Maria Pia Zito, Cinzia Fabbri, Francesca Del Grosso, Francesco Barci, Giuseppe Ferraro, Gessica De Pascale, Giovanna Santapaola, Mara Canzi, Valerio Neiviller, Alessandro Pizzo
{"title":"Nurses' Perception and Insight Into Uremic Pruritus in Patients With Chronic Kidney Disease on Dialysis: A Survey-Based Study","authors":"Maria Pia Zito, Cinzia Fabbri, Francesca Del Grosso, Francesco Barci, Giuseppe Ferraro, Gessica De Pascale, Giovanna Santapaola, Mara Canzi, Valerio Neiviller, 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}
{"title":"Moroccan Adaptation of the ‘Self-Care Behaviour Assessment Scale’ for Arteriovenous Fistula in Haemodialysis","authors":"Mazzi Loubna, Benksim Abdelhafid, Amane Mounia, Clemente Neves Sousa, Cherkaoui Mohamed","doi":"10.1111/jorc.70004","DOIUrl":"10.1111/jorc.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Arteriovenous fistula self-care behaviours in patients receiving haemodialysis are essential to maintain patency of vascular access and prevent its life-threatening complications. Assessing arteriovenous fistula self-care behaviours in patients receiving haemodialysis requires a reliable and valid tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to adapt and translate the Portuguese scale for the assessment of self-care behaviours of arteriovenous fistula in patients receiving haemodialysis into the Moroccan dialect and evaluate its psychometric properties in the Moroccan context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A quantitative cross-sectional validation study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>This study included 283 patients undergoing haemodialysis with arteriovenous fistula in the Marrakech-Safi region of Morocco.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>The translation was performed in accordance with international guidelines. Instrument validity was assessed using content validity and factor analysis with Varimax rotation for construct validity. Instrument reliability was assessed by measuring internal consistency using Cronbach's <i>α</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Content validity was assessed by a panel of experts. The Kaiser–Meyer–Olkin score of 0.885 justified data adaptation for factorial analysis. Bartlett's sphericity test confirmed the existence of significant relationships (chi-square = 1347.328; <i>p</i> < 0.001). A two-factor structure was extracted, explaining 50.85% of the total variance. Cronbach's <i>α</i> was 0.892, 0.853 and 0.752 for the overall scale, the self-care subscale for managing signs and symptoms and the self-care subscale for preventing complications, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Moroccan version of the Self-Care Behaviour Assessment Scale for Arteriovenous Fistula is a reliable and valid instrument for future studies evaluating the self-care behaviours of patients receiving haemodialysis with an arteriovenous fistula in Morocco.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007148","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 effect of music on fistula needle insertion-related pain intensity and pain distress: A single-centre, single-blind, randomised controlled trial","authors":"Sultan Baykan MSc, RN, Nazan Kılıç Akça PhD","doi":"10.1111/jorc.70001","DOIUrl":"10.1111/jorc.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients feel pain and distress when a needle is inserted into the fistula. This affects the comfort of patients. One of the nonpharmacological methods used to decrease pain and stress is music intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study was conducted to assess the effect of Turkish classical music in makams, which the patients preferred, via headphones on fistula needle insertion-related pain intensity and pain distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>It was single-blind randomised controlled study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>This study was conducted with 54 patients between March and June 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>The patient data were collected through a patient information form, visual analogue scale and distress thermometer. The intervention group was played music for 10 min, starting 5 min before the needle was inserted into the fistula. The music intervention was made in accordance with the established music protocol. The control group received only routine treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the intervention group were found to have a significant decrease in fistula needle insertion-related pain intensity and pain distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>According to the results obtained from the research, music listening to patients is a reliable, effective and low-cost way of a nursing intervention to reduce levels of fistula needle insertion-related pain intensity and pain distress. Additionally, the results will provide evidence-based guidance to dialysis nurses for pain and distress management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971250","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}
Dilantha Dharmagunawardene MD, Sanjeewa Kularatna PhD, Ureni Halahakone MHM, Louise Purtell PhD, Ann Bonner PhD, Helen G. Healy PhD, Sameera Senanayake PhD
