Effects of High-flux Hemodialysis With Narrative Care on Clinical Efficacy and Prognostic Quality of Life of Patients With Chronic Renal Failure.

ABSTRACT

Context Chronic renal failure (CRF) is the outcome of the continuous progression of various chronic kidney diseases. Effective treatment of a wide range of diseases may require decreasing patients' negative emotions and enhancing their disease resilience. Narrative care focuses on patients' inner awareness, feelings, and experience of a disease, stimulating positive energy in the face of it. Objective: The study intended to investigate the effects of using narrative care during high flux hemodialysis (HFHD) on clinical outcomes and prognosis of quality of life (QoL) for patients with chronic renal failure (CRF), to provide a reliable theoretical reference for future clinical treatment. Design: The research team performed a randomized controlled trial. Setting: The study took place at the Blood Purification Center at the Affiliated Hospital of Medical School at Ningbo University in Ningbo, Zhejiang, China. Participants: Participants were 78 patients with CRF who received treat with HFHD at the hospital between January 2021 and August 2022. Intervention The research team divided participants into two groups using the random number table method, with 39 participants in each group (1) and intervention group who received narrative nursing care and (2) a control group who receive the usual care. Outcome Measures: The research team (1) evaluated the clinical efficacy for both groups; (2) at baseline and postintervention, measured participants' blood creatinine (SCr) and blood urea nitrogen (BUN) using blood sampling; (3) counted adverse effects; (4) investigated participants' nursing satisfaction postintervention; (5) at baseline and postintervention, assessed psychology and QoL using the Self-Assessment Scale for Anxiety (SAS), the Self-Assessment Scale for Depression (SDS), and the General Quality of Life Inventory (GQOLI-74) scale. Results: No statistically significant differences existed between the groups in terms of efficacy or renal function postintervention (P > .05). The incidence of adverse reactions was significantly lower in the intervention group than in the control group postintervention (P = .033), and the group's nursing satisfaction was significantly higher (P = .042). In addition, participants' SAS and SDS scores decreased significantly in the intervention group postintervention (P < .05), while no change occurred for the control group (P > .05). Finally, the GQOLI-74 scores were all significantly higher in the intervention group than in the control group. Conclusions: Narrative care can effectively enhance the safety of HFHD treatment in CRF patients and reduce patients' negative emotions postintervention, which is important for improving their QoL.