Journal of renal care最新文献

{"title":"Facilitators of Peer Support Among Patients With Chronic Kidney Disease: A Systematic Review and Qualitative Meta-Synthesis","authors":"Amir Faravan,&nbsp;Mansour Ghafourifard,&nbsp;Akram Ghahramanian,&nbsp;Azad Rahmani,&nbsp;Hossein Namdar Areshtanab,&nbsp;Mostafa Ghasempour","doi":"10.1111/jorc.70085","DOIUrl":"https://doi.org/10.1111/jorc.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patient-to-patient peer support has been identified as a promising approach for the management of chronic kidney disease and has been associated with improved clinical and psychosocial outcomes. Multiple factors may influence the implementation and effectiveness of peer support programs across different healthcare settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This qualitative meta-synthesis aimed to identify the key facilitators influencing peer support among patients with chronic kidney disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and qualitative meta-synthesis were conducted. The electronic databases Web of Science, PubMed and Scopus were systematically searched to identify relevant studies. Thomas and Harden's three-stage thematic synthesis approach was used to synthesize the findings of the included qualitative studies. The methodological quality of the selected studies was assessed using the Critical Appraisal Skills Programme (CASP) tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 15 studies were included in the meta-synthesis. The analysis identified three main themes related to facilitators of peer support: (a) Cultivating a supportive culture through the healthcare system, (b) Weaving deep connections and good rapport and (c) Engaged and motivated peer supporters and recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This qualitative meta-synthesis demonstrates that successful implementation of peer support programs for people living with CKD depends on the interaction of organizational support, meaningful peer relationships and active participant engagement. These findings provide a conceptual framework that can inform the design, integration and strengthening of peer support programs within routine kidney care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099389","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 4/2026","authors":"","doi":"10.1111/jorc.70083","DOIUrl":"https://doi.org/10.1111/jorc.70083","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099621","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":"Barriers to Research and Quality Improvement in Nephrology: Nurses and Allied Health Professionals' Perspectives","authors":"Rachael C. Walker,&nbsp;Edward Zimbudzi,&nbsp;Ronald L. Castelino,&nbsp;Sangeeta Paudyal,&nbsp;Ginger Chu","doi":"10.1111/jorc.70084","DOIUrl":"10.1111/jorc.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nurses and allied health professionals play a critical role in delivering kidney care and improving outcomes for people with kidney disease. However, engagement in research remains limited, and barriers within nephrology are not well understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore perceived barriers and facilitators to research and quality initiatives engagement among nephrology nurses and allied health professionals in Australia and New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, Participants, and Methods</h3>\u0000 \u0000 <p>A mixed-methods convergent parallel study was conducted using an online survey and facilitated workshop at the Renal Society of Australasia Conference (June 2025). The Capability, Opportunity, Motivation–Behaviour (COM-B) framework guided data collection and analysis. Quantitative data were analysed descriptively, while qualitative data from focus groups were analysed using framework analysis and mapped to COM-B domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-seven survey responses and 28 workshop participants were included. Barriers related to <i>opportunity</i> (lack of time, resources, and organisational support) and <i>capability</i> (limited knowledge of research processes and low confidence with research methodologies) were identified. Despite these barriers, strong <i>motivational</i> facilitators were identified. Participants valued research as important for improving patient care and clinical practice and expressed a strong desire to be involved in future research and quality initiatives. Findings reinforced the importance of mentorship, networking, leadership support, and protected time as enablers of research engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Research engagement is influenced by interacting capability, opportunity, and motivational factors. Strategies to build research and quality improvement capacity in nephrology should address knowledge gaps, strengthen organisational support, and foster collaborative research cultures to enable sustainable clinician-led research and evidence-based kidney care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075095","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":"Editorial: Building Research Capacity and Capability in Kidney Care","authors":"Jessica Baillie","doi":"10.1111/jorc.70086","DOIUrl":"10.1111/jorc.70086","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069875","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":"Associations Among Caregiver Burden, Mindful Self-Care, and Health Perception in Informal Caregivers of Patients With Chronic Kidney Disease: A Cross-Sectional Study","authors":"Zehra Aydin,&nbsp;Kadriye Nilay Genc","doi":"10.1111/jorc.70082","DOIUrl":"10.1111/jorc.