<p>The purpose of this study was to describe how patients with hemodialysis experience their dialysis treatment. The study was conducted as a qualitative descriptive design. The study is based on six interviews. The interviews were transcribed in their entirety and analyzed according to content analysis inspired by Granheim and Lundman. The result is based on five categories; Stress and requirements, Life-supporting haemodialysis treatment, physical impairments, social constraints and a positive view on haemodialysis. Dialysis Patients experienced different matters from physical symptoms like feeling dizziness, headache and fatigue to feeling that life was limited in time, social interaction and energy. They also reported different experiences regarding their relationships with medical staff and other patients. The results obtained in this study shows that there should be spending more time and understanding on how patients experience their haemodialysis treatment in order to increase understanding and to master the situation by the staff and also to help patients. The study has also revealed that some patients feel persuaded by staff to perform as much of their treatment by themselves as possible. There are a lot of research about the haemodialysis treatment method, but very limited on how patients feel about their treatment and therefore it is needed more research in the experiences of dialysis to improve health care and nursing care.</p> / <p><strong>Sammanfattning</strong></p><p>Syftet med den här studien var att beskriva hur patienter med hemodialys upplever sin dialysbehandling. Studien genomfördes som kvalitativ med beskrivande design. Studien baseras på sex intervjuer. Intervjuerna har transkriberats i sin helhet och analyserats enligt innehållsanalys inspirerad av Granheim och Lundman. Resultatet bygger på fem kategorier som är; Stress och krav, Livsuppehållande hemodialysbehandling, kroppsliga nedsättningar, sociala begränsningar och positiv anblick på hemodialys behandling. Dialyspatienterna upplevde olika saker så som fysiska symptom som att känna yrsel, huvudvärk och trötthet, till att känna att livet blev begränsat i tid, social samvaro och energi. De uppgav också olika upplevelser angående deras relationer med sjukvårdspersonal och övriga patienter. Det resultat som framkommer i denna studie visar att det borde läggas ned mer tid och förståelse för hur patienter med hemodialys upplever sin behandling. För att öka förståelsen och kunna bemästra situationen som personal och även kunna hjälpa patienterna. I studien har det även framkommit att vissa av patienterna känner sig övertalade av personalen att kunna utföra så mycket av sin behandling själv.</p><p>Det sker mycket forskning omkring behandlingsformen hemodialys, men väldigt begränsat om hur patienterna upplever sin behandling och därför behövs mer forskning inom upplevelser inom dialys för att förbättra vården och omvårdnaden.</p>

The purpose of this study was to describe how patients with hemodialysis experience their dialysis treatment. The study was conducted as a qualitative descriptive design. The study is based on six interviews. The interviews were transcribed in their entirety and analyzed according to content analysis inspired by Granheim and Lundman. The result is based on five categories; Stress and requirements, Life-supporting haemodialysis treatment, physical impairments, social constraints and a positive view on haemodialysis. Dialysis Patients experienced different matters from physical symptoms like feeling dizziness, headache and fatigue to feeling that life was limited in time, social interaction and energy. They also reported different experiences regarding their relationships with medical staff and other patients. The results obtained in this study shows that there should be spending more time and understanding on how patients experience their haemodialysis treatment in order to increase understanding and to master the situation by the staff and also to help patients. The study has also revealed that some patients feel persuaded by staff to perform as much of their treatment by themselves as possible. There are a lot of research about the haemodialysis treatment method, but very limited on how patients feel about their treatment and therefore it is needed more research in the experiences of dialysis to improve health care and nursing care. / Sammanfattning Syftet med den här studien var att beskriva hur patienter med hemodialys upplever sin dialysbehandling. Studien genomfördes som kvalitativ med beskrivande design. Studien baseras på sex intervjuer. Intervjuerna har transkriberats i sin helhet och analyserats enligt innehållsanalys inspirerad av Granheim och Lundman. Resultatet bygger på fem kategorier som är; Stress och krav, Livsuppehållande hemodialysbehandling, kroppsliga nedsättningar, sociala begränsningar och positiv anblick på hemodialys behandling. Dialyspatienterna upplevde olika saker så som fysiska symptom som att känna yrsel, huvudvärk och trötthet, till att känna att livet blev begränsat i tid, social samvaro och energi. De uppgav också olika upplevelser angående deras relationer med sjukvårdspersonal och övriga patienter. Det resultat som framkommer i denna studie visar att det borde läggas ned mer tid och förståelse för hur patienter med hemodialys upplever sin behandling. För att öka förståelsen och kunna bemästra situationen som personal och även kunna hjälpa patienterna. I studien har det även framkommit att vissa av patienterna känner sig övertalade av personalen att kunna utföra så mycket av sin behandling själv. Det sker mycket forskning omkring behandlingsformen hemodialys, men väldigt begränsat om hur patienterna upplever sin behandling och därför behövs mer forskning inom upplevelser inom dialys för att förbättra vården och omvårdnaden.

