Understanding nurses' perceptions of sexual health and function in people requiring haemodialysis.

BACKGROUND: Sexual dysfunction is common for adults receiving chronic haemodialysis; however, renal nurses seldom discuss this topic with patients. OBJECTIVES: This study aimed to identify renal nurses' attitudes towards providing sexual healthcare and to determine their confidence in discussing sexual dysfunction with adults who are receiving haemodialysis. DESIGN: An online cross-sectional study. PARTICIPANTS: Renal nurses across Australia and New Zealand (n = 65) who were members of the Renal Society of Australasia provided direct care to adults receiving haemodialysis. MEASUREMENTS: Two questionnaires measuring (1) the frequency of sexual health discussions, levels of knowledge and competence, barriers to discussing sexual dysfunction and views on accountability (Van Ek survey) and (2) communication, practical knowledge, and attitude (sexual health educator for professionals scale) were used. Demographic characteristics were also collected. RESULTS: Most participants were females (60%) with postgraduate qualifications (61.4%). The average nephrology nursing experience was 13.10 ± 9.14 years. Most renal nurses identified as having positive attitudes (77.2%) about providing sexual healthcare and were confident in communicating with patients about sexual concerns (42.9%), although many nurses (64.35%) rarely did so. Less than one-half (48.6%) indicated feeling competent to discuss sexual dysfunction, and less than one-third (30%) had sufficient knowledge about sexual dysfunction. Barriers were lack of practical training (74.2%) and insufficient time (57.1%). Younger nurses (≤45 years old) and male nurses were significantly more confident in discussing sexual health matters. CONCLUSIONS: Overall, renal nurses had positive attitudes towards discussing sexual health concerns with patients however they rarely did so.

What are the qualitative experiences of people affected by kidney failure receiving haemodialysis?

BACKGROUND: People affected by kidney failure receiving haemodialysis experience complexity within their health condition unlike any other chronic illness or condition. Kidney failure impacts the individual in all areas of their life including relationships and activities of daily living. OBJECTIVE: To conduct a meta-aggregation of studies about the lived experiences of people with kidney failure receiving haemodialysis. DESIGN: Using PRISMA Guidelines, six databases (CINAHL, ClinicalTrials.gov, Cochrane Library, MEDLINE, PsycINFO, and Scopus) were comprehensively searched using keywords and subject headings from January 1990 to October 2021. Articles were assessed according to prespecified eligibility criteria. Data extraction and quality appraisal was conducted. A meta-aggregation of qualitative findings was conducted using the Joanna Briggs Institute methodology for meta-aggregation. RESULTS: Of the 9409 articles screened, 55 studies were included. This represented a total of 188 findings across 45 categories representing a range of unmet supportive care needs. The meta-aggregation identified 11 synthesised findings broadly related to psychological/emotional needs, physical needs, social needs, interpersonal/intimacy needs, patient-clinician communication needs, family related needs, health system/information needs, spiritual needs, daily living needs, practical needs and daily living needs. CONCLUSIONS: This meta-aggregation has identified that people affected by kidney failure can experience a range of unmet supportive care needs. It was evident that living with kidney failure and receiving haemodialysis impacted a person's sense of self, introduced practical needs and other complex needs which were not being addressed in existing services. This review has highlighted important implications for clinical practice and future research directions.

A scoping review of spirituality and religiosity in people who have had a kidney transplant.

AIM: To conduct a scoping review to discover what is known about the presence of spirituality and religiosity in people who have received a kidney transplant. DESIGN: Using Arksey and O'Malley's five-stage framework, a scoping review of seven key databases was performed in June 2020. The scoping review follows the PRISMA extension for scoping review process. METHODS: CINAHL, MEDLINE, Embase, OvidPsychINFO, JBI, Scopus and Cochrane databases were searched to identify original research, from which seven studies were identified with only four meeting the criteria. The search strategy focused on studies that were published between January 2000-May 2020. RESULTS: In synthesizing the available research, two key areas of interest were identified within the included studies, (1) clinical outcomes (medical adherence, renal function and transplant-related outcomes) and (2) well-being outcomes (locus of control and coping).

Nurse's practices and attitudes toward sexual health, wellbeing, and function in people receiving haemodialysis: A scoping review.

BACKGROUND: Sexual health, wellbeing, and function are important parts of a person's identity. Chronic diseases, such as kidney failure can alter, impair, and profoundly, affect sexual wellbeing and function. OBJECTIVE: To conduct a scoping review of studies about renal nurses' practice and attitudes towards sexual health, wellbeing, and function in people with kidney failure receiving haemodialysis. METHODS: Using Arksey and O'Malley's framework, seven databases were searched (CINAHL, MEDLINE, EMBASE, OvidPsycINFO, Scopus, Cochrane library, and JBI library). The search included studies published in English from January 2009 to January 2020. RESULTS: Four studies met the review criteria (two cross-sectional surveys and two qualitative). Role confusion in discussing sexual issues, lack of training, and education in addressing sexual concerns, personal, and workplace related barriers were four factors that emerged from the review of the studies. This review identified that renal nurses were uncomfortable and hesitant in initiating discussions about sexual health, wellbeing, and function with people receiving haemodialysis. CONCLUSION: Renal nurses experience role confusion about whose responsibility it is to initiate and discuss sexual concerns with patients, as well as who's role is it to conduct sexual health assessments. Work related and personal barriers impeded nurses' practice regarding sexual health, wellbeing, and function. Nurses working in renal units need knowledge and practical training about how to initiate and address sexual concerns in those affected by kidney disease.