{"title":"Effect of eHealth Interventions on Medication Adherence in Kidney Transplant Recipients: Meta-Analysis of Randomised Controlled Trials","authors":"Metin Tuncer, Gülsüm Zekiye Tuncer","doi":"10.1111/jorc.70015","DOIUrl":"https://doi.org/10.1111/jorc.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kidney transplant recipients must take immunosuppressive drugs for life, and medication non-adherence is a primary risk factor for graft loss and death. With the advancement of technology, electronic health applications are widely used in chronic disease management and offer the potential to improve medication adherence in kidney transplant recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This meta-analysis aims to evaluate randomised controlled trials (RCTs) that assess the effectiveness of eHealth interventions in improving medication adherence among kidney transplant recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study, which was designed as a systematic review and meta-analysis, followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols in the planning and reporting phases. Electronic databases and manual literature searches were the two main data sources. Full-text RCTs in PubMed, Medline, Web of Science and Scopus databases were systematically searched. The searches covered studies from 2014 to March 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The search yielded 524 articles. Eight RCTs with 779 participants were included in the analysis. The meta-analysis results indicated that, compared with the control group, adherence rates (RR: 1.19; 95% CI: 1.06–1.35; <i>p</i> = 0.01. Heterogeneity: <i>Q</i> = 8.69; <i>p</i> = 0.28; <i>I</i><sup>2</sup> = 19%) and adherence scores (SMD: 0.17; 95% CI: 0.05–0.29; <i>p</i> = 0.02. Heterogeneity: <i>Q</i> = 0.45; <i>p</i> = 0.93; <i>I</i><sup>2</sup> = 0%) significantly increased in the eHealth intervention group compared with the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this report show that eHealth interventions to improve medication adherence in kidney transplant recipients show favourable outcomes compared with standard care. We recommend eHealth interventions to improve long-term survival and patient outcomes in kidney transplant recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793615","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}
Karen Nagalingam, Lisa Whiting, Ken Farrington, Janet Migliozzi, Natalie Pattison
{"title":"Clinical Assessment of Fluid Status in Adults With Acute Kidney Injury: A Scoping Review","authors":"Karen Nagalingam, Lisa Whiting, Ken Farrington, Janet Migliozzi, Natalie Pattison","doi":"10.1111/jorc.70014","DOIUrl":"https://doi.org/10.1111/jorc.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute kidney injury refers to sudden, potentially reversible, reduction in kidney function. Hypovolaemia is commonly the major risk factor. When acute kidney injury is established, fluid can accumulate leading to fluid overload. Undertaking a rigorous fluid assessment is vital in the management of a patient in hospital with acute kidney injury, as insufficient or excessive fluid can lead to increased morbidity and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this scoping review is to identify which clinical assessments are useful when undertaking fluid assessment in a patient with acute kidney injury, and to identify signs and symptoms of fluid overload or dehydration in patients in hospital with acute kidney injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The JBI methodology for scoping reviews was followed and reported using the PRISMA-ScR checklist. PubMed, CINAHL Plus and SCOPUS were searched for research papers relating to the signs and symptoms or fluid assessments in patients with acute kidney injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen research papers were identified with four key areas being: Fluid balance/urine output and weight; early warning scores; clinical signs and symptoms; holistic assessment. The primary studies included in this scoping review have shown that hypovolaemia may be indicated by low blood pressure, orthostatic hypotension, low Mean Arterial Pressure, elevated heart rate, prolonged capillary refill time on the sternum (> 4.5 s) and subjectively reported cold peripheries. With clinical symptoms including dry mouth, increased thirst and dry skin. Accurate documentation of urine output and fluid balance is crucial in determining fluid status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The assessment of fluid should be holistic and include history taking, diagnosis, blood tests and associated clinical signs and symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778287","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}