Taiwan's population that undergoes medical dialysis, dialysis quality and survival rate are the highest in the world, hence, the infamous pun, "dialysis kingdom." In this study, Taiwan¡¦s hemodialysis industry development status, business strategies and the relationship between business strategies and resources will be explored. The hope is that by analyzing the dialysis industry in specific cases and its respons to relationship between the environment and its resources, which can provide useful knowledge for medical related industry references. In this study, dialysis patients had been given a questionnaire and statistical analysis to understand why the patients have chosen a specific dialysis center. Further research methods include, using exploratory case studies, and through the interviews of five experts in the industry, (including the three hemodialysis centers operators and two kidney specialists) as well as secondary data collection, data analysis and infe-rence by the case. The study concludes that relevant research findings, drastically impacts the he-modialysis patients choice in choosing the specific hospital based on various factors that are of great importance to the patients. The top five most important factors were: 1)The nurses attitudes of welcoming enthusiasm. 2)Needle skill of the nurses.3) Phy-sicians ethics and professionalism. 4)Clean and comfortable dialysis beds and lastly, 5)the gracious attitudes of the physicians. The five least important factors were: 1)Providing peritoneal dialysis services. 2)Whether or not there is a facility to provide free meals. 3) On site information services. 4)Recommendation of friends and finally, 5)spacious and comfortable transport vehicles. Using a specific business strategy, the proposed operators pinpoint the needs of patients and enhance the professional stan-dard of services, in which differentiating strategies can be taken and utilized in vari-ous marketing strategies.

Abstract: Hemodialysis is the commonest treatment for end-stage renal disease. We evaluated the factors associated with the stressors and coping methods for end-stage renal disease and hemodialysis by questionnaires. Two thousand, seven hundred and seventy-two patients with long-term hemodialysis from 13 cities in Taiwan were enrolled. The average stress score was 0.9 (ranged from 0-3 score on questionnaires). The most important stressors included fluid restriction, sleep disorder, operation for arteriovenous shunt, fatigue and fluid restriction, while the least important factors were sexual dysfunction and role conflict. Fatalism was the most popular copying method that these patients used. Others were as follows from the most common coping strategies: fatalism, wishful thinking, seeking support, problem solution, and positive reappraisal. Besides, age, dialysis duration, education, marital status, occupation, religion, transportation service and comorbidities were correlated significantly with stressors and coping methods. The patient characteristics were good predictors for stressors and coping methods. The results would be useful for dialysis staff to manage patients¡¦ stressors as well as to improve the staff-patient relationship.

Thesis (Ph. D.)--University of Texas at Austin, 2000. / Vita. Includes bibliographical references (leaves 261-290). Available also in a digital version from Dissertation Abstracts.

