Patients undergoing maintenance hemodialysis are characterized with lower cardiorespiratory capacity and muscle atrophy, thus easily leading to a sedentary lifestyle. These patients are usually associated with lower quality of life and worse prognosis. Evidence indicates appropriate exercise rehabilitation plan could help maintenance hemodialysis patients achieve better health outcomes. However, there is still a lack of evidence data to precisely recommend exercise type, intensity, frequency and timing specially designed for maintenance hemodialysis patients. This article aims to summarize the existing expert consensus on exercise rehabilitation for maintenance hemodialysis patients, important considerations in the implementation process, factors that affect exercise rehabilitation, with a view to encouraging maintenance hemodialysis patients to participate in the development of appropriate exercise rehabilitation plan and maximize health benefits.
Objective To explore the current situation and influencing factors of self-regulatory fatigue in maintenance hemodialysis (MHD) patients, so as to provide good dialysis treatment for MHD patients, reduce their level of self-regulated fatigue and improve their quality of life. Methods The convenient sampling method was used to select the MHD patients in the Wenjiang Hemodialysis Center of West China Hospital of Sichuan University between April 12 and April 30, 2022. The patients were investigated by self-made basic information scale and self-regulatory fatigue scale. Results A total of 131 patients were included. The average score of self-regulatory fatigue was 53.47±6.45, cognitive dimension was 20.21±2.39, emotional dimension was 20.85±2.85, behavioral dimension was 12.40±3.63. The results of multiple linear stepwise regression analysis showed that age, duration of dialysis and educational background could inversely predict the score of self-regulatory fatigue (P<0.05). Conclusions MHD patients have a high level of self-regulatory fatigue. Clinical nurses can make individual dialysis programs according to the actual situation of MHD patients, improve their self-regulated level and physical and mental health, and improve the quality of life of MHD patients.
Objective To explore the current status of electronic health (eHealth) literacy and online health information seeking behavior of maintenance hemodialysis (MHD) patients, and to explore the relationship between them. Methods MHD patients in the Hemodialysis Center of West China Hospital of Sichuan University between January and April 2022 were selected by convenient sampling method. The patients were investigated with general condition questionnaire, eHealth Literacy Scale and internet health information retrieval behavior questionnaire. According to the score of eHealth literacy, patients were divided into high eHealth literacy group and low eHealth literacy group, to compare the differences between the two groups, and analyze the factors that affected the internet health information retrieval behavior. Results A total of 194 MHD patients were included. Among them, 112 were male and 82 were female. The average score of eHealth literacy was 24.84±9.24. There were 136 cases in low eHealth literacy group, and the average score of eHealth literacy was 20.76±7.91. There were 58 cases in high eHealth literacy group, and the average score of eHealth literacy was 34.36±3.01. Multivariate analysis showed that eHealth literacy and education level were the influencing factors of health information search behavior (P<0.05). Conclusions The overall eHealth literacy of MHD patients is low, and the online health information search means is single and behaviorally inconsistent. It is necessary to improve the eHealth literacy of hemodialysis patients, and at the same time, provide various health information publicity and education for patients with different levels of eHealth literacy, which will help them better carry out disease management.
Objective To investigate the current status of health promoting lifestyle in maintenance hemodialysis (MHD) patients and to explore its correlation with chronic illness resource utilization. Methods Patients who underwent outpatient MHD in the Hemodialysis Room of the Department of Nephrology, West China Hospital, Sichuan University between January and March 2023 were selected. Patients were surveyed using the General Information Questionnaire, Chronic Illness Resource Survey, and Health Promoting Lifestyle Profile-Ⅱ Revise. Results A total of 158 patients were surveyed. MHD patients scored 103.37±18.52 on health promoting lifestyle, and 68.95±14.14 on chronic illness resource utilization. The Pearson correlation analysis results showed that there was a positive correlation between the chronic illness resource utilization and the total score of health promoting lifestyle in MHD patients (r=0.765, P<0.001), as well as scores in all dimensions (P<0.05). The results of multiple linear regression analysis showed that the main caregivers being parents [non-standardized partial regression coefficient (b)=8.150, 95% confidence interval (CI) (0.804, 15.497), P=0.030], weekly dialysis times [b=10.701, 95%CI (2.787, 18.615), P=0.008], and chronic illness resource utilization [b=0.936, 95%CI (0.800, 1.072), P<0.001] were influencing factors for health promoting lifestyle. Conclusions MHD patients have an average health promoting lifestyle, and ideal chronic illness resource utilization. Hemodialysis nurses can take targeted measures to enhance chronic illness resource utilization and health promoting lifestyle in MHD patients, which can further improve the quality of life of MHD patients.
ObjectiveTo discuss the application of Miller pyramid teaching method in the competency training of new nurses in hemodialysis room and evaluate the effect.MethodsFourteen new nurses in hemodialysis room adopting conventional teaching method from January 2017 to December 2018 were retrospectively selected as the control group; from January to December 2019, another 14 new nurses in hemodialysis room were prospectively selected as the trial group and Miller pyramid teaching method was adopted. After three months of training, the theory and operation of the two groups of new nurses were assessed, and the post competency was assessed by using the Competency Inventory for Registered Nurse, and the teaching satisfaction was assessed by using the self-designed questionnaire on the teaching effect satisfaction of new nurses in hemodialysis room. The data of the two groups were compared.ResultsThe theoretical examination score (91.54±5.89 vs. 83.86±6.45), operational examination score (96.89±3.65 vs. 90.58±5.15), score of Competency Inventory for Registered Nurse (186.66±4.89 vs. 163.76±6.89), and teaching satisfaction (4.56±0.72 vs. 3.56±0.97) in the trial group were all higher than those in the control group, the differences were statistically significant (P<0.05).ConclusionMiller pyramid teaching method is feasible to train the post competency of new nurses in hemodialysis room, which is helpful to improve the theoretical basis, operational skills, post competency, and teaching satisfaction of new nurses in hemodialysis room.
