Journal of renal care最新文献

{"title":"Clinical Relevance of an Online Self-Management Intervention in Haemodialysis: A Secondary Data Analysis of the ‘Connected We St@nd’ Programme","authors":"Helena Sousa,&nbsp;Oscar Ribeiro,&nbsp;Ana Bártolo,&nbsp;Mário Rodrigues,&nbsp;Elísio Costa,&nbsp;Joana Quental,&nbsp;Fernando Ribeiro,&nbsp;Constança Paúl,&nbsp;Daniela Figueiredo","doi":"10.1111/jorc.70012","DOIUrl":"https://doi.org/10.1111/jorc.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The ‘Connected We St@nd’ programme is an Internet-mediated self-management intervention that combines health education with psychosocial support, with evidenced feasibility and acceptability in haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the clinical relevance of the programme and to better understand which intervention outcomes/health-related self-report measures are most sensitive to reflect changes between pre- and post-intervention assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study followed a pre-post quasi-experimental design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Twenty-six individuals (16 people on haemodialysis and 10 family caregivers) completed the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Participants filled out a web-based assessment protocol before and after the intervention. To determine the clinical relevance of within-group pre-post changes, effect sizes, minimal clinically important differences, and reliable change indexes were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinically meaningful results were found on outcome measures with reasonable sensitivity to detect pre-post changes in the positive affect dimension of subjective well-being, purpose in life, overall quality of life, and psychological health. The latter was the variable that obtained the greatest number of respondents with reliable post-intervention improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participation in the programme led to clinically important and reliable improvements in several intervention outcomes, hinting that this evidence-informed intervention has the potential to be a valuable resource for promoting successful psychosocial adjustment among this population. Suggestions were made to fine-tune the evaluation and implementation of a large-scale trial to, in due course, encourage the integration of this technology-assisted interdisciplinary initiative into existing kidney care services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Perspectives on Using Plastic Cannula for Vascular Access in Haemodialysis: Outcomes of a National Web-Based Survey","authors":"Vicki Smith,&nbsp;Monica Schoch","doi":"10.1111/jorc.70011","DOIUrl":"https://doi.org/10.1111/jorc.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Plastic cannulae were introduced into Australia over a decade ago as a safer alternative to metal dialysis needles for arteriovenous fistula cannulation, decreasing the risk of infiltration resulting in haematoma formation, bruising, and pain for patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore the uptake and current practices for using plastic cannulae for vascular access in Australian dialysis units.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A 31-item exploratory descriptive web-based cross-sectional survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Renal clinicians who cannulate arteriovenous fistulae or arteriovenous grafts for haemodialysis in Australian haemodialysis units.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 185 clinicians responded to the questionnaire, with the majority of respondents from the Australian east coast Australia, specifically Queensland (36%, <i>n</i> = 66), New South Wales (27%, <i>n</i> = 50) and Victoria (26%, <i>n</i> = 48). Sixty-five percent of respondents were either registered nurses (47%, <i>n</i> = 88) or clinical nurse specialists (18%, <i>n</i> = 34). Of 140 participants who reported plastic cannula availability, only 62 (44%) used them personally. Plastic cannulae were mainly used with new (<i>n</i> = 55/65, 85%) and established (<i>n</i> = 56/60, 90%) vascular access, but rarely in home haemodialysis (<i>n</i> = 7/60, 11%). Plastic cannula was commonly used for the first 2 weeks with new fistula, then switched to metal needles due to high cost, however 41% (<i>n</i> = 22/54) reported that decisions on long-term cannula use was based on patient clinical needs. Training and gauge of cannula varied by state, with 16-guage the most common.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Plastic cannula use is increasing across Australia, but cost and training barriers still exist. Nevertheless, plastic cannulae remain a viable alternative to metal needles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Year Follow-Up of a Communication Intervention on Medication Adherence and Health Literacy in Kidney Transplanted Recipients—A Randomised Controlled Study","authors":"Tone K. Vidnes,&nbsp;Astrid K. Wahl,&nbsp;Marie H. Larsen,&nbsp;Käthe B. Meyer,&nbsp;Åsmund Hermansen,&nbsp;Marit H. Andersen","doi":"10.1111/jorc.70010","DOIUrl":"https://doi.org/10.1111/jorc.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with chronic conditions, including kidney transplanted recipients, are required to actively participate in their continuous care and maintain motivation to adhere consistently to treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Our study aimed to test long-term effectiveness of a new health communication intervention designed to improve on medication adherence and health literacy in kidney transplant recipients 2 years following transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A randomised controlled non-blinded study was conducted between March 2020 and August 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>One hundred and ninety-five kidney transplant recipients were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Primary outcomes were self-reported medication adherence, measured by the BAASIS questionnaire, and health literacy, measured by the Health Literacy Questionnaire. The response rate was 87% (170 of 195 patients).