Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 6 uppsatser.

by Szeto, Cheuk Chun. / Thesis (M.D.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (p. 183-206). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.

Source: Dissertation Abstracts International, Volume: 70-03, Section: B, page: 1628. Advisers: Belinda M. Reininger; Henry S. Brown. Includes bibliographical references.

DISSERTATION (PH.D.)--THE UNIVERSITY OF MICHIGAN / CO-CHAIRMEN: ARNOLD MONTO; GENE HIGASHI

DISSERTATION (PH.D.)--THE UNIVERSITY OF MICHIGAN / CO-CHAIRMEN: ARNOLD MONTO; GENE HIGASHI

Hemodialysbehandling är en livsuppehållande behandling vid terminal njursvikt. Behandlingen utförs flera gånger i veckan och medför stora livsförändringar. Delaktighet är i fokus i dagens hälso- och sjukvård, vilket forskning och lagstiftning bekräftar. Syftet med denna litteraturöversikt var att beskriva upplevelsen av delaktighet hos vårdsökande personer som genomgår hemodialysbehandling på sjukhus. Metoden som valdes var litteraturöversikt med kvalitativ ansats. Nio artiklar granskades genom induktiv innehållsanalys och mynnade ut i kategorierna; hämmande maktlöshet och att känna sig säker med underkategorierna kommunikationsbrister och brister i bemötandet respektive kunskap ger trygghet och känna tillit. Resultatet visar att vårdsökande person upplever en kamp för delaktighet i sin behandling.  De som upplever att de är delaktiga beskriver ett ökat välbefinnande. Slutsatsen är att vårdpersonalen behöver utöka sin kunskap om vad som främjar delaktighet hos personer som genomgår hemodialysbehandling. / Hemodialysis is a life supporting treatment in terminal kidney failure. The treatment is given several times a week and results in major life changes. Participation is in focus in today’s healthcare, which is confirmed by current research and legislation. The aim of this literature review was to describe the experience of participation among persons undergoing in-center hemodialysis treatment. The method used was qualitative literature review. Nine articles were reviewed using inductive content analysis and two categories derived: 1. Inhibitory powerlessness with subcategories; lack of communication and deficiencies in treatment and 2. To feel secure with subcategories; knowledge gives security and to feel trust. The result shows experiences of struggle to participate in hemodialysis treatment. Persons who take active part of the treatment describe a high wellbeing. The conclusion is that healthcare professionals need to increase their knowledge in what promotes participation among persons undergoing hemodialysis treatment.

