.0 kg. Regression analysis revealed that sex, academic level, marital status, treatment control dimension and causal (physical) factors of illness perceptions explained 12.7% variance in the total FCHPS score. Age, normalized whole-body urea clearance (Kt/V), dry weight (DW) residual urine volume (mL/24 h) and consequence dimension of illness perceptions explained 29.0% variance in IDWG. About mediating effect analysis, positive indirect effects on IDWG were found for identity, consequences and emotional representations through the attitude dimension of FCHPS, and negative indirect effects on IDWG were found for treatment control and illness coherence through the attitude dimension of FCHPS. The results demonstrated that some sociodemographic and clinical characteristics and illness perceptions were associated with fluid-control adherence, and the patient's attitude toward fluid control is an important mediator between illness perceptions and IDWG, implying that attitude can be a focus of intervention programs based on illness perceptions to improve Chinese HD patients' fluid-control adherence.

The preventive effect of seamless nursing care on pressure ulcer and related complications in elderly inpatients.

OBJECTIVE: To study the preventive effect of seamless nursing care on pressure ulcer and related complications in elderly inpatients. METHODS: This study was performed in 132 elderly patients aged over 65 years. According to the random number table, these patients were allocated to the control group (n=66) and the experimental group (n=66). Patients in the control group received routine care, while those in the experimental group received both routine care and seamless nursing care. The number and grade of pressure ulcer during hospitalization, average length of stay, satisfaction in care, and incidence of complications during hospitalization were compared between the two groups. RESULTS: The incidence of pressure ulcer in the experimental group, which consisted of grade 1 pressure ulcer (2 cases) was significantly lower than that in the control group (P=0.001), which consisted of grade 1 pressure ulcer (9 cases) and grade 2 pressure ulcer (5 cases). The incidence of complications (wound infection and muscle aches) in the experimental group was significantly lower than that in the control group (P<0.05). Compared with the control group, the average length of stay in the experimental group was decreased (P<0.001). Satisfaction with care in the experimental group was significantly higher than that in the control group (P<0.01). CONCLUSION: Seamless nursing care contributes to the reduced number of pressure ulcer, reduced incidence of related complications, and improved satisfaction with care.