Patient and treatment characteristics associated with patient activation in patients undergoing hemodialysis: a cross-sectional study

Bulck, Liesbet Van; Claes, Kathleen; Dierickx, Katrien; Hellemans, A.; Jamar, Sofie; Smets, Sven; Pottelbergh, Gijs Van

doi:10.1186/s12882-018-0917-2

Cited by 31 publications

(36 citation statements)

References 32 publications

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“…Compared with other studies, the baseline HRQOL with our measures are similar. 28 - 30 Inclusion of kidney-specific HRQOL measures such as the Kidney Disease Quality of Life (KDQOL) may have led to different results. Home dialysis patient quality of life has historically been low, 31 as was demonstrated in our study.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a Web-Based eHealth Portal for Delivery of Care to Home Dialysis Patients: A Single-Arm Pilot Study

Kiberd

Stockman

Radhakrishnan

et al. 2018

Can J Kidney Health Dis

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BackgroundImproving a patient’s experience with their care through an online interface for communication (an eHealth patient portal) has been shown to be beneficial in some studies of chronic disease populations. However, little is known about the effectiveness of an eHealth portal for delivery of care to home dialysis patients.ObjectivesPrimary: To determine whether an eHealth portal is effective at improving a patient’s experience with their home dialysis care. Secondary: (1) To determine whether an eHealth portal improves health-related quality of life for home dialysis patients, (2) to assess patient satisfaction with an eHealth portal and perceived impact on aspects of their home dialysis therapy and health, (3) to determine the acceptability of the eHealth portal software, and (4) to determine the change in telephone usage for communication after patient adoption of an eHealth portal.DesignSingle-arm pilot trial with recruitment over a 4-month period.SettingThe multidisciplinary home dialysis clinic in Halifax Nova Scotia Canada.PatientsAdults (>18 years) receiving either home hemodialysis or peritoneal dialysis.MeasurementsConsumer quality index (CQI), health-related quality of life using the EuroQol Five Dimensions Questionnaire (EQ-5D), acceptability of the eHealth portal software (using the Acceptability E-scale), and satisfaction/perceived impact (using a modified questionnaire).MethodsA web-based application (McKesson, Canada, RelayHealth®) allowed patients and health care workers to communicate through a secure, password-protected online portal that permitted visualization of the messaging history by patient and provider. Patients and the home dialysis health care team had the ability to send messages related to patient care at any time including proposed changes to medication, instructions after a clinic visit, times of new appointments, upcoming investigations, or questions about care. Patient experience with home dialysis care using the CQI, health-related quality of life using the EQ-5D, acceptability of the eHealth portal software, and satisfaction/perceived impact were assessed at baseline, 6, and 12 months of follow-up (where applicable). Total minutes of telephone communication was assessed prior to and after adoption of the portal.ResultsOf the 41 patients who consented to join the portal, 27 (66%) created an online account. At baseline, patients had a positive experience for the care and communication provided by their nephrologist (CQI: 3.63, 95% confidence interval [CI]: 3.50-3.76) and this did not change significantly over the study period. Similar results were observed for the care provided by other nephrology health care team members. Health-related quality of life using the EQ-5D score was 0.80 (interquartile range [IQR]: 0.71-0.83) at baseline and this also did not significantly change over the study period. Patients were satisfied with the eHealth portal (mean Likert scale score of 6.5 ± 0.6 in overall satisfaction, scale ranging from 1 completely dissatisfied to 10 completely satis...

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Section: Discussionmentioning

confidence: 99%

Effectiveness of a Web-Based eHealth Portal for Delivery of Care to Home Dialysis Patients: A Single-Arm Pilot Study

Kiberd

Stockman

Radhakrishnan

et al. 2018

Can J Kidney Health Dis

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“…Similar disparities have been found between patients and treating nephrologists (Yau et al, 2016) regarding home‐based haemodialysis care. However, it has been shown that haemodialysis patients tend to have lower patient activation measure scores than other populations with chronic disease (Bulck et al, 2018; Zimbudzi et al, 2017). This fact shows a need to find and adopt methods to increase patient activation specifically in this population, in order to increase patient interest and capability for participation and self‐care.…”