Meredith Stensland, Elizabeth Sanford, Adrian Elorriaga, Martha Block, Geoffrey Block, Timothy Houle, Jacie Flaman, Donald McGeary
{"title":"Clinic-Based Animal-Assisted Intervention for Haemodialysis Patients' Treatment Adherence, Pain and Depression: An Interrupted Time Series Analysis","authors":"Meredith Stensland, Elizabeth Sanford, Adrian Elorriaga, Martha Block, Geoffrey Block, Timothy Houle, Jacie Flaman, Donald McGeary","doi":"10.1111/jorc.70013","DOIUrl":"https://doi.org/10.1111/jorc.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maintaining adherence to one's haemodialysis regimen is paramount to overall health and well-being. The purpose of this study was to evaluate the feasibility and preliminary efficacy of a clinic-based animal-assisted intervention for improving patients' treatment adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using an interrupted time series analysis, this study examined the probability of unplanned missed haemodialysis treatment not due to hospitalization upon introducing therapy dog visits into the clinic, following a 3-month lead-in phase before dog exposure. An interrupted time series model was used to estimate the odds ratio (OR) of weekly non-adherence after dog exposure relative to pre-exposure adherence. Depression, anxiety and pain were secondary outcomes and were evaluated within-subjects based on self-reported ratings before and after each dog visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the eligible clinic dialysis patients, 100% enrolled (17 of 17) and 82% (14 of 17) completed the study. The effect estimate for the reduction in probability of missing haemodialysis treatments following dog exposure phase compared to pre-exposure was OR 0.24 [95% CI: 0.09–0.62] (<i>p</i> = 0.003). Significant immediate mean reductions were also observed in self-reported pain (<i>p</i> = 0.004), depression (<i>p</i> = 0.029), anxiety (<i>p</i> = 0.019) and negative affect (<i>p</i> = 0.006).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>As the first study to evaluate therapy dog visits as a treatment adherence intervention for patients receiving haemodialysis, findings indicate this animal-assisted intervention is feasible and well accepted by patients based on high rates of study engagement and low rates of dropout. Meaningful human-animal interaction in the clinic setting may provide motivation to avoid appointment no-shows.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761904","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":"Issue Information: Journal of Renal Care 2/2025","authors":"","doi":"10.1111/jorc.12500","DOIUrl":"https://doi.org/10.1111/jorc.12500","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12500","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761905","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":"Reviewer Summary for Journal of Renal Care","authors":"","doi":"10.1111/jorc.70016","DOIUrl":"https://doi.org/10.1111/jorc.70016","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717026","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}
Helena Sousa, Oscar Ribeiro, Ana Bártolo, Mário Rodrigues, Elísio Costa, Joana Quental, Fernando Ribeiro, Constança Paúl, Daniela Figueiredo
{"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, Oscar Ribeiro, Ana Bártolo, Mário Rodrigues, Elísio Costa, Joana Quental, Fernando Ribeiro, Constança Paúl, 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, 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}
Tone K. Vidnes, Astrid K. Wahl, Marie H. Larsen, Käthe B. Meyer, Åsmund Hermansen, Marit H. Andersen
{"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, Astrid K. Wahl, Marie H. Larsen, Käthe B. Meyer, Åsmund Hermansen, 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> < 0.02) and two essential Health Literacy Questionnaire domains—‘navigating the health care system’ (<i>p</i> < 0.02) and ‘having social support for health’ (<i>p</i> > 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> < 0.04), ‘having social support for health’ (<i>p</i> < 0.04), and ‘ability to understand health information well enough to know what to do’ (<i>p</i> < 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}
Jenny Stenberg, Oskar Sandberg, Kerstin Marttala, Maria K. Svensson
{"title":"Ambulatory Blood Pressure Monitoring During 52 Hours in Patients With Chronic Kidney Disease and Haemodialysis Treatment—An Exploratory Pilot Study","authors":"Jenny Stenberg, Oskar Sandberg, Kerstin Marttala, 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}
Edward Appiah Boateng, Bernice Bodua-Mango, Joana Kyei-Dompim, Philemon Adoliwine Amooba
{"title":"A Qualitative Study on Nurses' Caring Experiences With Individuals With Kidney Failure Receiving Haemodialysis","authors":"Edward Appiah Boateng, Bernice Bodua-Mango, Joana Kyei-Dompim, 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}