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EN
Purpose: Recent studies have shown that the role of social support is a predictive factor influencing the course of the disease. The current study is focused on patients’ assessment of quality of life and the relationship of the latter with perceived social support. Materials and methods: A total sample of 40 hemodialysis patients voluntarily participated in this study. Participants were recruited from two clinics in Athens and have been under hemodialysis. The measures used were the Missoula- Vitas Quality of Life Index–15 and the Multidimensional Scale of Perceived Social Support. For the data analysis descriptive statistics, parametric Pearson r test and Non-parametric Spearman’s rho test were used. Statistical level was set up at 0.05. Results: The results of the current study provide good quality of life of hemodialysis patients and significant statistical significance between quality of life in several domains. Conclusions: This study concludes that the participants’ assessment of quality of life is poor regarding the well-being dimension. Also, perceived social support is significantly related to quality of life
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Purpose: To assess pain levels of hemodialysis (HD) patients and to report pain management techniques. Materials and methods: A quantitative descriptive study design with a summative approach to qualitative analysis was held, with a personal interview of the HD patients in a Southern European city hospital (n=70), using the Visual Analog Scales (VAS), the Wong-Baker Pain Scales (WBPS) and McGill Pain Questionnaire. People confused or in a coma, with hearing or reading problems and inability to communicate in the spoken language were excluded. Results: Renal patients under investigation were 69.72 ±12.45 years old, male (58.5%) and on HD for 35.5 ± 27.4 months. In the Wong Baker Scale, pain was rated as “hurts little more” 30.8%, (n=20) and in the VAS 30.8% (n=20) reported 6/10 the amount of pain experienced. Forty-six percent pinpointed internal pain in the legs. Pain experienced was characterized as sickening (70.8%), tiring (67.7%), burning (66.2%), rhythmic (86.2%), periodic (66.2%) and continuous (61.5%). The patients studied mainly manage pain either with warm towel/cloth (85.2% females and all male patients), with massage (84.2% and 88.9%, respectively) or painkillers (47.4% and 52.6%, respectively). In a correlation of gender and pain management techniques, statistical significance was found only with warm towel (p=0.038). Conclusions: As renal patients are an increasing group of healthcare service users, and pain is affecting their everyday life, it is essential to individualize pain evaluation and to provide further education to clinical nurses so that they can effectively manage pain.
EN
Introduction: Proton-pump inhibitors (PPIs) are a class of drugs which decrease gastric acid production, their overuse is becoming increasingly common. Purpose: The aim of this study was to evaluate medical indications for PPIs in a cohort of prevalent hemodialysis (HD) patients and their awareness about the medical effects of these drugs. Materials and methods: The study was performed in 78 HD patients enrolled in a chronic dialysis program in a single academic dialysis unit. The study was based on medical history obtained from the patients (survey about drugs they take with intention of revealing PPIs, indications for the treatment, their awareness of the mechanism of action of these drugs).Results: 46 patients (59%) took or have been taking PPIs. Almost half (49%; n=22) had no clear medical indications for the drugs. Prescription of PPIs without medical indications was more common among nephrologists (27%), when compared with gastroenterologists (5%; p<0.05). Only 29% (n=13) of patients taking PPIs were aware of the mechanism of action of the drugs. Conclusions: Results of this study reveal the problem of PPI overuse among HD patients. Gastroenterologists usually prescribed PPIs according to medical indications. Lack of patients’ knowledge about the indications for PPI therapy is overwhelming.
PL
Leczenie nerkozastępcze może odbywać się w formie dializoterapii i transplantacji nerek. Dializoterapia jest przeprowadzana za pomocą dwóch metod: hemodializy i dializy otrzewnowej. Proces hemodializy (HD) jest dynamicznym zabiegiem, w czasie którego osocze krwi pacjenta jest poddawane kilkugodzinnemu oddziaływaniu na nie roztworu leczniczego, jakim jest płyn dializacyjny. Do najważniejszych ostrych powikłań, jakie mogą wystąpić w trakcie zabiegu, należą: hipotonia i hipertonia śróddializacyjna, kurcze mięśni, świąd skóry, odczyny gorączkowe, hipoglikemia. Rzadziej występują zespół pierwszego użycia dializatora, zespół niewyrównania, hiper- i hipokaliemia, zator powietrzny, hemoliza. Ważnym członkiem w zespole terapeutycznym stacji dializ jest pielęgniarka. To właśnie ona jest najbliżej pacjenta, sprawuje bezpośredni nadzór nad prawidłowym przebiegiem zabiegu hemodializy, obserwuje chorego, reaguje natychmiast, kiedy pojawią się powikłania. Odgrywa również znaczącą rolę w edukacji chorych, co skutkuje poprawą jakości życia, lepszym samopoczuciem w okresie międzydializacyjnym oraz zmniejszeniem liczby powikłań.
EN
Renal replacement therapy may take the form of dialysis and kidney transplantation. Dialysis is performed by means of two methods: hemodialysis and peritoneal dialysis. Hemodialysis (HD) is a dynamic procedure during which the patient's blood plasma is exposed for a few hours to a therapeutic solution such as dialysis fluid. The most important acute complications that may occur during the procedure are hypotension and hypertonic muscle cramps, skin pruritus, fever, hypoglycaemia. The less frequently observed complications include the first dialysis use syndrome, decompensation syndrome, hyperand hypocalcaemia, air embolism and hemolysis. A nurse is an important member of the therapeutic dialysis unit. She is in direct control of the normal course of hemodialysis, she observes the patient, reacting immediately whenever complications occur. She plays an important role in the process of educating patients, which results in improved quality of life and improved well-being observed in patients during the interval between dialysis and the reduction in the number of occurring complications.