Bakgrund: När njurfunktionen blir försämrad bör dialysbehandling påbörjas. I Sverige får ungefär 2700 patienter hemodialysbehandling och 800 patienter behandlas med peritonealdialys. Vid dialysbehandling uppstår svårigheter som kan påverka patientens liv på flera olika sätt. För att patienten ska kunna hantera den svåra tiden med dialysbehandling kan copingstrategier användas. Det har visat sig att sjuksköterskan spelar en viktig roll för att stödja och uppmuntra patienter under den svåra tiden med dialysbehandling. Syfte: Att beskriva patienters upplevelser av dialysbehandling samt att granska valda artiklars datainsamlingsmetod. Metod: En beskrivande design och 13 vetenskapliga artiklar med kvalitativ ansats har använts i denna litteraturstudie. Databaserna CINAHL, Medline via PubMed och PsycINFO användes vid sökning av artiklar. Huvudresultat: Att vara beroende av långvarig dialysbehandling gjorde att patienterna var tvungna att spendera mycket tid på sjukhuset. Detta begränsade deras frihet att utföra dagliga aktiviteter, resa eller arbeta. Patienternas självbild påverkades negativt på grund av kroppsliga förändringar relaterade till sjukdomen och behandlingen. Känslomässiga reaktioner såsom rädsla, depression och oro inför framtiden var de vanligaste förekommande upplevelserna hos patienterna. För att övervinna dessa svåra situationer använde patienterna sig av copingstrategier. De inkluderade 13 artiklarna i denna litteraturstudie hade en kvalitativ ansats och intervjuer användes som datainsamlingsmetod. Slutsatser: Den svåra tiden med dialysbehandling påverkade patienterna fysiskt, psykiskt och socialt. För att klara av negativa och krävande omständigheter som sjukdomen och behandlingen medförde behövde patienterna olika strategier. Det krävdes även att sjuksköterskor gav stöd och information som kunde underlätta för patienter att hantera situationer som kunde uppstå relaterat till dialysbehandlingen / Background: When renal function is impaired should dialysis treatment start. In Sweden, there are about 2700 people have hemodialysis treatment and 800 individuals on peritoneal dialysis. On dialysis treatment, there are many difficulties that affect the patient's life in several ways. To handle the tough times with the dialysis treatment can patient use coping strategies. In addition it has been shown that the nurse plays an important role in supporting and encouraging patients during the difficult period of dialysis treatment. Aim: To describe patients' experiences of dialysis treatment and to review data collection method of the included articles. Method: A descriptive design and 13 scientific articles with qualitative approach were used in this study. The databases CINAHL, MEDLINE though PubMed and PsycINFO were used for searching articles. Results: To be depended on the long-term dialysis treatment made the patients had to spend a lot of time in the hospital. This limited the patient's freedom to perform daily activities, to travel or to work. There was a negative impact on patients' self-image because of bodily changes related to the disease and treatment. Emotional reactions such as fear, depression and anxiety about the future were the common experiences of the patients. One way to overcome these difficult situations, patients used coping strategies. The included 13 articles in this study had a qualitative approach and interviews were used as data collection method. Conclusion: During the difficult period of dialysis treatment, the patient was affected physically, psychologically and socially. To cope with the adverse and demanding circumstances that the disease and treatment caused, patients needed different strategies. It also requires that nurses provide support and information that can help patients to handle these situations.

