Journal of renal care最新文献

{"title":"Advancing arteriovenous fistula needling: The role of physical exam and doppler ultrasound.","authors":"Rui Pinto, João Barros, Ricardo Ferreira, Pedro Alves, Rui Sousa, Liliana Oliveira, Lénia Pereira, Ana Luísa Correia, Ana Rita Silva, Andreia Henriques, Magda Guerra, Fernando Mata, Anabela Salgueiro, Isabel Fernandes, Rui Alves, Clemente Sousa","doi":"10.1111/jorc.12505","DOIUrl":"10.1111/jorc.12505","url":null,"abstract":"<p><strong>Background: </strong>The success of haemodialysis (HD) critically depends on the effective use of arteriovenous fistulas (AVFs). The precise needling technique is vital to minimise complications and ensure functional vascular access.</p><p><strong>Objective: </strong>This study assesses the effectiveness of a nursing consultation protocol, which integrates physical examination (PE) with Doppler Ultrasound (DUS), in preparing patients for the first AVF needling.</p><p><strong>Design/participants: </strong>A cross-sectional analysis at a Portuguese National Health Service Hospital engaged thirty new HD patients, four HD needling experienced nurses and one HD vascular access nurse. This study examines the accuracy of PE in assessing the matured AVF by the four nurses compared to a trained vascular access nurse encompassing systematic PE and DUS.</p><p><strong>Measurements: </strong>The primary data incorporated AVF characteristics derived from PE (inspection, palpation, and auscultation) and DUS findings (vein depth, diameter, and blood flow). A secondary focus was evaluating the change in nurses' perceived needling complexity following the nursing consultation.</p><p><strong>Results: </strong>The nursing consultation significantly enhanced the identification of crucial AVF features, such as accessory veins (p = 0.002), and improved the accuracy of AVF morphology assessments. This led to identifying longer needling tracks (p = 0.031) and a higher number of safe needling points (p = 0.016). Nurses reported a notable reduction in perceived complexity and potential adverse events following this method (p = 0.027).</p><p><strong>Conclusions: </strong>Integrating structured PE with DUS in a nursing consultation framework significantly improves the preparation for AVF needling. This approach enhances the efficiency and safety of AVF needling and boosts nurse confidence and patient care in HD settings.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288279","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":"Exploration of low-phosphate diet management of patients receiving renal dialysis: An interpretive description.","authors":"Kenneth M Christensen, Eithne H Bauer, Christina Prinds","doi":"10.1111/jorc.12506","DOIUrl":"10.1111/jorc.12506","url":null,"abstract":"<p><strong>Background: </strong>Patients with dialysis-dependent kidney failure and treated for hyperphosphatemia receive a combination of dietary advice, phosphate binders and prolonged dialysis. However, research focusing on the challenges patients meet in everyday life addressing diet and medication is sparse.</p><p><strong>Objective: </strong>The objective of this study is to explore the everyday challenges patients meet when following treatment for hyperphosphatemia.</p><p><strong>Design: </strong>Interpretive description was the methodological approach. Semistructured in-depth interviews were employed to study the challenges patients experienced. Data were analysed using Braun and Clarke's reflexive thematic analysis.</p><p><strong>Participants: </strong>Patients (n = 14) receiving haemodialysis and treated for hyperphosphatemia from two hospitals in Southern Denmark.</p><p><strong>Findings: </strong>The analysis resulted in one over-arching theme; separation in social gatherings and two subthemes; a new social code, and my food and their food. Participants experienced difficulty integrating diet and medication in daily life, especially at social gatherings. They felt separated from others when special menus were provided for them or struggled when choosing between high and low phosphate-containing food. A new awareness of self and others arose, especially their position among families and friends, and how they presented themselves and their social identity to others. Likewise, a new social code manifested itself, which was difficult to accept. Most participants experienced that diet and medication were accompanied by a moral responsibility of whether to accept prepared food with high phosphorus content or not, which affected commensality.</p><p><strong>Conclusion: </strong>Patients were often nonadherent to hyperphosphatemia treatment at social gatherings. Hyperphosphatemia treatment led to new social identities with new social codes, which patients found difficult to accept.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427107","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":"Understanding nurses' perceptions of sexual health and function in people requiring haemodialysis.","authors":"Amanda L Mckie, Amornrat Saito, Theresa Green, Ann Bonner","doi":"10.1111/jorc.12509","DOIUrl":"10.1111/jorc.12509","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunction is common for adults receiving chronic haemodialysis; however, renal nurses seldom discuss this topic with patients.</p><p><strong>Objectives: </strong>This study aimed to identify renal nurses' attitudes towards providing sexual healthcare and to determine their confidence in discussing sexual dysfunction with adults who are receiving haemodialysis.</p><p><strong>Design: </strong>An online cross-sectional study.</p><p><strong>Participants: </strong>Renal nurses across Australia and New Zealand (n = 65) who were members of the Renal Society of Australasia provided direct care to adults receiving haemodialysis.</p><p><strong>Measurements: </strong>Two questionnaires measuring (1) the frequency of sexual health discussions, levels of knowledge and competence, barriers to discussing sexual dysfunction and views on accountability (Van Ek survey) and (2) communication, practical knowledge, and attitude (sexual health educator for professionals scale) were used. Demographic characteristics were also collected.