EN
BackgroundThe chronic kidney disease, blood hypertension and diabetes are recognized as civilization diseases that affect more and more people. The probability of encountering a patient suffering from these diseases is increasing. As such, it appears crucial to better understand the specific dental needs of such groups of patients. The aim of the work was to assess the oral hygiene status and the needs of patients suffering from the end-stage chronic kidney disease, arterial hypertension or/and diabetes.Material and MethodsTwo hundred and twenty eight patients were included in the research. One hundred and eighty patients were hemodialized in Diaverum dialysis stations and 48 patients were from the Conservative Dentistry with Endodontics Clinic of the Academic Centre of Dentistry in Bytom, Silesian Medical University in Katowice, and from the Dentistry Division of the Arnika Clinic in Zabrze, and were not not diagnosed with any of the diseases mentioned. The research scheme was divided into 3 parts, consisting of an analysis of the general health socio-economic status, a survey and an assessment of oral health.ResultsThe patients who were not suffering from any of the discussed diseases were more aware of how to properly perform hygienic procedures. Most of the patients from both the control and examined groups were not using any rinsing solutions. A higher percentage of patients in the control group was using dental floss, changing their toothbrush every 3 months and brushing their teeth for ≥2 min. The Aproximal Plaque Index and the Oral Hygiene Index-Simplified values in the control group were significantly lower in comparison to the examined group.ConclusionsThe socio-economic status of hemodialized patients was low, which in most cases was a result of the difficulties in starting a job. Due to the lower standards of life, the neglect of oral hygiene maintenance and its consequences could be observed.
EN
ObjectivesThe aim of the presented study was to compare the health locus of control (HLC) between employed and unemployed patients after kidney transplantation (KT), and to investigate the relationship between HLC and the quality of life (QoL).Material and MethodsThe study group consisted of 101 KT patients and the control group of 60 hemodialysis (HD) patients. The applied methods were: the Multidimensional Health Locus of Control Questionnaire (MHLC), the WHO Quality of Life Questionnaire (WHOQoL-BREF), and a survey collecting information on the socio-demographic status and work experience.ResultsOverall, 57.5% of KT patients were employed and 42.5% were unemployed. In the HD group, 25% were employed and 71% were unemployed, while 4% did not disclose their employment status. The unemployed KT patients, in comparison with the employed ones, presented a higher feeling of the impact of chance on their health (unemployed M±SD 23.68±6.59; employed M±SD 21.02±4.57) and a lower level of QoL on the Somatic Scale (unemployed Me = 14.00, IQR = 3.00; employed Me = 1450, IQR = 3.00) and the Environmental Scale (unemployed M±SD 15.39±2.83; employed M±SD 16.85±3.24). In the employed KT group, the Internal Control Scale (MHLC) correlated with all QoL scales (the Somatic Scale: r = 0.292, p = 0.036; the Psychological Scale: r = 0.455, p = 0.001; the Social Scale: r = 0.304, p = 0.029; and the Environmental Scale: r = 0.307, p = 0.027). In the unemployed KT group, the Internal Control Scale (MHLC) correlated significantly with the Somatic Scale (r = 0.396, p = 0.013) and the Psychological Scale (r = 0.374, p = 0.019).ConclusionsThe employed KT patients have a higher level of independence, with results indicating a strong internal type. Additionally, the working patients assess their QoL better, both in terms of their health condition and the organization of satisfying environment. The obtained knowledge about the psychological characteristics of KT patients may be useful for the occupational activation programs and psycho-education for those with weaker predispositions.
PL
Na całym świecie, w tym także w Polsce, obserwuje się stały wzrost populacji pacjentów ze schyłkową niewydolnością nerek wymagających leczenia nerkozastępczego. Liczba chorych dializowanych z powodu cukrzycowej choroby nerek utrzymuje się na wysokim poziomie i systematycznie rośnie. Celem pracy była próba ukazania zakresu opieki pielęgniarskiej nad pacjentem dializowanym z powodu cukrzycowej choroby nerek. Posłużono się metodą „studium indywidualnego przypadku”. Wykorzystano techniki badawcze: wywiad, analiza dokumentacji medycznej, obserwacja, pomiar parametrów życiowych. Opieka pielęgniarska nad pacjentem dializowanym z powodu cukrzycowej choroby nerek wymaga wnikliwej obserwacji chorego oraz umiejętności rozpoznawania i szybkiego reagowania na mogące wystąpić powikłania hemodializy. Celem opieki jest umiejętne rozpoznawanie problemów pielęgnacyjnych i wprowadzenie profesjonalnych działań, które doprowadzą do ich rozwiązania. Oprócz działań doraźnych niezbędna jest edukacja i profilaktyka.
EN
Worldwide, Poland included, a steady increase can be observed in the population of patients with end-stage renal disease who require renal replacement therapy. The number of the sick dialysed due to diabetic kidney disease remains high and is growing systematically. The aim of this paper is to present the nursing problems involved in the care of patients dialysed due to diabetic kidney disease. The ‘individual case study’ method has been employed here. The research techniques used include: an interview, a talk, an analysis of medical documentation, participant observation as well as an analysis of the results of laboratory and specialist tests. Nursing care of patients dialysed due to diabetic renal disease involves their careful observation as well as requiring the ability to recognise and quickly respond to possible complications following hemodialysis. The purpose of the care in question is skillful identification of nursing problems and implementation of solutions leading to effective problem resolution. Apart from immediate actions, education and prophylaxis are essential.
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