Introdução: O uso de membranas de alto fluxo tornou-se comum na prática de hemodiálise convencional (HDC), hemodiafiltração (HDF) e hemofiltração (HF) devido ao elevado coeficiente de ultrafiltração e à maior permeabilidade do poro. A produção de fluido de reposição online proporciona maior facilidade na execução de HDF e HF. Estas modalidades aumentam a depuração de solutos maiores por convecção. O objetivo do estudo é comparar a eficácia de três métodos dialíticos: HDC, HDF online (HDF-OL) pós-diluição e HF online (HF-OL) pré-diluição, por meio da quantificação direta da dose de diálise pela extração de solutos. Método: Trata-se de um ensaio clínico, envolvendo 14 pacientes em hemodiálise. Os pacientes iniciaram no estudo na modalidade de HDC com prescrição de quatro horas, fluxo de sangue de 350ml/min e fluxo de dialisato de 800ml/min com dialisador novo de alto fluxo e alta eficiência. Posteriormente, os mesmos pacientes foram submetidos à uma sessão de HDF-OL pós-diluição de quatro horas, fluxo de sangue de 350ml/min, fluxo de reposição de 100ml/min e fluxo de dialisato de 700ml/min. Por último, fizeram uma sessão de HF-OL pré-diluição com mesma duração, fluxo de sangue de 350ml/min e fluxo de reposição de 100% do fluxo de sangue. Foram realizadas 42 sessões de tratamento. A extração de solutos foi avaliada por meio de dosagens plasmáticas e quantificação do efluente. Resultados: As concentrações séricas dos solutos pré-diálise não foram diferentes entre as sessões do estudo. O volume de substituição em HDF-OL foi de 20,6 ± 0,8L/sessão e em HF-OL foi de 81,8 ± 7,1L/sessão. A HDF-OL quando comparada com a HDC não apresentou diferença na extração de moléculas pequenas. Da mesma forma, a extração de ?2-microglobulina foi semelhante nas 3 modalidades: 121,1 ± 46,4 mg em HDC, 130,1 ± 46,5 mg em HDF-OL e 106,0 ± 45,0 mg em HF-OL. A perda de albumina foi significativamente maior em HDF-OL (1360,2 ± 425,0 mg) e HF-OL (1310,3 ± 201,4 mg) Vs. HDC (269,6 ± 15,3 mg) (p<0,0001). A depuração de pequenos solutos foi superior em HDF-OL. A depuração de ?2-microglobulina foi maior em HDF- OL (114,0 ± 15,7 ml/min) e HF-OL (116,1 ± 19,5 ml/min) Vs. HDC (86,5 ± 16,1 ml/min) (p<0,0001). A dose de diálise avaliada pelo singlepool, equilibrated, standard Kt/V e pela quantificação direta da diálise (DDQKt/V) não foi diferente entre HDF-OL e HDC. Na HF-OL a ausência de difusão contribuiu para menor extração e menor Kt/V de solutos pequenos (p<0,0001). Conclusão: A dose de diálise avaliada pela extração de solutos foi semelhante entre HDC e HDF-OL sendo a HF-OL menos favorável na extração de solutos pequenos / Introduction: The use of high-flux membranes became common practice in conventional hemodialysis (CHD), hemodiafiltration (HDF) and hemofiltration (HF) due to the high pore permeability and ultrafiltration coefficient. The online production of substitution volume can make easier HDF and HF execution. These modalities can increase the clearance of larger solutes by convection. The aim of this study is to compare the dialysis efficacy among three methods: CHD, online post-dilution HDF (OL-HDF), and online pre- dilution HF (OL-HF) through the direct quantification of dialysis dose by the solutes extraction. Method: This is a clinical trial involving 14 patients on hemodialysis. The patients began the study in CHD modality with a four-hour prescription, blood flow of 350ml/min and dialysate flow of 800ml/min with new high-flux and high efficiency dialyzer. Subsequently, these patients were submitted to a four-hour post-dilution OL-HDF session, with flow replacement of 100ml/min, blood flow of 350ml/min and dialysate flow of 700ml/min. Finally, patients underwent a pre-dilution OL-HF with the same duration, blood flow of 350ml/min and flow replacement of 100% of the blood flow. Forty-two sessions of treatments were performed. The solutes extraction was assessed by plasma measurements and effluent quantification Results: Pre-treatment serum concentrations of different solutes showed no statistical difference among the modalities. The substitution volume in OL- HDF was 20.6 ± 0.8L/session and in OL-HF was 81.8 ± 7.1 L/session. The OL-HDF compared to CHD showed no difference in the small solutes extraction. Similarly, ?2-microglobulin extraction was similar among the three modalities: 121.1 ± 46.4 mg in CHD, 130.1 ± 46.5 mg in OL-HDF and 106.0 ± 45.0 mg in OL-HF. Albumin loss was significantly higher in OL-HDF (1360.2 ± 425.0 mg) and OL-HF (1310.3 ± 201.4 mg) Vs. CHD (269.6 ± 15.3 mg) (p<0.0001). The small solutes clearance was greater in OL-HDF. ?2- microglobulin clearance was higher in OL-HDF (114.0 ± 15.7 ml/min) and OL- HF (116.1 ± 19.5 ml/min) Vs. CHD (86.5 ± 16.1 ml/min) (p<0.0001). The dialysis dose measured by singlepool, equilibrated, standard Kt/V and by direct dialysis quantification (DDQ Kt/V) was not different between CHD and OL-HDF. In OL-HF the absence of diffusion contributed to lower extraction and lower Kt/V of small solutes. Conclusion: The dialysis dose evaluated by extraction of solutes was similar between CHD and OL-HDF being a OL-HF less favorable in small solutes extraction

