Fluid compliance among patients having haemodialysis: can an educational programme make a difference?

Barnett, Tony; Tang, Li Yoong; Pinikahana, Jaya; Tan, Shouyong

doi:10.1111/j.1365-2648.2007.04528.x

Cited by 90 publications

(63 citation statements)

References 20 publications

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“…In line with our findings, most previous studies showed the positive effects of education on weight management (38), itching, and nausea (25,39,40). Nonetheless, a study reported that education did not significantly affect fluid intake and was not effective in behavior modification (41).…”

Section: Discussionsupporting

confidence: 82%

The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

2017

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Background: Providing patients with comfort is the basis of nursing care and a favorable outcome of nursing care measures. Comfort is of special importance to hemodialysis patients because they spend a large part of their lives in hemodialysis units and are constantly dealing with different physical and mental health problems. This study aimed to evaluate the effects of comfort-based interventions (back massage along with patient and family education) on the level of comfort among hemodialysis patients. Methods: As a randomized controlled trial, this study was undertaken in 2016 in the hemodialysis unit of Shahid Chamran hospital, Ferdows, Iran. A convenience sample of forty hemodialysis patients was recruited. Patients were alternately allocated to control or intervention groups based on their hemodialysis days. The hospice comfort questionnaire was completed for all participants at the beginning and at the end of the study. This questionnaire showed that the comfort needs of patients were related to muscle cramps, headache, back pain, nausea, lack of knowledge about arteriovenous fistula care, dietary and treatment regimens, itching, rest and sleep disorders, and impaired comfort. Patients in the intervention group received massage as well as patient and family education in six consecutive hemodialysis sessions, while their counterparts in the control group solely received the routine care services of the study setting. The SPSS software (v. 18.0) was used for data analysis through running the paired-and the independent-sample t tests. The significance level was set at less than 0.05. Results: The mean scores of comfort and its environmental and psychospiritual dimensions significantly increased in the intervention group (P < 0.001). Significant increases were also observed in the mean scores of comfort and its psychospiritual dimension in the control group (P < 0.05). Before the intervention, there were no significant differences between the groups respecting the mean values of comfort and its dimensions (P > 0.05). However, after the intervention, there were significant between-group differences in the mean scores of comfort and its environmental dimension as well as in the pretest-posttest mean difference for the environmental dimension of comfort.

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Section: Discussionsupporting

confidence: 82%

The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

2017

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“…Self-report and intradialytic weight gain were used to measure fluid adherence in CKD participants. Non adherence using inter-dialytic weight gain ranged from 9.7% in USA to 70% in UK (24,35,36,37,38,39,40,41,42,43,44). Through self-report, non-adherence to fluid intake ranged from 40.3% in China to 72% in Belgium (19,45).…”

Section: Medication Adherencementioning

confidence: 99%

Adherence of adult Chronic Kidney Disease patients with regard to their dialysis, medication, dietary and fluid restriction

