Measures of treatment burden in dialysis: A scoping review

IF 1.5 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2023-09-12 DOI:10.1111/jorc.12480

Emma Caton MSc, Shivani Sharma PhD, Enric Vilar PhD, Ken Farrington MD

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Abstract

Background

Dialysis is a life-sustaining treatment for patients with advanced kidney failure, but it is extremely burdensome. Despite this, there are very few tools available to assess treatment burden within the dialysis population.

Objective

To conduct a scoping review of generic and disease-specific measures of treatment burden in chronic kidney disease, and assess their suitability for use within the dialysis population.

Design

We searched CINAHL, MEDLINE and the Cochrane Library for kidney disease-specific measures of treatment burden. Studies were initially included if they described the development, validation or use of a treatment burden measure or associated concept (e.g., measures of treatment satisfaction, quality of life, illness intrusiveness, disease burden etc.) in adult patients with chronic kidney disease. We also updated a previous scoping review exploring measures of treatment burden in chronic disease to identify generic treatment burden measures.

Results

One-hundred and two measures of treatment burden or associated concepts were identified. Four direct measures and two indirect measures of treatment burden were assessed, using adapted established criteria, for suitability for use within the dialysis population. The researchers outlined eight key dimensions of treatment burden: medication, financial, administrative, lifestyle, health care, time/travel, dialysis-specific factors, and health inequality. None of the measures adequately assessed all dimensions of treatment burden.

Conclusion

Current measures of treatment burden in dialysis are inadequate to capture the spectrum of issues that matter to patients. There is a need for dialysis-specific burdens and health inequality to be assessed when exploring treatment burden to advance patient care.

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透析治疗负担的衡量标准：范围综述。

背景：透析是维持晚期肾衰竭患者生命的一种治疗方法，但其负担极重。尽管如此，可用于评估透析人群治疗负担的工具却很少：目的：对慢性肾脏病治疗负担的通用和特定疾病测量方法进行范围界定，并评估其在透析人群中的适用性：设计：我们在 CINAHL、MEDLINE 和 Cochrane 图书馆中检索了肾脏疾病的特定治疗负担指标。如果研究描述了针对成年慢性肾病患者的治疗负担测量方法或相关概念（如治疗满意度、生活质量、疾病侵扰性、疾病负担等测量方法）的开发、验证或使用情况，则初步纳入该研究。我们还更新了之前探讨慢性病治疗负担测量方法的范围综述，以确定通用的治疗负担测量方法：结果：我们确定了一百零二种治疗负担或相关概念的测量方法。研究人员采用经过调整的既定标准，对治疗负担的四种直接测量方法和两种间接测量方法进行了评估，以确定是否适合在透析人群中使用。研究人员概述了治疗负担的八个主要方面：药物、经济、行政、生活方式、医疗保健、时间/交通、透析特定因素和健康不平等。结论：目前透析治疗负担的测量方法并不能充分评估治疗负担的所有方面：结论：目前衡量透析治疗负担的方法不足以反映患者所关心的所有问题。在探讨治疗负担以促进患者护理时，有必要对透析特定负担和健康不平等进行评估。

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来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.