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Informal caregivers of individuals with chronic kidney disease face multidimensional demands that may adversely affect their perceived health and self-care behaviours. Clarifying the relationships among caregiver burden, health perception, and self-care is essential for developing supportive interventions in nephrology care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the relationships among caregiver burden, health perception, and mindful self-care in caregivers of patients with chronic kidney disease and to identify associated demographic and psychosocial factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A descriptive, cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The analysis included 248 informal caregivers. Eligibility criteria included providing care for at least 6 months and voluntary participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Data were collected using a Descriptive Information Form, the Zarit Caregiver Burden Scale, the Health Perception Scale, and the Mindful Self-Care Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Informal caregivers reported a moderate burden (25.65 ± 16.66), with mean health perception and mindful self-care scores of 38.79 ± 8.56 and 103.98 ± 23.82, respectively. Caregiver burden was weakly and negatively associated with mindful self-care (<i>r</i> = −0.226, <i>p</i> &lt; 0.001). Older age was associated with lower health perception (<i>r</i> = −0.194, <i>p</i> = 0.002). Higher education was positively associated with health perception (<i>β</i> = 0.353) and mindful self-care (<i>β</i> = 0.217), whereas greater caregiver burden and perceived caregiving fatigue were negatively associated with mindful self-care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Informal caregivers experienced a moderate caregiving burden. Routine caregiver assessment and targeted support should be integrated into nephrology care to promote well-being and sustain caregiving capacity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920087","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":"Acute Haemodynamic and Perceptual Responses to Graded Intradialytic Exercise in Patients on Maintenance Haemodialysis: A Randomised Crossover Trial","authors":"Montaha Hmida,&nbsp;Mohamed Amine Abouzida,&nbsp;Yasmine Bardiaa,&nbsp;Kais El Abed","doi":"10.1111/jorc.70081","DOIUrl":"10.1111/jorc.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute responses to graded intradialytic exercise in people receiving haemodialysis remain incompletely characterised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine acute haemodynamic and perceptual responses to graded intradialytic resistance exercise compared with a non-exercise control condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Randomised crossover trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Forty-eight clinically stable adults receiving maintenance haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Participants completed seated control and graded lower-limb resistance exercise targeting Borg category-ratio 10 ratings of 3, 5 and 7. Systolic and diastolic blood pressure, mean arterial pressure, heart rate, peripheral oxygen saturation, rating of perceived exertion and acute fatigue were measured before, immediately after and 30 min after each condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses increased progressively with perceived intensity. Compared with control, higher perceived intensity increased systolic blood pressure by 14.9 mmHg (95% confidence interval = 12.7–17.0), diastolic blood pressure by 8.4 mmHg (6.8–10.0), mean arterial pressure by 10.6 mmHg (9.2–12.0) and heart rate by 15.5 beats per minute (12.9–18.1). Rating of perceived exertion increased by 6.7 points (95% confidence interval = 6.3–7.1). Mean peripheral oxygen saturation remained between 95.1% and 97.5%, with no value below 90%. Recorded symptoms occurred in 13 out of 48 higher perceived-intensity sessions; no serious adverse events occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Graded, rating-guided intradialytic resistance exercise produced clear acute dose–response haemodynamic and perceptual changes. These findings support supervised individualisation of acute exercise dose but do not establish long-term safety or superiority of higher perceived-intensity training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Pan African Clinical Trial Registry: PACTR202606476360900.