by Yip Mei Po. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 128-150). / Abstract and questionnaire also in Chinese. / Acknowledgements --- p.i / Abstract --- p.iii-iv / Chapter Chapter 1 --- Introduction --- p.1 / Chapter Chapter 2 --- Literature Review / End stage renal failure and dialysis therapy --- p.3 / Stress / The concept of stress --- p.4 / Lazarus' stress and coping model --- p.5 / Different approaches to stress --- p.6 / Stressors in hemodialysis patients: a convergence of chronic strains and daily hassles --- p.8 / The outcome of stressors in hemodialysis patients --- p.10 / Coping / Definition: Coping as a process --- p.12 / Problem focused and emotional focused coping --- p.12 / Functions of coping: its effectiveness --- p.14 / The use of coping methods in hemodialysis patients --- p.17 / Factors affecting coping response to illness in hemodialysis patients --- p.19 / Social Support / Approaches to social support: definitions and measurements --- p.22 / The effect of social support on adjustment to illness --- p.25 / "Social support as a coping resource in hemodialysis patients," --- p.27 / Quality of life / Quality of life as an adjustment outcome to illness --- p.28 / "The quality of life concept: dimensions, components and measurement" --- p.29 / Limitations of studies of quality of life in hemodialysis patients --- p.33 / Approaches to quality of life in hemodialysis patients --- p.34 / "The relation between stress, coping, social support and quality of life" --- p.36 / Chapter Chapter 3 --- Method / Research design --- p.38 / Research hypothesis --- p.40 / Operational definitions --- p.41 / Population --- p.42 / Sample --- p.43 / Ethical issue --- p.47 / Data collection --- p.50 / Instruments --- p.56 / Data analysis --- p.64 / Chapter Chapter 4 --- Results / Descriptives analyses --- p.66 / Correlation analyses --- p.83 / Regression analyses --- p.88 / Supplementary qualitative data --- p.90 / Chapter Chapter 5 --- Discussion and conclusion / Stressors --- p.98 / Coping --- p.104 / Social support --- p.108 / Quality of life --- p.110 / "Stress, coping, social support and quality of life" --- p.114 / Predictors of quality of life --- p.119 / Conclusions --- p.122 / Chapter Chapter 6 --- Limitation of the study --- p.124 / Implications and recommendations --- p.126 / References --- p.128 / Appendices / Chapter A. --- Table showing relationship of the use & effectiveness of eight coping styles with length of time on treatment / Chapter B. --- Descriptions of eight coping styles on the 1987 revised Jalowiec Coping Scale / Chapter C. --- A Sample of interview script / Chapter D. --- Letter of ethical approval / Chapter E. --- Letter of request for permission to conduct researchin clinical setting / Chapter F. --- Letter of request for revealing Hemodialysis Stressor Scale / Chapter G. --- Questionnaire / Chapter H. --- Consent form

No description available.

Dissertation in fufillment of the degree of MSc(Med), Faculty of Health Sciences, University of the Witwatersrand / Introduction: Measurement of small solute clearance is the objective means of quantifying dose of peritoneal dialysis (PD) and various organisations have issued guidelines on target values. Assessment of PD adequacy involves other factors such as blood pressure control, anaemia management, mineral metabolism, nutritional status and ultrafiltration. Membrane transport characteristic is important for PD prescription on an individual patient basis and is related to patient outcome. In this study the adequacy of PD, using small solute clearance measurement as well as other factors, and membrane characteristics have been assessed and classification of patients using our own reference values is reported for the first time. Nutritional status has been studied and the use of simple tools such as the subjective global assessment has been validated for use in our patients. Materials and Methods: A cross sectional study involving 80 adult continuous ambulatory peritoneal dialysis (CAPD) patients. Peritoneal equilibration test (PET) was performed to assess the membrane characteristics; 24 hour dialysate fluid and urine samples were collected and used for the measurement of solute clearance, while nutritional status was assessed using the subjective global assessment (SGA) instrument, anthropometric measurements and serum albumin estimation. Results: The mean age was 38 ± 12.43 years, 42.3% were females and 86% were blacks. Mean duration on CAPD was 19.8 ± 20.67 months. The mean of 4 hour D/P creatinine was 0.74 ± 0.13 and based on this, 18% were high transporters, 33.8% high average, 36.9% low average and 12% low transporters. Mean kt/v urea was 1.72± 0.32, and the recommended level of 1.7 was achieved by 62.8% of the patients. Mean haemoglobin was 10.99 ± 2.14 g/dl and the recommended target value of 11-12g/dl was reached by 55.8% of the patients. The mean BMI vi was 24.76 ± 3.50, mean Mid Upper Arm Circumference (MUAC) was 28.53±3.89 cm and mean serum albumin was 37.10 ± 7.6 g/l. Based on SGA scores, 42% of our patients were well nourished, 50% moderately undernourished while 8% were severely malnourished. We noted significant correlations between SGA score and BMI and MUAC while there was none with serum albumin level. The mean serum calcium and phosphate levels were within normal though the mean PTH level was higher. Conclusion: The D/P creatinine at 4 hours was higher than those reported in the literature, though the distribution of the transport types was similar. The recommended targets of kt/v and haemoglobin were achieved by the majority of our patients. Mineral metabolism parameters were within normal range. Malnutrition is common and SGA is a reliable method for nutritional assessment in our patients.