{"title":"Health system related kidney supportive care interventions for adults with chronic kidney disease: A systematic review","authors":"Dilantha Dharmagunawardene MD, Sanjeewa Kularatna PhD, Ureni Halahakone MHM, Louise Purtell PhD, Ann Bonner PhD, Helen G. Healy PhD, Sameera Senanayake PhD","doi":"10.1111/jorc.12517","DOIUrl":"10.1111/jorc.12517","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Kidney failure can be managed either conservatively or via kidney replacement therapy. Kidney supportive care combines the expertise of nephrology with palliative care in a multidisciplinary team with a focus on improving quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify and appraise evidence-based health system kidney supportive care interventions</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review (PROSPERO Registration - CRD42022333650).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Adults with chronic kidney failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>Six databases were searched, using terms “palliative care” and “chronic kidney disease” for publications between January 2010 and March 2024. The Cochrane “Effective Practice and Organisation of Care” and “Clinical Practice Guidelines for Quality Palliative Care” domains informed data extraction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 60 studies included, one-third were randomised controlled trials. The most common “Effective Practice and Organisation of Care” domain described was care delivery (58/60). End-of-life care (33/60), and physical aspects of care (19/60), were commonly described “Clinical Practice Guidelines for Quality Palliative Care” domains. Multidisciplinary shared care was highlighted in 26 studies. Least described domains were cultural (0/60) and ethical aspects (3/60). Almost 2/3 (39/60) of studies compared the outcomes of kidney supportive care interventions, and the most common outcome assessed was advance care planning (18/39). Key findings reported integrated palliative care reduced hospital admissions and costs, facilitated better patient-clinician communication, and improved symptom management. Gaps were identified in cultural and ethical/legal aspects of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The studies highlighted the effectiveness of kidney-supportive care interventions in improving patient outcomes, especially in end-of-life care and symptom management. However, significant existing gaps identified necessitate further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785753","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}
Takashi Kemmochi RN, MN, Michiyo Oka RN, PhD, Mitsuhiro Matsumoto RN, CNS, MN, Yoshiko Sato RN, MN, Moe Sato RN, BN, Ai Fukuda RN, BN, Asuka Sadakata RN, BN, Kazumi Kimura RN, BN
{"title":"Self-compassion in patients undergoing haemodialysis: A qualitative study","authors":"Takashi Kemmochi RN, MN, Michiyo Oka RN, PhD, Mitsuhiro Matsumoto RN, CNS, MN, Yoshiko Sato RN, MN, Moe Sato RN, BN, Ai Fukuda RN, BN, Asuka Sadakata RN, BN, Kazumi Kimura RN, BN","doi":"10.1111/jorc.12516","DOIUrl":"https://doi.org/10.1111/jorc.12516","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients undergoing haemodialysis require long-term treatment and suffer from physical limitations and emotional distress due to restrictions in daily life, such as food and fluid restrictions, which can lead to self-criticism and depression. To address these issues, the concept of self-compassion, which is important for patients undergoing haemodialysis, has gained attention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to identify self-compassion in patients undergoing haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This is an interview-based qualitative study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Participants were recruited from a regional general hospital in Japan between August and September 2022. They were ≥18-year-old patients with diabetes and chronic kidney disease and visited the hospital for maintenance haemodialysis. Fifteen patients who agreed to participate in the study were interviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Semistructured interviews were conducted, and each interview was recorded and transcribed verbatim. Data analysis was conducted using reflecxive thematic analysis (TA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Thematic analysis generated three themes—acceptance, affirmation, and reinvention—from the seven subthemes. A different concept, “reinvention”, has been generated in this study. Regarding the sequential nature of the themes, it was predicted that they would proceed in the order of acceptance, affirmation, and reinvention, moving back and forth through these stages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It can be said that nurses can support patients undergoing haemodialysis by providing feedback to them about their thoughts and feelings, which were captured based on the themes and subthemes of this study, to promote the patients' awareness and increase their self-compassion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708165","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 1/2025","authors":"","doi":"10.1111/jorc.12499","DOIUrl":"https://doi.org/10.1111/jorc.12499","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"51 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708176","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 4/2024","authors":"","doi":"10.1111/jorc.12472","DOIUrl":"https://doi.org/10.1111/jorc.12472","url":null,"abstract":"","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"50 4","pages":"319-321"},"PeriodicalIF":1.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142665877","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}
Tone Karine Vidnes MSc, Astrid Klopstad Wahl, Marie Hamilton Larsen, Käthe Birgitte Meyer PhD, Åsmund Hermansen, Marit Helen Andersen
