Predialysis patient education: effects on functioning and well‐being in uraemic patients

Abstract

This study evaluated the effects of a predialysis patient education programme on functioning and well-being in 28 uraemic patients. The programme consisted of four group sessions with the following themes: renal disease and dietary restriction, active renal replacement therapy, physical exercise, and the impact of chronic renal failure on economy, family and social life. Three to 9 months after having started dialysis the patients were evaluated regarding symptoms, perceived health (Health Index), functional (SIP) and emotional (STAI) status. Twenty-eight patients already on dialysis treatment informed according to conventional routines constituted the comparison group. There were no significant differences between the groups regarding age, sex, educational or social background, duration of kidney disease, choice of dialysis treatment, cause of renal disease and laboratory tests except for s-urea. The patients who participated in the education programme scored significantly better mood, less mobility problems (HI), less functional disabilities (SIP) and lower levels of anxiety (STAI) compared to the comparison group. There were no significant differences between the two groups regarding symptoms and overall health. The differences between the groups prevailed during the first 6 months on dialysis treatment, after which the differences disappeared. In the comparison group age correlated significantly to anxiety and overall SIP, which was not the case in the experimental group. In conclusion, the experimental group that participated in a predialysis patient education programme, showed better functional and emotional well-being than the non-educated comparison group. The positive effects of participating in an education programme prevailed during the first 6 months of dialysis treatment. Moreover, the younger patients seemed especially to benefit from participation in a predialysis patient education programme. It is suggested that patient education should be ongoing for patients with end-stage renal failure initiated during the predialysis stage and continued after maintenance dialysis has been established.

Estresse e ansiedade em pacientes renais crônicos submetidos à hemodiálise

“…Alguns pesquisadores relatam que a ansiedade em paciente renal é frequente, pois a doença é percebida como ameaça à vida, à integridade corporal e como interrupção do meio de sobrevivência, prejudicando a identidade do paciente, sua autoridade e muitas vezes trazendo incertezas em relação ao seu futuro (Klang, Björvell, Berglund, Sundstedt & Clyne, 1998;Ramirez et al, 2012). As expressões de raiva dos pacientes são reações comuns à doença, como maneira de enfrentar a ansiedade e geralmente em resposta a uma ameaça, insulto ou lesões como punções e procedimentos dolorosos (Meireles, Goes & Dias, 2008).…”

The effect of group training implemented on hemodialysis patients for their stress management, psychosocial adjustment and self-care strength

“…This study has found similar results with other studies, supporting the effectiveness of the training program in decreasing levels of stress. (Klang et al, 1998;Tsay &lee, 2005). However, in the study by Hiçdurmaz and Öz a statistically significant relationship was not encountered between the methods of coping with stress and the status of receiving training for hemodialysis in the hemodialysis patients (Hiçdurmaz & Öz, 2009).…”

American Society of Nephrology Quiz and Questionnaire 2015: ESRD/RRT

“…The benefits of a multidisciplinary team approach to CKD care are well established, including delayed progression to ESRD and improved survival (1-3), improved patient psychologic profile (better moods and less anxiety), less physical functional disability (4,5), fewer HD catheter starts (2), and increased choice and likelihood of home-based dialysis modalities (2). However, we do not typically provide "excellent education to inform modality decision making."…”