</p><p><strong>Results: </strong>Most participants were females (60%) with postgraduate qualifications (61.4%). The average nephrology nursing experience was 13.10 ± 9.14 years. Most renal nurses identified as having positive attitudes (77.2%) about providing sexual healthcare and were confident in communicating with patients about sexual concerns (42.9%), although many nurses (64.35%) rarely did so. Less than one-half (48.6%) indicated feeling competent to discuss sexual dysfunction, and less than one-third (30%) had sufficient knowledge about sexual dysfunction. Barriers were lack of practical training (74.2%) and insufficient time (57.1%). Younger nurses (≤45 years old) and male nurses were significantly more confident in discussing sexual health matters.</p><p><strong>Conclusions: </strong>Overall, renal nurses had positive attitudes towards discussing sexual health concerns with patients however they rarely did so.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988211","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":"Challenges in posttransplantation care for kidney transplant recipients: A qualitative study highlighting gaps in psychological, social and exercise support.","authors":"Jasmine De Beir, Stijn De Baets, Marieke Vandecruys, Marie Renier, Stefan De Smet, Amaryllis H Van Craenenbroeck, Wim Van Biesen, Evi V Nagler, Francis Verbeke, Patrick Calders, Karsten Vanden Wyngaert","doi":"10.1111/jorc.12507","DOIUrl":"10.1111/jorc.12507","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation offers meaningful health improvements compared to dialysis, yet the quality of life and life expectancy of kidney transplant recipients still lag behind those of their healthy peers. Physical inactivity and poor physical fitness are prevalent among kidney transplant recipients, affecting overall life participation.</p><p><strong>Objectives: </strong>To explore challenges hindering life participation for kidney transplant recipients and reveal facilitators and barriers to integrating rehabilitation into their daily lives.</p><p><strong>Design: </strong>An explorative study using a qualitative method.</p><p><strong>Participants: </strong>Fourteen purposively selected kidney transplant recipients.</p><p><strong>Approach: </strong>Semistructured, individual interviews were conducted posttransplantation. The following topics were covered: living with chronic kidney disease, pretransplantation challenges, posttransplantation recovery, engagement in various activities, including physical activity, and the need for supervised exercise rehabilitation programmes. Interviews were recorded and transcribed verbatim, and an inductive thematic analysis approach was used.</p><p><strong>Findings: </strong>Data saturation occurred after analysing 12 interviews, revealing two main themes: the impact on life participation and the impact on physical and mental functioning. Participants expressed the need for comprehensive posttransplant care, including mental health support, family education and guidance on returning to work. Structured support in managing physical fitness, tailored to individual preferences, was also recognised as important.</p><p><strong>Conclusions: </strong>The study underscores the necessity for a biopsychosocial approach to posttransplant care that addresses the multifaceted challenges faced by kidney transplant recipients. A multidisciplinary approach, tailored support, education and individualised exercise programmes are crucial for enhancing their overall well-being and integrating rehabilitation into their daily lives, considering both physical and psychosocial aspects.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759409","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":"Cultural and linguistic diversity is associated with increased inter-dialytic weight gain among patients on long-term haemodialysis.","authors":"Asha Blessan, Edward Zimbudzi","doi":"10.1111/jorc.12512","DOIUrl":"10.1111/jorc.12512","url":null,"abstract":"<p><strong>Background: </strong>Factors associated with suboptimal interdialytic weight gain have long been established. However, the influence of cultural and linguistic diversity on interdialytic weight gain among patients receiving haemodialysis is not well-understood.</p><p><strong>Objective: </strong>This study examined the relationship between interdialytic weight gain and cultural and linguistic diversity among patients receiving haemodialysis.</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Participants and measurements: </strong>Demographic and clinical data were collected from electronic medical records of patients receiving haemodialysis at five dialysis units. Logistic regression analysis was performed to determine factors associated with suboptimal interdialytic weight gain.</p><p><strong>Results: </strong>Two hundred and sixty-nine patients, 62% of whom were female, with mean ± age of 65.8 ± 14.8 years, were studied. Most were from culturally and linguistically diverse backgrounds (60%) and a significant number belonged to the most disadvantaged socioeconomic group. Patients from culturally and linguistically diverse backgrounds had significantly higher relative interdialytic weight gain (2.40% ± 1.45%) compared to those from nonculturally and linguistically diverse backgrounds (1.83 ± 1.09%) (mean difference: 0.57%, 95% CI: 0.25-0.90, p = 0.001). Being from culturally and linguistically diverse backgrounds was associated with increased odds of higher relative interdialytic weight gain (OR: 2.40; 95% CI: 1.38-4.17, p < 0.01).</p><p><strong>Conclusion: </strong>Among patients on maintenance haemodialysis, individuals from culturally and linguistically diverse backgrounds had higher interdialytic weight gain compared to those from nonculturally and linguistically diverse backgrounds. Future research focusing on co-developing culturally sensitive interventions to improve self-management capability of patients on maintenance haemodialysis from culturally and linguistically diverse backgrounds is needed.