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900759","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":"An International Multicentre Study of Haemodialysis Patients' Knowledge of Safe Self-Disconnection From the Dialysis Machine in Emergencies","authors":"Nurten Ozen,&nbsp;Savaş Ozturk,&nbsp;Cansu Polat Dunya,&nbsp;Tomasz Hryszko,&nbsp;Filipa Fernandes,&nbsp;Stavroula Vovlianou,&nbsp;Joris I. Rotmans,&nbsp;Kristine Lindhard,&nbsp;Edwin Castillo Velarde,&nbsp;Ergun Parmaksiz,&nbsp;Damla Kaya,&nbsp;Sibel Yucel Kocak,&nbsp;Filiz Turan,&nbsp;Abdulkadir Celik,&nbsp;Ilkay Coban,&nbsp;Clemente Neves Sousa,&nbsp;Vesile Unver","doi":"10.1111/jorc.70080","DOIUrl":"10.1111/jorc.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although international guidelines recommend that patients be trained in emergency self-disconnection procedures from the dialysis machine, little is known about patients' knowledge and procedural accuracy regarding this practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the knowledge of people receiving haemodialysis and their ability to correctly identify the steps required to disconnect themselves from the dialysis machine in an emergency, safely.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This international multicentre descriptive study was conducted between September 2025 and January 2026 in 10 dialysis centres across six countries: Türkiye, Denmark, Greece, Portugal, Poland and Peru. Adult patients receiving maintenance haemodialysis for at least 3 months were eligible to participate. Data were collected using a participant information form and a self-disconnection checklist consisting of two sections evaluating preparation knowledge and procedural steps. Descriptive statistics were used to summarise the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 626 people receiving haemodialysis included in the study, 125 (20.0%) had received training on self-disconnection from the dialysis machine (Türkiye, Peru, Greece, and Denmark). Overall, 22.4% of patients reported knowing how to disconnect themselves from the dialysis machine in an emergency. According to the checklist evaluation, 40.3% of patients correctly identified the first stage of the procedure, and 38.3% correctly identified the second stage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A substantial gap exists between perceived knowledge and actual procedural competence regarding emergency self-disconnection among people receiving haemodialysis. These findings highlight the need for structured education, simulation-based training and standardised protocols to improve disaster preparedness and patient safety in dialysis units.</p>\u0000 \u0000 <p><b>ClinicalTrials.gov:</b> NCT07412834.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892034","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":"Validation and Reliability Assessment of the Indonesian Version of the Self-Care Behaviour Instrument for Haemodialysis With Arteriovenous Fistula","authors":"Firah Azzahra,&nbsp;Wahyu Hidayati,&nbsp;Sri Padma Sari,&nbsp;Fitria Handayani,&nbsp;Henni Kusuma,&nbsp;Clemente Neves Sousa","doi":"10.1111/jorc.70078","DOIUrl":"10.1111/jorc.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Arteriovenous fistula is a vascular access commonly used for long-term haemodialysis because of its durability and lower complication rate. Adequate self-care is essential, as poor self-care may lead to thrombosis, infection, and early access failure. Currently, Indonesia lacks a validated instrument to measure specific self-care behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to adapt and translate the Assessment of Self-Care Behaviours with Arteriovenous Fistula instrument into Indonesian and to evaluate its psychometric properties among patients receiving haemodialysis in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional validation study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>This study included 160 patients undergoing haemodialysis using an arteriovenous fistula.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurement</h3>\u0000 \u0000 <p>The cross-cultural adaptation process followed internationally recognised guidelines. Content validity was evaluated by experts using the Item Content Validity Index and Scale Content Validity Index. Construct validity was examined using Exploratory Factor Analysis. Reliability testing was conducted using Cronbach's <i>α</i> coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All 16 items demonstrated satisfactory content validity. The Kaiser–Meyer–Olkin value was 0.815, and Bartlett's test was significant (<i>p</i> &lt; 0.001), confirming data suitability for factor analysis. Exploratory factor analysis identified a two-factor structure explaining 55.04% of the total variance, representing management of signs and symptoms and prevention of complications. The overall scale showed excellent internal consistency (<i>α</i> = 0.902), with α values of 0.902 and 0.833 for Factors 1 and 2, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Indonesian version of the Assessment of Self-Care Behaviours with Arteriovenous Fistula scale is valid and reliable in assessing self-care behaviours among patients receiving haemodialysis with arteriovenous fistula in Indonesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880926","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":"The Impact of Educational or Behavioural Interventions on Fatigue in Adults Receiving Haemodialysis: A Systematic Review and Meta-Analysis","authors":"Qingshu Zhang,&nbsp;Tiqiong Gong,&nbsp;Yansheng Ye","doi":"10.1111/jorc.70079","DOIUrl":"10.1111/jorc.