Chironda¹,

Bhengu²,

Manwere³

2017

Research Journal of Health Sciences

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Objective: Chronic Kidney Disease (CKD) has become a major health problem as a result of complicated interrelationships with diabetes mellitus, hypertension and other associated diseases. Effective management of CKD depends on patient's adherence to their dialysis plan, medications, dietary and fluid restrictions. This study aimed at systematically reviewing the adherence of adult Chronic Kidney Disease (CKD) patients with regard to their dialysis, medication, dietary and fluid restriction.Methods: Key words were used for the search in various data bases: "adherence", "Chronic Kidney Disease", "dialysis", "medication", "dietary" and "fluid restriction". Online data bases namely Medline, PubMed, Ebsco Host, CINAHL, google scholar and grey literature were used to identify published research from 1993 -2016. Forty three (43) articles were identified regarding adherence of CKD patients to dialysis, medication, dietary and fluid restriction.Results: Medication non adherence ranged from 3 to 80% through self-report, structured interview and biological markers. Fluid non-adherence was 10-74%. Using self-report and biological markers, nonadherence to diet was 2-39% and 19-57% respectively. With regards to dialysis, skipping and shortening hemodialysis adherence ranged from 2.5% -19% and 20.3% -32.3 % respectively. Globally, adherence rates to CAPD are not well documented in literature. Conclusion:Non-adherence to dialysis, medication, dietary and fluid restriction is an area of concern internationally in CKD population. Furthermore, non-adherence rates are not well researched and documented in African literature. Therefore, Nephrology professionals in clinical practice are agents of improving adherence of CKD patients to ensure effective management of the disease.Keywords: Adherence and non-adherence to medication, fluid, diet and dialysis, Chronic Ambulatory Peritoneal Dialysis (CAPD), Chronic Kidney Disease (CKD) and hemodialysis. Méthodes: Les mots clés suivants ont été utilisés pour la recherche: l'observance, la maladie rénale chronique, la dialyse, la médication, la restriction alimentaire et la restriction des fluides. La recherche a identifié 47 articles qui quantifient l 'adhérence des patients CKD à la dialyse, à la médication, à la restriction alimentaire et à la restriction des fluides.Résultats: La non-adhésion aux médicaments variait de 3 à 80% grâce à l'auto-évaluation, à l'entrevue structurée et aux marqueurs biologiques. La non-adhésion fluide de 30-74% en utilisant l'auto-rapport et de 10 à 60% sur la base d'un gain de poids interdialytique inapproprié. À l'aide de marqueurs biologiques et d'auto-évaluation, la nonadhésion à l'alimentation était respectivement de 2 à 39% et de 19 à 57%. En ce qui concerne la dialyse, le saut et le raccourcissement de l'hémodialyse ont varié respectivement de 2,5% à 19% et de 20,3% à 32,3%. Globalement, les taux d'adhésion à la CAPD ne sont pas bien documentés dans la littérature. Conclusion:Des preuves documentées ont révélé une non-adhésion à la dialyse, aux m...

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“…(1) IDWG as a measure of nonadherence: For decades it has been emphasized that adherence to fluid restriction is necessary to reduce IDWG, and IDWG has been equated with nonadherence [28,29,30,31,32,33,34,35,36,37,38] (in an oversimplified disregard of the thirst mechanism, as specified below).…”

Section: Interdialytic Weight Gain: Reported Causes and Consequencesmentioning

confidence: 99%

Significance of Interdialytic Weight Gain versus Chronic Volume Overload: Consensus Opinion

et al. 2013

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Predialysis volume overload is the sum of interdialytic weight gain (IDWG) and residual postdialysis volume overload. It results mostly from failure to achieve an adequate volume status at the end of the dialysis session. Recent developments in bioimpedance spectroscopy and possibly relative plasma volume monitoring permit noninvasive volume status assessment in hemodialysis patients. A large proportion of patients have previously been shown to be chronically volume overloaded predialysis (defined as >15% above ‘normal' extracellular fluid volume, equivalent to >2.5 liters on average), and to exhibit a more than twofold increased mortality risk. By contrast, the magnitude of the mortality risk associated with IDWG is much smaller and only evident with very large weight gains. Here we review the available evidence on volume overload and IDWG, and question the use of IDWG as an indicator of ‘nonadherence' by describing its association with postdialysis volume depletion. We also demonstrate the relationship between IDWG, volume overload and predialysis serum sodium concentration, and comment on salt intake. Discriminating between volume overload and IDWG will likely lead to a more appropriate management of fluid withdrawal during dialysis. Consensually, the present authors agree that this discrimination should be among the primary goals for dialysis caretakers today. In consequence, we recommend objective measures of volume status beyond mere evaluations of IDWG.

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Fluid compliance among patients having haemodialysis: can an educational programme make a difference?

Abstract: Nephrology nurses often have long-term relationships with their patients and are ideally placed to provide ongoing education and encouragement, especially for those experiencing difficulties in adhering to fluid and dietary restrictions.

Cited by 90 publications

References 20 publications

The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

Adherence of adult Chronic Kidney Disease patients with regard to their dialysis, medication, dietary and fluid restriction

Significance of Interdialytic Weight Gain versus Chronic Volume Overload: Consensus Opinion

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