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study showed a significant difference between groups in favour of the intervention group for medication adherence (<i>p</i> &lt; 0.02) and two essential Health Literacy Questionnaire domains—‘navigating the health care system’ (<i>p</i> &lt; 0.02) and ‘having social support for health’ (<i>p</i> &gt; 0.03)—2 years after transplantation. Regarding health literacy, three Health Literacy Questionnaire domains showed a significant correlation with adherence: ‘having sufficient information to manage health’ (<i>p</i> &lt; 0.04), ‘having social support for health’ (<i>p</i> &lt; 0.04), and ‘ability to understand health information well enough to know what to do’ (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings in the study highlight the pivotal role of health communication in enhancing medication adherence and supporting important health literacy aspects for kidney transplant recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory Blood Pressure Monitoring During 52 Hours in Patients With Chronic Kidney Disease and Haemodialysis Treatment—An Exploratory Pilot Study","authors":"Jenny Stenberg,&nbsp;Oskar Sandberg,&nbsp;Kerstin Marttala,&nbsp;Maria K. Svensson","doi":"10.1111/jorc.70009","DOIUrl":"https://doi.org/10.1111/jorc.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hypertension in patients with haemodialysis is mainly characterised by high pre-dialysis blood pressure (BP) due to body fluid retention before dialysis, and the BP tends to decrease after dialysis due to removal of water during dialysis. Intervals between haemodialysis treatments vary and a long inter-dialytic interval dialysis is associated with increased mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine variations in BP; how ambulatory BP vary during a dialysis treatment performed after the long inter-dialytic interval, that is, the first treatment of the week, compared to dialysis after a short inter-dialytic interval, and in the interval between the two dialysis sessions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Exploratory non-interventional observational.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Eleven patients with chronic kidney disease Stage 5 treated with haemodialysis were enroled. The mean age was 69 years (range 48–87) and mean dialysis duration 65 months (range 4–128).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Ambulatory BP was recorded for 52 h including two haemodialysis treatments and one inter-dialytic interval. For statistical analyses the Wilcoxon signed ranks test was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant differences in systolic and diastolic BPs were observed between dialyses after long inter-dialytic interval and short inter-dialytic interval, respectively (systolic 122 mmHg vs. 114 mmHg, <i>p</i> = 0.012 and diastolic 62 mmHg vs. 61 mmHg, <i>p</i> = 0.036). In addition, the BP declined during the first 90 min during dialysis in both settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Measuring ambulatory BP for 52 h in patient with chronic kidney disease and haemodialysis is feasible and show that both systolic and diastolic BP differ between dialysis treatments following inter-dialytic intervals of diverse length. These findings should be replicated in larger studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study on Nurses' Caring Experiences With Individuals With Kidney Failure Receiving Haemodialysis","authors":"Edward Appiah Boateng,&nbsp;Bernice Bodua-Mango,&nbsp;Joana Kyei-Dompim,&nbsp;Philemon Adoliwine Amooba","doi":"10.1111/jorc.70006","DOIUrl":"10.1111/jorc.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kidney failure is a major health issue globally, particularly in Ghana and other low- and middle-income countries. Nurses are centrally involved in the direct care and technical operations of managing individuals with kidney failure, and they have first-hand exposure to the complexities of kidney failure management, including haemodialysis within resource-constrained settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study explored the experiences of nurses who provide care to individuals with kidney failure receiving haemodialysis in Ghana.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative exploratory descriptive approach was used. Sixteen participants were selected using purposive sampling. Data was collected through in-depth interviews and analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four main themes that reflect the experiences of nurses caring for individuals with kidney failure receiving haemodialysis in Ghana were identified, showing that nurses caring for these individuals consider their care as expensive, demanding, suboptimal and emotionally distressing for nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides valuable insights that could enhance the understanding of the meaning and significance of caring for individuals receiving haemodialysis. Improving the haemodialysis caring experiences of nurses in Ghana requires addressing issues related to cost, emotional stress and workload of nurses, and resource availability. Changes to the healthcare system are needed to enhance the experience of patients and medical professionals involved in haemodialysis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advance care planning intervention in chronic kidney care: A qualitative evaluation","authors":"Christina Egmose Frandsen RN, MSc(Nursing), PhD,&nbsp;Hans Dieperink MD, PhD,&nbsp;Bettina Trettin RN, MSc(Nursing), PhD,&nbsp;Hanne Agerskov RN, MSc(health), PhD","doi":"10.1111/jorc.70000","DOIUrl":"10.1111/jorc.