Section: Discussionmentioning

confidence: 99%

Interest and perceived capability of self‐care in haemodialysis units

Kurtz

Geron

Shadmi

2020

Journal of Clinical Nursing

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Aims To (a) assess patients' interest and perceived capability of participating in haemodialysis; (b) assess nurses' perceptions of patients’ interest and perceived capability of participating in haemodialysis; and (c) examine associations between patient characteristics and interest and perceived capability of performing haemodialysis self‐care. Design Cross‐sectional, questionnaire‐based study. Methods Data were collected from dialysis patients and their nurses between October 2018–May 2019. Patients’ interest and perceived capability of participation were assessed by a 10‐item Likert‐type scale developed and tested for this study, with responses ranging from 1 (not interested/no perceived capability) to 5 (already doing task independently). Multivariate linear regression was used to assess the relationship between patient characteristics, including age, sex, education level and severity of illness to ratings of activation level and haemodialysis self‐care scale scores. The STROBE checklist was used as a guideline for this study. Results Ninety‐one patients and 31 nurses participated. Overall, patients expressed interest (2.43 ± 0.93) and perceived themselves capable (2.34 ± 0.9) of participating in various haemodialysis‐related tasks. Nurses assessed lower interest (2.19 ± 0.77) than patients, but similar average capability (2.31 ± 0.8). Both greater interest and perceived capability were correlated with more years of education and higher patient activation; additionally, interest was associated with disease severity and perceived capability was associated with age. Conclusion Haemodialysis patients are interested and perceive themselves capable of participating in the tasks involved in dialysis care. Nurses underestimate patient interest in participation. Relevance to clinical practice Self‐care behaviours among haemodialysis patients are important, as they may affect quality of life and survival. Determining interest and perceived capability of participation is a first step towards evaluating the feasibility of self‐care in a supervised haemodialysis setting.

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“…14 In a systematic review that identified, through 36 articles, the variables that most influenced the HRQOL of people on renal dialysis, the variable activation was not used. 15 In addition, studies associating patient activation with HRQOL in people with CKD are limited 16,17 and, when considering people on hemodialysis treatment, are even more restricted. 17 In this sense, little is known about the relationship between activation of HD patients and their HRQOL.…”

Section: Introductionmentioning

confidence: 99%

“…And when considering that activation is positively related to better self-reported health of patients in HD 17 and to a lower symptom burden of patients in all stages of CKD, including those on dialysis, 4 it may be a factor that interferes with HRQOL. 4,17 In this sense, the question that guided this study was: "What is the association between the level of activation and HRQOL of people on hemodialysis? It is hypothesized that a higher level of activation is favorable to a better HRQOL.…”

Section: Introductionmentioning

confidence: 99%

Nível de ativação e qualidade de vida relacionada à saúde de pessoas em hemodiálise

et al. 2021

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Resumo Objetivo associar o nível de ativação com a qualidade de vida relacionada à saúde de pessoas que realizam o tratamento hemodialítico. Método estudo quantitativo, transversal e correlacional com 162 pessoas em tratamento hemodialítico. Os dados foram coletados por meio da aplicação de questionários para a caracterização sociodemográfica, socioeconômica e clínica do Kidney Disease Quality of Life Short Form e da escala Patient Activation Measure. Os dados secundários foram coletados por meio do prontuário médico. Para a análise dos dados, utilizaram-se a estatística descritiva e a regressão logística. Resultados a ativação do paciente em hemodiálise associou-se positivamente com os domínios sintomas, funcionamento físico, saúde geral, bem-estar emocional, energia/fadiga e o componente mental da qualidade de vida relacionada à saúde. Conclusão e implicação para a prática como a ativação apresenta relação com a qualidade de vida relacionada à saúde, na prática assistencial, essa métrica deve ser considerada ao implementar medidas que visem a aumentar a qualidade de vida relacionada à saúde das pessoas em hemodiálise.

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Patient and treatment characteristics associated with patient activation in patients undergoing hemodialysis: a cross-sectional study

Cited by 31 publications

References 32 publications

Effectiveness of a Web-Based eHealth Portal for Delivery of Care to Home Dialysis Patients: A Single-Arm Pilot Study

Effectiveness of a Web-Based eHealth Portal for Delivery of Care to Home Dialysis Patients: A Single-Arm Pilot Study

Interest and perceived capability of self‐care in haemodialysis units

Nível de ativação e qualidade de vida relacionada à saúde de pessoas em hemodiálise

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