Randomised controlled trial of a smartphone application‐based dietary self‐management program on haemodialysis patients

Pack, Songyi; Lee, Jia

doi:10.1111/jocn.15627

“…With the continuous improvement of hemodialysis technology and nursing level, the survival time and quality of life of patients were significantly improved. According to clinical studies, the duration of fistula maintenance in hemodialysis is closely related to surgical skills, vascular conditions, and nursing quality [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

To Explore the Application of PDCA in Hemodialysis Center and Its Effect on the Maintenance of Internal Fistula

Su

¹

,

Cui

²

,

Pu

³

et al. 2022

BioMed Research International

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Background. The survey found that in recent years, with the incidence of chronic kidney disease (CKD) increasing, some patients with CKD even progressed to end-stage renal disease. Luckily, progressive hemodialysis technology and nursing level can improve the quality of life and prognosis of patients. Objective. To explore the application of plan-do-check-adjust (PDCA) cycle in the management of nurses in hemodialysis center and its effect on the maintenance of internal fistula in patients. Methods. In this study, a randomized controlled trail (RCT) was used to select 90 patients who underwent maintenance hemodialysis in the hemodialysis center of our hospital from January 2018 to June 2021 as objects. They were divided into a PDCA group (with PDCA nursing management) and routine group (with routine nursing management) by random number table with each of 45 cases for 6 months to compare the differences of the internal fistula complications, internal fistula maintenance quality, patients’ microinflammatory state, and satisfaction with nursing, as well as nursing staff’s operational and theoretical performance between the two groups. Results. There was no significant difference in CRP, IL-1, TNF-α, and IL-6 levels between the two groups before intervention ( P > 0.05 ); after that, these levels in the PDCA group were lower than those in the routine group, with statistically significant difference ( P < 0.05 ); before intervention, there was no statistically significant difference in the qualification rate of blood flow, the awareness rate of health education, and the incidence of nursing defects between the two groups ( P > 0.05 ); after that, the qualification rate of blood flow and the awareness rate of health education among nurses in PDCA group were higher than those in routine group, while the incidence of nursing defect accidents in the PDCA group was lower than that in routine group, and the differences were statistically significant ( P < 0.05 ); before intervention, there was no significant difference in the complication rate between the two groups ( P > 0.05 ); after that, the complication rate of the PDCA group was lower than that of the routine group, and the differences were statistically significant ( P < 0.05 ); after intervention, the theoretical assessment and practical skills assessment scores of the PDCA group were higher than those of the routine group, and the differences were statistically significant ( P < 0.05 ); after intervention, the nursing satisfaction of the PDCA group was higher than that of the routine group, and the differences were statistically significant ( P < 0.05 ). Conclusion. The application of PDCA approach in the management of nurses in hemodialysis centers can effectively improve the quality of internal fistula management and improve the practical and theoretical level of nurses, as well as reduce the microinflammation of patients.

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“…Hemodialysis treatment is a relatively long-term process. During hemodialysis, patients not only need to bear a large economic burden but also the possible complications during renal dialysis [ 4 , 5 ]. Patients are prone to psychological pressure of depression and anxiety and resist hemodialysis, which affect the clinical treatment effect.…”

Section: Introductionmentioning

confidence: 99%

Study on Nursing Effect of Psychological Intervention on Uremic Hemodialysis Patients

Chen

¹

,

Ding

²

,

Li

³

et al. 2022

Computational and Mathematical Methods in Medicine

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Aim. Patients in the hemodialysis stage are prone to psychological pressure of depression and anxiety and have resistance, which affects the clinical treatment effect. Effective psychological intervention plays a very important role in improving patients’ psychological pressure and patients’ compliance. The aim of this study is to explore the nursing effect of psychological intervention on uremic hemodialysis patients. Methods. There were 126 uremic hemodialysis patients admitted to the hospital from August 2020 to December 2021. The patients were randomly divided into the routine nursing care group ( n = 63 ) and psychological intervention group ( n = 63 ). The routine nursing care group received routine nursing care for uremia hemodialysis patients. The psychological intervention group implemented psychological intervention on uremia hemodialysis patients. The methods of psychological intervention mainly include establishing a good nurse-patient relationship, popularizing hemodialysis knowledge, timely psychological counseling for patients, and organizing patient communication meetings. The treatment compliance, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) of the two groups were compared before and after nursing. SF-36 scale was used to evaluate the quality of life of patients. The incidence of complications and nursing satisfaction were compared between the two groups. Results. The treatment compliance rate and nursing satisfaction of hemodialysis uremic patients in the psychological intervention group were significantly higher than the routine nursing care group. The SAS and SDS of hemodialysis uremia patients in the psychological intervention group were significantly lower than the routine nursing care group after psychological intervention, and SF-36 scale was significantly higher than the routine nursing group. The main complications of uremic hemodialysis patients are hypotension, hyperkalemia, internal fistula occlusion, and infection. Compared with the routine nursing care group, the incidence of complications in the psychological intervention group was significantly reduced. Conclusion. The implementation of psychological nursing intervention for uremic hemodialysis patients have a very significant effect on reducing the incidence of complications and improving anxiety, depression, treatment compliance, and the quality of life and the nursing satisfaction.

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“…We may be able to develop a practical method to help haemodialysis patients reduce SRF and promote self-management. Nurse-led self-management interventions have had positive outcomes in haemodialysis patients (Pack & Lee, 2021).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Self‐management experiences of haemodialysis patients with self‐regulatory fatigue: A phenomenological study

Tao

¹

,

Liu²,

Li

³

et al. 2023

Journal of Advanced Nursing

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Aim: To understand the real experiences of self-management in haemodialysis patients with self-regulatory fatigue, and to explore the influencing factors and coping strategies for patients with decreased self-management.Design: A qualitative study was carried out using the phenomenological analysis method.Methods: From 5 January to 25 February, 2022, semi-structured interviews were conducted with 18 haemodialysis patients in Lanzhou, China. Thematic analysis of the data was performed using the NVivo 12 software based on the 7 steps of Colaizzi's method. The study reporting followed the SRQR checklist.Results: Five themes and 13 sub-themes were identified. The main themes were difficulties in fluid restrictions and emotional management, hard to adhere to long-term self-management, uncertainty about self-management, influencing factors are complex and diverse and coping strategies should be further improved. Conclusion:This study revealed the difficulties, uncertainty, influencing facts and coping strategies of self-management among haemodialysis patients with self-regulatory fatigue.A targeted program should be developed and implemented according to the characteristics of patients to reduce the level of self-regulatory fatigue and improve self-management. Impact: Self-regulatory fatigue has a significant impact on the self-management behaviour of haemodialysis patients. Understanding the real experiences of selfmanagement in haemodialysis patients with self-regulatory fatigue enables medical staff to correctly identify the occurrence of self-regulatory fatigue in time and help patients adopt positive coping strategies to keep effective self-management behaviour. Patient or Public contribution:Haemodialysis patients who met the inclusion criteria were recruited to participate in the study from a blood purification centre in Lanzhou, China.

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Randomised controlled trial of a smartphone application‐based dietary self‐management program on haemodialysis patients

Cited by 17 publications

References 23 publications

To Explore the Application of PDCA in Hemodialysis Center and Its Effect on the Maintenance of Internal Fistula

To Explore the Application of PDCA in Hemodialysis Center and Its Effect on the Maintenance of Internal Fistula

Study on Nursing Effect of Psychological Intervention on Uremic Hemodialysis Patients

Self‐management experiences of haemodialysis patients with self‐regulatory fatigue: A phenomenological study

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