Thesis (M.S.)--Virginia Commonwealth University, School of Nursing. / Includes bibliographical references (leaves 48-52). Also available online.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine in Anaesthesia Johannesburg, 2015 / Patients with chronic renal failure are considered to be at risk of perioperative pulmonary aspiration and consequently the recommendation is to perform a rapid sequence induction on such patients. Rapid sequence induction is not without its risks and may not be necessary. The aim of this study was to determine whether patients who are on a chronic haemodialysis program have sufficient residual gastric contents after an overnight fast, to place them at risk of pulmonary aspiration of gastric contents during anaesthesia. The presence and volume of gastric content was ascertained by ultrasound examination of the stomachs of twenty patients. Patients were asked to fast overnight and an ultrasound was scheduled for a morning on which the patient was due to come in for a dialysis session. The appearance of the stomach and the contents were graded by the radiologist and the diameters of the gastric antrum were then measured so that the cross sectional area could be calculated. Once the cross sectional area was known the gastric volume was calculated using a validated equation. The risk of perioperative pulmonary aspiration was then assessed according to the graded appearance as well as calculated gastric volumes. If the stomach was found to contain fluid a cut off value of 0.8ml/kg was used as a relative gastric volume that would place the patient at increased risk of perioperative pulmonary aspiration. Any patient with a gastric antrum found to be distended with fluid in both the supine and lateral positions or seen to contain solid contents was assessed as being at increased risk of perioperative pulmonary aspiration. Gastrointestinal symptoms were assessed and compared to residual gastric volumes. Urea and creatinine concentrations were also correlated to residual gastric volumes. In this study none of the patients with chronic renal failure on a chronic haemodialysis program were considered to be increased risk of perioperative pulmonary aspiration, after an overnight fast. Gastrointestinal symptoms were found in 60% of patients. There was no association between gastrointestinal symptoms and residual gastric volumes. There was no correlation between either urea or creatinine levels and residual gastric volumes.

Diss. Linköping : Univ., 2002.

MSc(Med), Bioethics and Health Law, Faculty of Health Sciences, University of the Witwatersrand / The current exclusion criteria for accessing renal dialysis in South African public hospitals places great emphasis on the allocation of scarce resources. The case of Soobramoney at the Constitutional Court highlighted the ethical and legal implications of providing this scarce resource. Mr. Soobramoney was denied access to renal dialysis on the basis of scarce resources and he did not qualify for care due to not meeting the criteria set for renal care. The Soobramoney case was considered mainly on the basis of scarce allocation of resources and offering treatment on an emergency basis. It was argued by the appellant that the state had an obligation to provide him with the treatment in terms of s 27(3) read with s 11 of the Constitution (para 14). This report takes a different slant and looks at the quality of life argument for increasing access to renal dialysis for those denied it based on current South African protocols. In exploring this concept one would venture to offer a definition of ‘quality of life’ according to Brown as an overall sense of well-being. This includes an individual’s satisfaction with their own lives (Brown, 2007: 72). A health related quality of life extends the definition to include the way a person’s v health affects their ability to carry out normal social and physical activities (ibid). A case is made for increasing access by developing programmes to cater for those in need of enhancing their quality of life. This is what is being motivated for in cases similar to Soobramoney, especially those with comorbid disease. The quality of life argument is based on the fact that there are indications in literature that patients with end-stage renal disease rate their own quality of life to be as important as the quality of life of the general population. Furthermore, there is no indication that the elderly live more miserable lives when they are on dialysis. The idea of respect for persons is highlighted - respect for the autonomous choices patients make concerning how they live their lives and including respect for them towards the end of their lives. Finally, I reflect on some legal issues concerned with the Soobramoney versus the Minister of Health Kwa-Zulu Natal 1997.

Diss. (sammanfattning) Umeå : Univ., 2006. / Härtill 5 uppsatser.

Thesis (doctoral)--Lund University, 1995. / Added t.p. with thesis statement inserted.

Thesis (M.S.)--University of Wisconsin--Madison, 1985. / Typescript (photocopy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 81-86).