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391384","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":"Use of toe systolic blood pressures and toe brachial pressure indices in people receiving dialysis: A scoping review.","authors":"Rachel Carle, Peta E Tehan, Sarah Stewart, Matthew R Carroll","doi":"10.1111/jorc.12514","DOIUrl":"10.1111/jorc.12514","url":null,"abstract":"<p><strong>Introduction: </strong>Current guidelines for noninvasive lower limb vascular testing specify a preference for toe brachial pressure measurement to aid in the diagnosis of peripheral arterial disease populations with high suspicion of peripheral vessel calcification, such as those with kidney failure with replacement therapy.</p><p><strong>Objectives: </strong>The aim was to identify the current literature on toe systolic blood pressure and toe brachial pressure index for individuals with kidney failure who are receiving replacement therapy.</p><p><strong>Design: </strong>A scoping review.</p><p><strong>Methods: </strong>MEDLINE, CINAHL, AMED and SPORTDiscus were systematically searched between July 15 and July 30, 2023. The scoping review followed the Arksey and O'Malley framework, with data reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews.</p><p><strong>Results: </strong>Sixteen studies were included in the review. There was limited data examining the significance of toe systolic blood pressure and toe brachial pressure index during a dialysis session. There were differences in the normative values for toe brachial pressure index values used in the studies and limited reporting on the measurement protocols used to determine toe systolic blood pressure and toe brachial pressure index.</p><p><strong>Conclusion: </strong>The review found limited data examining the clinical utility of toe systolic blood pressure and toe brachial pressure index in populations receiving dialysis. The use of toe systolic blood pressure and toe-brachial index to identify peripheral artery disease in this population is important. However, there is limited evidence and conflicting information on measurement protocols, reliability, diagnostic accuracy, and prognostic capacity.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582879","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":"Perspectives of Chinese nephrology nurses on discussing sexual dysfunction with patients receiving haemodialysis: A qualitative study","authors":"Lei An, Kantaporn Yodchai, Waraporn Kongsuwan","doi":"10.1111/jorc.12511","DOIUrl":"https://doi.org/10.1111/jorc.12511","url":null,"abstract":"BackgroundThe study underscores the crucial yet often neglected issue of sexual dysfunction in haemodialysis patients. Despite nephrology nurses'close relationships with patients, there is a significant communication gap on this topic. In China, limited research highlights the need for further study.ObjectiveTo describe the perspectives of Chinese nephrology nurses on discussing sexual dysfunction with patients receiving haemodialysis.DesignA qualitative descriptive study.ParticipantsTen Chinese nephrology nurses from a tertiary public hospital in Guizhou province, China.ApproachSemistructured interviews were conducted using an interview guide. Qualitative content analysis approach was utilised in analysis.ResultsThere were five themes described: (1) lack of training in sexual education, as nephrology nurses described never being trained to manage patients' sexual health issues; (2) discomfort when discussing sexual topics, Chinese nephrology nurses found the topic of sexual dysfunction embarrassing and avoided discussing it; (3) sexual dysfunction viewed as a nonurgent topic, nephrology nurses prioritise physical health to aid patient survival; (4) belief in physicians as ultimate care advisors, nephrology nurses believed that doctors should handle discussions on sexually related topics; and (5) lack of a suitable environment for discussing sexual dysfunction, nephrology nurses viewed sex as a private matter, inappropriate for discussion in a public unit.ConclusionThe study identifies barriers to discussing sexual dysfunction in healthcare, including provider knowledge deficits, discomfort and lack of supportive environments. It recommends specialised training and conducive settings to improve communication in renal care. Future research should evaluate the effectiveness of these interventions.","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142184018","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 3/2024","authors":"","doi":"10.1111/jorc.12471","DOIUrl":"https://doi.org/10.1111/jorc.12471","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12471","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141980485","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":"Issue Information: Journal of Renal Care 2/2024","authors":"","doi":"10.1111/jorc.12470","DOIUrl":"https://doi.org/10.1111/jorc.12470","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141073756","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":"Mind the gap in kidney care: Translating what we know into what we do","authors":"Valerie A. Luyckx MD,&nbsp;Katherine R. Tuttle MD,&nbsp;Dina Abdellatif MD,&nbsp;Ricardo Correa-Rotter MD,&nbsp;Winston W. S. Fung MD,&nbsp;Agnès Haris MD,&nbsp;Li-Li Hsiao MD,&nbsp;Makram Khalife MSc,&nbsp;Latha A. Kumaraswami BA,&nbsp;Fiona Loud BA,&nbsp;Vasundhara Raghavan BA,&nbsp;Stefanos Roumeliotis MD,&nbsp;Marianella Sierra BA,&nbsp;Ifeoma Ulasi MD,&nbsp;Bill Wang BA,&nbsp;Siu-Fai Lui MD,&nbsp;Vassilios Liakopoulos MD,&nbsp;Alessandro Balducci MD,&nbsp;for the World Kidney Day Joint Steering Committee","doi":"10.1111/jorc.12495","DOIUrl":"10.1111/jorc.12495","url":null,"abstract":"<p>Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071350","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}