Nursing Care for Dialysis Patients in Japan

Abstract

In Japan, the number of chronic renal failure patients requiring dialysis treatment is increasing by approximately 10,000 patients a year, totalling 229,538 or 1,801.2 patients per one million population at the end of December, 2002 according to the survey conducted by the Japanese Society for Dialysis Therapy. The primary disease is diabetic nephropathy (28.1% of patients), and with greater numbers of long-term and elderly patients, the incidence and severity of complications continue to increase. Dialysis units provide more diversified care, but budget cuts in health care make it difficult to secure sufficient personnel, and the workload on nurses has intensified. In this study, a survey of 157 out of 300 randomly selected dialysis facilities in Japan was made regarding nursing systems and nurses' concerns for medical care of dialysis patients.

Psychological stress and strain on employees in dialysis facilities: a cross-sectional study with the Copenhagen Psychosocial Questionnaire

“…In spite of the favourable comparison with hospital nursing, this indicates that the quantitative demands are in need of improvement. Many studies show clearly that quantitative demands are a critical issue, particularly in the context of staff reductions [5,17] or limited number of staff [10,26]. As for the emotional demands, the hospital nurses rated this aspect considerably higher than the other two professional groups.…”

“…However, the dialysis employees rated their influence and the degree of freedom as being significantly lower than did hospital nurses, thus a compensation of the relatively high demands by high control or support is not given. An obvious conclusion is that the standardized work processes allow little possibility of influencing the work; the employees themselves described their work as routine [17]. Other studies also have shown that dialysis staff would like to be more actively involved in the decision making process [1,17,29].…”

“…An obvious conclusion is that the standardized work processes allow little possibility of influencing the work; the employees themselves described their work as routine [17]. Other studies also have shown that dialysis staff would like to be more actively involved in the decision making process [1,17,29]. There are major possibilities for development in this dimension.…”

“…Current scientific knowledge indicates that there are positive aspects of this work, including high job satisfaction [1,7]. Moreover, nurses in dialysis facilities perceived their work as worthwhile and were very interested in professional details [17]. They enjoyed the high responsibility [1], as well as the chance to do things for people, the freedom to use their own judgement and the job security [15].…”

“…They enjoyed the high responsibility [1], as well as the chance to do things for people, the freedom to use their own judgement and the job security [15]. The negative aspects of dialysis work, as described in the literature, include low involvement in decision making [1,17], pressure at work, lack of time for individual patients, monotonous work and fear of blood-borne diseases [17]. Other negative aspects were the low salary and the general working conditions [15].…”