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with chronic kidney disease and their families request early and continuous advance care planning. Based on user involvement, an advance care planning intervention was developed to support patients, family members and healthcare professionals (HCPs) in advance care planning conversations in a nephrology outpatient setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the experiences and perceptions of an advance care planning intervention among patients with chronic kidney disease, family members and healthcare professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An exploratory qualitative study with a phenomenological-hermeneutic approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Six patients with chronic kidney disease, four family members and four healthcare professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Semistructured interviews with patients and family members and a focus group interview with healthcare professionals were conducted. Data were analysed using Ricoeur's interpretation theory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Patients and their families were impacted in various ways when the patient received the diagnose of chronic kidney disease. The need for an advance care planning intervention was based on a range of individual needs. The intervention supported patients, their family members, and healthcare professionals through open dialogues and reflections about thoughts and concerns. Healthcare professionals' reflected that it might be too early to deliver an increased amount of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>When the disease challenged family and everyday life, the advance care planning intervention was useable and facilitated an open dialogue and reflections. The advance care planning conversations developed awareness among the patients and family members about their values, preferences, and needs, and supported them in sharing them. There is a need for training in initiating and conducting advance care planning conversations among healthcare professionals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational or Behavioural Interventions to Improve Long-Term Haemodialysis Vascular Access Self-Management: A Systematic Review","authors":"Colette Wembenyui,&nbsp;Nicole Marsh,&nbsp;Emily Larsen,&nbsp;Ann Bonner","doi":"10.1111/jorc.70005","DOIUrl":"10.1111/jorc.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Globally, haemodialysis is the most frequent type of kidney replacement therapy and necessitates access to the bloodstream either through a native arteriovenous fistula, arteriovenous graft or central venous catheter. Vascular access complications are a major cause of morbidity and mortality in adults receiving haemodialysis, and effective vascular access self-management is required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the effectiveness of educational or behavioural interventions designed to improve self-management of long-term vascular access in adults receiving haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>English language publications from January 2013 to May 2023 retrieved from PubMed, Embase, CINAHL, Cochrane Library, PsycINFO and Joanna Briggs Institute (JBI) databases were undertaken. Two independent reviewers identified studies for full-text review, data extraction and quality assessment. Data synthesis and quality assessment followed the JBI guidelines for quantitative reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven studies involving 540 participants were included: two studies were randomised control trials and five were quasiexperimental. All studies involved patient education, predominantly provided by nurses, and employed a variety of teaching resources, such as education booklets, practical demonstrations and videos. Outcomes measured included vascular access self-management behaviours, self-efficacy and vascular access knowledge although there was no consistency between studies. Overall, vascular access self-management significantly improved following education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Educational interventions led to improvements in self-management behaviours in adults with long-term haemodialysis vascular access. However, there was insufficient evidence for the delivery and duration of intervention education. Further research is needed. An evidence-based nurse-led codesign intervention could lead to improvements in vascular access self-management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-Producing Peritoneal Dialysis Nursing Sensitive Indicators for Quality Care: A Multinational Consensus Building Design","authors":"Jessica Baillie,&nbsp;Ann Bonner,&nbsp;Sonia Guillouet,&nbsp;Cornelia Mikut,&nbsp;Sally Punzalan,&nbsp;Anna Kaczmarek,&nbsp;Lawrence Climaco Wenzyl,&nbsp;Jeanette Finderup","doi":"10.1111/jorc.70008","DOIUrl":"10.1111/jorc.