by Tong Lai Wah, Christina. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 101-112). / Abstracts in English and Chinese. / Title Page --- p.i / Authorization Page --- p.ii / Signature Page --- p.iii / Acknowledgements --- p.iv / Table of Contents --- p.v-viii / List of Figures --- p.ix / List of Tables --- p.x / List of Append --- p.ix xi / Title Page --- p.xii / Abstract --- p.xiii / Chapter 1 --- Introduction --- p.14-15 / Chapter 2 --- Literature Review --- p.16-24 / Chapter 2.1 --- Introduction / Chapter 2.2 --- End-stage renal disease / Chapter 2.3 --- Continuous ambulatory peritoneal dialysis / Chapter 2.4 --- Patient participation / Chapter 2.4.1 --- Definition of participation / Chapter 2.4.2 --- Benefits of participation / Chapter 2.4.3 --- Problems of patient participation / Chapter 2.4.4 --- Application of patient participation / Chapter 2.5 --- Conclusion / Chapter 3 --- Methodology --- p.25-43 / Chapter 3.1 --- Introduction / Chapter 3.2 --- Overview of grounded theory / Chapter 3.3 --- Procedures / Chapter 3.3.1 --- Data generation / Chapter - --- Sampling / Chapter - --- Data gathering / Chapter - --- Data recording / Chapter 3.3.2 --- Data analysis / Chapter - --- Open coding / Chapter - --- Constant comparative analysis / Chapter - --- Categorization / Chapter - --- Axial coding / Chapter - --- Theoretical sensitivity / Chapter - --- Memoing / Chapter 3.3.3 --- Theory construction / Chapter - --- Core category / Chapter 3.4 --- Method application / Chapter 3.4.1 --- Data collection / Chapter - --- Sampling / Chapter - --- Interview / Chapter - --- Recording / Chapter 3.4.2 --- Data analysis / Chapter - --- Open coding / Chapter - --- Constant comparative analysis / Chapter - --- Categorization and Axial coding / Chapter - --- Theoretical sensitivity / Chapter - --- Memoing / Chapter 3.4.3 --- Theoretical construction / Chapter - --- Concept formation / Chapter - --- Concept development / Chapter 3.5 --- Credibility & Trustworthiness / Chapter 3.6 --- Conclusion / Chapter 4 --- Findings --- p.44-72 / Chapter 4.1 --- Introduction / Chapter 4.2 --- Core category: Integrative Restructuring / Chapter 4.3 --- Emotional Labour / Chapter 4.3.1 --- Entering the active zone / Chapter (a) --- Conditions to go into active zone / Chapter (b) --- Outcomes of emotional labour / Chapter (c) --- Strategies used for emotional labour / Chapter - --- Letting go of emotions / Chapter - --- Aligning cognitive consistency / Chapter - --- Maximizing ego / Chapter - --- Locating self / Chapter - --- Boosting power / Chapter i. --- Active control / Chapter ii. --- Building positive expectancies / Chapter iii. --- Covariance to positive expectancies / Chapter 4.3.2 --- Retreating into comfort zone / Chapter (a) --- Contexts of comfort zone / Chapter (b) --- Conditions to build comfort zone / Chapter (c) --- Strategies used within comfort zone / Chapter - --- Defending / Chapter - --- Relinquishing / Chapter - --- Anchoring / Chapter 4.3.3 --- Migrating between the two zones / Chapter (a) --- Conditions to initiate the move / Chapter (b) --- Covariance to the movement / Chapter (c) --- Strategies to make progress / Chapter 4.4 --- Conclusion / Chapter 5 --- Discussion --- p.73-92 / Chapter 5.1 --- Introduction / Chapter 5.2 --- Theoretical framework / Chapter 5.3 --- Core category: Integrative Restructuring / Chapter 5.4 --- Variables affecting the move to active zone / Chapter 5.4.1 --- Preparations / Chapter 5.4.2 --- Support / Chapter (a) --- Source of support / Chapter (b) --- Context of support / Chapter (c) --- Effects of support / Chapter (i) --- Effects upon support-seekers / Chapter (ii) --- Supporter's reaction to support-giving relationship / Chapter 5.4.3 --- Commitment / Chapter (a) --- Perception of the situation / Chapter (b) --- Cultural influences / Chapter 5.4.4 --- Control / Chapter 5.5 --- Conclusion / Chapter 6 --- Concluding Chapter --- p.93-100 / Chapter 6.1 --- Limitations / Chapter 6.2 --- Implications / Chapter 6.2.1 --- Practice / Chapter 6.2.2 --- Research / Chapter 6.2.3 --- Teaching / Chapter 6.2.4 --- Policy Making / Chapter 6.2.5 --- Summary / Chapter 6.3 --- Future research / Chapter 6.4 --- Reflections upon the study / Chapter 6.5 --- Conclusion / References --- p.101-112