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fatigue is common and debilitating in adults undergoing haemodialysis, significantly impairing health-related quality of life. Non-pharmacological interventions such as self-management education, exercise training, and cognitive behavioural therapy have been shown to reduce fatigue in this population. However, a comprehensive quantitative synthesis of their overall effectiveness is still lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the efficacy of self-management education, exercise training, and cognitive behavioural therapy in reducing fatigue among adults receiving haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review with meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Adults receiving haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Nine databases were searched from inception to 27 January, 2026. Randomised controlled trials and quasi-experimental studies were included. Study quality was appraised using the Joanna Briggs Institute critical appraisal tools. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Meta-analyses were conducted using R (version 4.4.1), with pooled effects reported as standardised mean differences based on change scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty studies were included. Self-management education demonstrated a significant effect on fatigue (SMD = 0.98, 95% CI [0.69, 1.28], <i>p</i> &lt; 0.001, moderate certainty evidence). Exercise training also yielded a significant benefit (SMD = 0.82, 95% CI [0.44, 1.20], <i>p</i> &lt; 0.001, low certainty evidence). Cognitive behavioural therapy did not show a significant effect (SMD = 1.45, 95% CI [−0.46, 3.37], <i>p</i> = 0.137, very low certainty evidence).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Self-management education may be considered for routine clinical care, while exercise training may serve as an adjunctive strategy. The efficacy of cognitive behavioural therapy remains inconclusive. Further high-quality trials are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865567","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":"Haemodialysis Nurses' Self-Reported Cultural Competence and Responsiveness: A Cross-Sectional Survey","authors":"Sara Aryal,&nbsp;Rochelle Wynne,&nbsp;Areum Hyun,&nbsp;Paul N. Bennett,&nbsp;Melissa J. Bloomer","doi":"10.1111/jorc.70077","DOIUrl":"https://doi.org/10.1111/jorc.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>People receiving in-centre haemodialysis have distinct cultural care needs and preferences, and nurses are expected to respond to these. However, haemodialysis nurses' cultural competence and responsiveness are unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine nurses' cultural competence and responsiveness when caring for people with diverse cultural characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An online cross-sectional survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Haemodialysis nurses from Australia and New Zealand (<i>n</i> = 123), recruited through the Renal Society of Australasia and professional networks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>The 25-item Cultural Competence Assessment instrument measured cultural awareness and sensitivity, and culturally responsive behaviours. Demographic characteristics were also collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 123 complete responses, overall cultural competence was high (<i>M</i> = 5.09, SD = 0.76), particularly awareness and sensitivity (<i>M</i> = 5.76, SD = 0.53), with significantly higher scores among those who had completed cultural awareness training (<i>p</i> = 0.009). In contrast, culturally responsive behaviours were moderate (<i>M</i> = 4.53, SD = 1.23), highlighting the gap between cultural competence and responsiveness. The lowest scoring areas were documentation of patients' cultural needs (<i>M</i> = 3.88, SD = 2.02) and access to cultural learning resources (<i>M</i> = 3.02, SD = 1.75), indicating limited supports. Qualitative findings reflected practices of culture care preservation and accommodation, with themes of cultural awareness and language differences highlighting barriers related to language and resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High cultural competence does not necessarily translate into culturally responsive behaviour. Organisational supports, including guidance for documenting cultural needs, cultural assessment tools and accessible learning resources, may help strengthen culturally responsive haemodialysis care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148783920","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}