In 2020, chronic kidney disease has become one of the top 10 causes of death in the world. More and more evidence shows that proper exercise rehabilitation is beneficial to the health of patients with chronic kidney disease, which can improve the survival rate and slow down the decline of renal function. However, existing studies have significant differences in form, intensity, duration, and specific implementation methods of sports rehabilitation, which need to be further standardized and unified. This article introduces the impact of exercise rehabilitation on patients with chronic kidney disease and the clinical application of Chinese traditional exercises in patients with chronic kidney disease, and mainly discusses the application experience of exercise rehabilitation characterized by “Three-in-one Taiji” in the Department of Nephrology of West China Hospital of Sichuan University. It aims to provide a basis for the model innovation of integrated management of chronic kidney disease in China.
Objective To understand the incidence of frailty in maintenance hemodialysis (MHD) patients, and to explore the correlation and influencing factors of frailty in MHD patients, so as to provide some basis for the intervention of frailty in MHD patients. Methods Patients who underwent MHD in the Department of Nephrology of West China Hospital of Sichuan University from January to March 2021 were selected. Frail scale and Pittsburgh Sleep Quality Index (PSQI) were used for evaluation, and the influencing factors of frail in patients with MHD and its correlation with frail were analyzed. Results A total of 141 patients with MHD were included, including 57 cases without frailty (40.43%), 71 cases in early frailty (50.35%), and 13 cases in frailty (9.22%). 54 cases (38.30%) had very good sleep quality, 56 cases (39.72%) had good sleep quality, 24 cases (17.02%) had average sleep quality, and 7 cases (4.96%) had very poor sleep quality. The frailty of MHD patients was positively correlated with age (rs=0.265, P=0.002), PSQI (rs=0.235, P=0.005) and magnesium (rs=0.280, P=0.001). Logistic regression analysis showed that the influencing factors of MHD patients’ frailty were gender [odds ratio (OR) =4.321, 95%confidence interval (CI) (1.525, 12.243), P=0.006], PSQI [OR=1.110, 95%CI (1.009, 1.222), P=0.032], magnesium [OR=122.072, 95%CI (4.752, 3 135.528), P=0.004], hypertension [OR=0.112, 95%CI (0.023, 0.545), P=0.007] and other diseases [OR=0.102, 95%CI (0.019, 0.552), P=0.008]. Conclusions The incidence of frailty in MHD patients is high. Gender, PSQI, magnesium, hypertension and other diseases are the influencing factors of frailty in MHD patients, and there is a correlation between frailty and sleep. It is suggested that renal medical staff should pay more attention to the assessment of MHD frailty and sleep, and carry out multi-disciplinary personalized intervention to improve the quality of life of MHD patients.
The incidence of sarcopenia and frailty in maintenance hemodialysis patients are high, and there are often comorbidities, which easily lead to more complications, thus increasing the hospitalization rate and reducing the quality of life of patients. This article reviews the definition, physiological mechanism, incidence and diagnosis, relationship and treatment strategies of sarcopenia and frailty in maintenance hemodialysis patients, in order to better prevent and intervene the occurrence of sarcopenia and frailty and provide a reference for prevention and treatment.
Objective To explore the current status of nutritional literacy in maintenance hemodialysis (MHD) patients and analyze its influencing factors. Methods MHD patients in Wenjiang Hemodialysis Center of West China Hospital, Sichuan University between January and April 2022 were selected by convenient sampling method. A questionnaire survey was conducted using the Nutrition Literacy Evaluation Scale for end-stage renal disease dialysis patients, and the current status and influencing factors of nutritional literacy in MHD patients were analyzed. Results A total of 214 patients were included, with an average nutritional literacy score of 19.14±5.78 for MHD patients. Among them, there were 60 cases (28.04%) of highly likely low nutritional literacy, 124 cases (57.94%) of moderate nutritional literacy, and 30 cases (14.02%) of highly likely high nutritional literacy. The correlation test results showed that hemoglobin, albumin, cholesterol, triglyceride, calcium, phosphorus, potassium, creatinine, estimated glomerular filtration rate, and nutritional literacy scores were not correlated. The results of multiple linear stepwise regression analysis showed that education level [non-standardized partial regression coefficient (b)=1.821, 95% confidence interval (CI) (1.143, 2.498), P<0.001], age [b=−2.460, 95%CI (−4.247, −0.672), P=0.007], hypertensive kidney damage [b=2.233, 95%CI (0.428, 4.039), P=0.016] were all factors affecting the nutritional literacy of MHD patients. Conclusions In clinical work, more attention should be paid to MHD patients with low educational level, older age, and more primary diseases. And targeted interventions should be adopted to improve the level of nutritional literacy in order to improve the quality of life of MHD patients.
At present, the whole lifecycle management of vascular access for hemodialysis in China is still in its early stages. Faced with a large group of chronic kidney disease patients, hospitals at all levels lack systematic and continuous nursing management models. To address the issue of lacking continuous and effective nursing management of vascular access for dialysis during the period from hospitalization for autologous arteriovenous fistula surgery to outpatient maintenance hemodialysis treatment, this article introduces the background, specific implementation methods, and preliminary results of the new model of integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period constructed by the Wenjiang Hemodialysis Center of West China Hospital, Sichuan University. The purpose is to explore a new model for continuous and effective management of vascular access for hemodialysis patients.