{"title":"Health literacy profiles in kidney transplanted patients: A cluster analysis","authors":"Tone Karine Vidnes MSc, Astrid Klopstad Wahl, Marie Hamilton Larsen, Käthe Birgitte Meyer PhD, Åsmund Hermansen, Marit Helen Andersen","doi":"10.1111/jorc.12515","DOIUrl":"10.1111/jorc.12515","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Health literacy is important in chronic conditions, such as kidney transplantation. Understanding patients' health literacy profiles can assist tailoring follow-up and educational programmes to the health literacy needs of vulnerable kidney transplant recipients. This approach enabled us to cluster patients according to their profiles of challenges and strengths in different health literacy domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to identify different health literacy profiles within kidney transplant recipients and what characterized the different profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>One hundred ninety-five kidney transplanted recipients were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Measurements</h3>\u0000 \u0000 <p>We used the self-reported Health Literacy Questionnaire and analyzed using Ward's method (hierarchical cluster approach). We also collected background characteristics and clinical variables, including psychological distress (Hopkins Symptoms Checklist) and perceived health status (visual analogue scale, EuroQol-5D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis revealed four clusters with substantial differences in health literacy profiles. One cluster's patients had the most challenges in all health literacy domains constituting 24% of the sample. Compared to the other three clusters, this cluster was associated with shorter duration of kidney disease, higher number of patients in dialysis before transplantation, higher percentage of male patients, lower number of kidneys from living donors, higher number of patients not working and higher representation of psychological distress. All four clusters reported the most challenges in the same domain: the ability to critically appraise health information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In kidney transplant recipients, profiling clusters with the Health Literacy Questionnaire and Ward's method aids in identifying health literacy needs in vulnerable groups, enabling transplant professionals to offer tailored health literacy support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"50 4","pages":"529-537"},"PeriodicalIF":1.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12515","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622361","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}
Currie Moore PhD, Helen Ellis-Caird ClinPsyD, Catherine Fielding PhD, Faizan Awan, Tarsem Paul, Rebecca Flanagan BSc, Shivani Sharma PhD, Kieran McCafferty MDRes, Sabine N. van der Veer PhD, Ken Farrington PhD, David Wellsted PhD
{"title":"Patients' perspectives on key aspects influencing needling for haemodialysis: A qualitative study","authors":"Currie Moore PhD, Helen Ellis-Caird ClinPsyD, Catherine Fielding PhD, Faizan Awan, Tarsem Paul, Rebecca Flanagan BSc, Shivani Sharma PhD, Kieran McCafferty MDRes, Sabine N. van der Veer PhD, Ken Farrington PhD, David Wellsted PhD","doi":"10.1111/jorc.12513","DOIUrl":"10.1111/jorc.12513","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For many patients, cannulation (‘needling’) is essential for haemodialysis. It is associated with anxiety and fear and contributes to the overall burden of treatment. Limited research exists on patient experience of needling and how this might vary by individual and clinical characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore and identify key aspects of needling impacting patients' experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative, multicentre, cross-sectional, co-produced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Adults on haemodialysis with working fistulae or grafts (<i>n</i> = 41).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We used interviews to explore patients' experiences of needling and key aspects contributing to this. Interviews were conducted in two sets: unstructured (<i>n</i> = 24, broadly investigated needling experience) and semistructured (<i>n</i> = 17, refined themes and assessed cultural relevance). Thematic analysis was used to identify themes driving experience and examine variation. A Patient Steering Group comprising people with lived experience of needling was integral to the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A thematic framework capturing patients' view of needling was developed. It defined a core theme (The Nature of needling) and five foundational aspects of needling (Health of the fistula or graft, Steps in needling, The needler, The patient, Organisational context). We identified two further themes important to overall experience, Learning from needling experience and Reciprocity (the two-way interaction between patient and needler). Both interrelated across themes, highlighting the complexity of needling and junctures where patient experience can be influenced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Needling is shaped by multiple psychological and relational influences. These findings provide healthcare professionals with a basis to improve patient experience as part of a broader drive to enhance quality in healthcare delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"50 4","pages":"538-551"},"PeriodicalIF":1.5,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.12513","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622367","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}