End stage renal failure refers to an irreversible kidney dysfunction in which the kidneys fail to remove toxins from the blood stream. Haemodialysis is an effective treatment modality to sustain the lives of patients with end stage renal failure by removing waste products like urea, creatinine, and excess fluid. It involves a challenging regimen including dietary restrictions to ensure long-term survival. Failure to adhere with the regimen can result in fatal consequences. Renal patient discomfort related to non-adherence is commonly seen in clinical settings; however, there is currently no evidence-based fluid or dietary education program available to haemodialysis patients. This dissertation aims to identify and evaluate current evidence for the effectiveness of dietary and fluid control programs in the treatment of haemodialysis patients, to assess the transferability and feasibility of implementing a nurse-led education program regarding dietary and fluid control in haemodialysis patients, and to develop an evidence-based, nurse-led fluid and dietary control program for haemodialysis patients. Four electronic bibliographical databases including PubMed, Cochrane library, PsycInfo and CINAHL and two searching engines including Google scholar and ProQuest were used to identify studies that examined the effectiveness of educational programs or interventions on fluid or dietary control for patients on haemodialysis. Forty-five unique studies were identified as potentially relevant. Eleven of those studies met the selection criteria and were evaluated in this dissertation. Appraisal instrument was used to evaluate the quality of the selected studies. Six studies and three studies showed statistically significant in reduction of serum phosphate level and interdialytic weight gain respectively after educational intervention. Critical evaluation of the available studies led to an evidence-based, nurse-led, fluid and dietary control program for haemodialysis patients that followed the guideline development process of the Scottish Intercollegiate Guideline Network. Comparison on the similarity of patient characteristics, staff competence, and organizational settings of the evaluated studies were similar to those of the target unit. Therefore, the proposed program may be transferable and feasible. Furthermore, a cost-benefit analysis showed that the benefit of the fluid and dietary control program to patients outweighs the cost needed to implement the program. This dissertation outlines a proposed twenty-week program including marketing of the program, training of staff in the targeted renal unit, pilot testing, and application of the proposed program. Evaluation of the program will focus on three categories: patient outcome, health care provider outcome, and organization outcome. Clinical effectiveness of the program is defined by an overall reduction in patients’ mean interdialytic weight gain and mean serum phosphate level, improvement in knowledge test scores by patients, satisfactory nurses’ attendance rate in the renal training sessions, high nurse satisfaction with the educational program, and reduction of admission rate related to non-adherence. / published_or_final_version / Nursing Studies / Master / Master of Nursing

No description available.

Hemodialysis catheter occlusion compromises hemodialysis adequacy and increases the cost of care. Repeated administration of alteplase in hemodialysis catheters typically produces only short-term benefits. The purpose of this study was to design, implement and evaluate the efficacy of a step-by-step algorithm to optimize the management of hemodialysis catheter occlusion. The study had a prospective quasi-experimental design in two parts. Baseline data on the use of alteplase and catheter exchange were collected during Part I; while, Part II consisted of algorithm implementation. Rates of alteplase use and catheter exchange per 1000 catheter days were main outcomes of the study. One-hundred and seventy-two catheters in 131 patients were followed up during the course of the study. The vast majority of the study population were on clopidogrel or aspirin (75%); whereas, approximately 11% were on warfarin. The adjusted rate of alteplase use was not significantly different after algorithm implementation (Part I vs. Part II relative risk: 1.10; 95% CI: 0.73 – 1.65, p > 0.05). Similarly, catheter exchange rates were not significantly different in both parts of the study (1.12 vs. 1.03 per 1000 catheter-days, p > 0.05). Regression analysis showed that the rate of alteplase use was inversely related to the catheter age (p < 0.05). In a secondary analysis on a subgroup of patients with occlusion-related catheter exchanges (n = 28), the number of alteplase administrations significantly increased with longer waiting time for catheter exchange (p < 0.05). In conclusion the hemodialysis catheter management algorithm was not effective in decreasing the rate of alteplase use.

No description available.

Hemodialysis catheter occlusion compromises hemodialysis adequacy and increases the cost of care. Repeated administration of alteplase in hemodialysis catheters typically produces only short-term benefits. The purpose of this study was to design, implement and evaluate the efficacy of a step-by-step algorithm to optimize the management of hemodialysis catheter occlusion. The study had a prospective quasi-experimental design in two parts. Baseline data on the use of alteplase and catheter exchange were collected during Part I; while, Part II consisted of algorithm implementation. Rates of alteplase use and catheter exchange per 1000 catheter days were main outcomes of the study. One-hundred and seventy-two catheters in 131 patients were followed up during the course of the study. The vast majority of the study population were on clopidogrel or aspirin (75%); whereas, approximately 11% were on warfarin. The adjusted rate of alteplase use was not significantly different after algorithm implementation (Part I vs. Part II relative risk: 1.10; 95% CI: 0.73 – 1.65, p > 0.05). Similarly, catheter exchange rates were not significantly different in both parts of the study (1.12 vs. 1.03 per 1000 catheter-days, p > 0.05). Regression analysis showed that the rate of alteplase use was inversely related to the catheter age (p < 0.05). In a secondary analysis on a subgroup of patients with occlusion-related catheter exchanges (n = 28), the number of alteplase administrations significantly increased with longer waiting time for catheter exchange (p < 0.05). In conclusion the hemodialysis catheter management algorithm was not effective in decreasing the rate of alteplase use.