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nursing sensitive indicators are a way of measuring aspects of patient care that are most affected by the actions of the nurse. Despite the existence of nursing sensitive indicators, these are largely not suitable to measure peritoneal dialysis nursing practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This project aimed to co-develop a set of peritoneal dialysis nursing-sensitive indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Informed by the Donabedian quality framework (structure, process, outcome), a multinational co-production consensus design was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants and Measurements</h3>\u0000 \u0000 <p>First, an expert panel of seven professionals proposed potential indicators from clinical expertise and examining peer-reviewed articles and clinical guidelines. Next, the expert panel undertook a consensus building process involving face-to-face meetings and online discussion to refine the indicators. Lastly indicator confirmation was undertaken using a 5-point rating scale involving delegates at a major conference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The initial indicator proposal, based on evidence and clinical experience, identified 65 potential indicators (20 structural, 22 process and 23 outcome). The consensus process involved discussion and negotiation to reduce the potential indicators to 28 (eight structural, 12 process and eight outcome). Confirmation involved 25 nurses with all 28 indicators supported (all &gt; 3.5/5). Indicators highly supported were patient satisfaction, fluid balance assessment, peritoneal dialysis catheter exit-site, clinical signs measurement, peritonitis investigation, peritoneal dialysis catheter complications referral and infection rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Following further validity, reliability and feasibility testing, these nursing sensitive indicators can be used to measure the quality of peritoneal dialysis nursing care provided for patients and families.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Haemodialysis Nurses' Perceptions on Kidney Replacement Therapy Modality Education: A Framework Analysis","authors":"Elke Jaibeeh Barah,&nbsp;Jennifer Jackson","doi":"10.1111/jorc.70002","DOIUrl":"10.1111/jorc.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many people with kidney failure start and remain on in-centre haemodialysis treatment despite evidence of improved outcomes with home dialysis. To make an informed modality decision patients must receive frequent, high-quality modality education. This education is inconsistent in the in-centre haemodialysis setting, where patients spend the most time with nurses while receiving haemodialysis treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to examine in-centre haemodialysis nurses' perceptions around modality education for patients receiving in-centre haemodialysis using the COM-B model of behaviour change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We used framework analysis as a research method, applying the COM-B model as a theoretical framework to understand nurses' perceptions of modality education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>We interviewed 13 in-centre haemodialysis nurses in a single province in Canada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We completed semi-structured interviews via Zoom, which ranged from 30 to 60 min.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Participants reported knowledge deficits, lack of experience or exposure to other dialysis modalities, and lack of resources to support modality education practices. In-centre haemodialysis nurses reported some factors that enhanced modality education, including strong nurse–patient therapeutic relationships and previous experience in other dialysis modalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nurses could have a role in modality education but had different views on what this role should be. Nurses faced barriers in modality education such as knowledge deficits, a lack of experience with home modalities, and limited patient teaching resources. Factors that favoured modality education were strong nurse–patient relationships and previous experience with other modalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' Perception and Insight Into Uremic Pruritus in Patients With Chronic Kidney Disease on Dialysis: A Survey-Based Study","authors":"Maria Pia Zito,&nbsp;Cinzia Fabbri,&nbsp;Francesca Del Grosso,&nbsp;Francesco Barci,&nbsp;Giuseppe Ferraro,&nbsp;Gessica De Pascale,&nbsp;Giovanna Santapaola,&nbsp;Mara Canzi,&nbsp;Valerio Neiviller,&nbsp;Alessandro Pizzo","doi":"10.1111/jorc.70003","DOIUrl":"10.1111/jorc.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Uremic pruritus is a quite common condition among patients with chronic kidney disease. Symptom severity and patterns are variable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess how nurses in the field of nephrology perceive the issue of uremic pruritus in dialysis patients and the relevance of this condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative survey-based study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Nurses working in the field of nephrology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nurses were administered an online survey with a 10-item survey (5 on socio-demographics, 5 specific to nephrology). Responses were reported in descriptive form and response rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study involved 185 nurses working in the field of nephrology, most of which were over the age of 40, and 39% had over 20 years of experience. Most perceived that uremic pruritus has decreased over the years thanks to better dialysis methods and that it is currently independent of the type of dialysis. Fifty-two percent estimate pruritus affects half or more of patients, and 47.6% that it affects only a minority. 75% estimate moderate-to-severe uremic pruritus involves between 1 and 3 cases every 10 patients (40.5% estimating ≤3/10 patients and 34.6% ≤1/10 patients), and 25% it affects at least half of patients. 41% estimate that more than half the patients do not find relief from PU to prevent it from impairing their quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results highlight a large divergence in the perception of uremic pruritus among nurses. While this evidence the need for greater awareness on uremic pruritus, this also suggests a privileged role for nurses in detecting uremic pruritus occurrence and properly referring patients to nephrologist.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}