Benefit of an Internet-Based Management System among Hemodialysis Patients at the Risk of Intradialytic Hypotension and Muscle Cramps: A Controlled before and after Study

2021 ◽  
pp. 1-8
Author(s):  
Jinsheng Xu ◽  
Jingjing Jin ◽  
Meijuan Cheng ◽  
Wei Zhou ◽  
Shenglei Zhang ◽  
...  
Keyword(s):  
Management System ◽  
Intervention Group ◽  
Hemodialysis Patients ◽  
Muscle Cramp ◽  
Self Management ◽  
The Internet ◽  
Intradialytic Hypotension ◽  
Significant Implication ◽  
Muscle Cramps ◽  
Before And After

<b><i>Background:</i></b> The purpose of this study was to observe the impact of an internet-based management system on the incidence of intradialytic hypotension (IDH) and muscle cramps in hemodialysis patients. <b><i>Methods:</i></b> The patients, who underwent maintenance hemodialysis in the center from January 2018 to June 2020, were recruited and divided into the pre-intervention group (before operation of the internet-based hemodialysis management system, from January 2018 to December 2018) and intervention group (after operation of the system, from June 2019 to June 2020). The clinical outcomes were compared between groups. <b><i>Results:</i></b> The compound endpoint of &#x3e;1 IDH or muscle cramps happened in 182 patients (61.7%) in the pre-intervention group and 99 participants (30.8%) in the intervention group (relative risk [RR] = 0.50 [95% confidence interval [CI], 0.42; 0.60]). IDH occurred in 122 patients (1–5 episodes in 47 patients, 6–10 episodes in 25 patients, and &#x3e;10 episodes in 50 patients) and 33 patients (30 patients had 1–5 episodes and 3 patients had 6–10 episodes) before and after execution of the internet-based management system, respectively (RR = 0.25 [95% CI, 0.18; 0.35]). The incidence of muscle cramps was significantly decreased (RR = 0.57 [95% CI, 0.45; 0.73]) after the implementation of the system, and the number of patients with 6–10 episodes dropped from 10 to 1. Multivariate analyses also showed significantly lower RRs in the intervention group: 0.29 ([95% CI, 0.20; 0.41]) for IDH and 0.58 ([95% CI, 0.45; 0.74]) for muscle cramps. Compared with the pre-intervention, participants in the intervention group had a large improvement in self-management (<i>p</i> &#x3c; 0.001) and self-efficacy (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> The study found that the internet-based hemodialysis management system was effective in reducing the IDH and muscle cramp events and improving self-management. It provided a significant implication for the development and application of internet-based programs in hemodialysis management.

THE EFFECT OF DHIKR ON ANXIETY AND DEPRESSION LEVEL IN HEMODIALYSIS PATIENTS AT PURWOKERTO ISLAMIC HOSPITAL

2021 ◽  
Vol 2 (1) ◽  
pp. 15-25
Author(s):  
Muhammad Anggun ◽  
Titik Kusumawinakhyu ◽  
Irma Finurina Mustikawati ◽  
Wiharto Wiharto
Keyword(s):  
Intervention Group ◽  
Depression Scale ◽  
Sampling Technique ◽  
Hemodialysis Patients ◽  
Anxiety And Depression ◽  
Control Group ◽  
Control Group Design ◽  
Hemodialysis Unit ◽  
Before And After ◽  
The Mean

Hemodialysis is a routinely performed therapy on chronic kidney patients, leading to psychological problems among subjects who undergo hemodialysis, such as anxiety and depression. One of the efforts to overcome anxiety and depression is with the dhikr intervention. Dhikr presents hearts to remember and be obedient to Allah followed by the words and actions in various conditions.  Discover dhikr's influence on the level of anxiety and depression in patients on hemodialysis in  Purwokerto Islamic Hospital. It was a quantitative study using quasi experiment with a non-quivalent control group design. The number of samples was 12 subjects consisting of 6 subjects in the control group and six subjects in the intervention group with the purposive sampling technique. Instruments were used to measure anxiety and depression are the HADS ( Hospital Anxiety and Depression Scale ) before and after dhikr intervention as much as 12 times. Research is carried out in Hemodialysis Unit of  Purwokerto Islamic Hospital. Test statistics on research are used paired t-test and independent t-tests. This study showed a decrease in the mean level of anxiety from 5, 83 to 1.67 in the experimental group ( p = 0.003). The mean level of depression experienced a decline of 9, 67 becomes 4.67 on a group experiment ( p = 0.003). Dhikr reduces the level of anxiety and depression in hemodialysis patients at the Purwokerto Islamic Hospital.

Pengaruh Pendidikan Kesehatan Menggunakan Booklet Berbahasa Madura Terhadap Self Management Pada Klien Hipertensi di Poli Jantung Rsud dr. Abdoer Rahem Situbondo

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Silvia Nuruddani ◽  
Handono Fatkhur Rahman ◽  
Setiyo Adi Nugroho ◽  
Sri Astutik Andayani ◽  
Abdul Hamid Wahid
Keyword(s):  
Health Education ◽  
Quantitative Research ◽  
Intervention Group ◽  
T Test ◽  
Self Management ◽  
Uncontrolled Hypertension ◽  
Control Group ◽  
P Value ◽  
Before And After ◽  
Group A

Objective:   Hypertension  is one of the main problems of public health, and if still a big challenge in indonesia with a high prevelention amounting to 34,1% (percent). Uncontrolled hypertension will cause  complication and death. One of the factors that can cause hypertension is a bad self management. To improve self management on hypertensive dilent is health education needs to be done.Methods:   The kind of quantitative research with Quasi Experiment design in the form of a Pretest-Posttest Nonequivalent Control Group sampale selection with Simple Random Samping as many as 40 respondets 20 intervention groups, 20 control graups data collection techniaques with self management questioner (H-SCALE).Results:   Paired T-test results of the intervention group obtained a P-value of 0,000, and in the control group a P-value of 0.106 was obtained. While the results of the Independent T-test in the intervention group and the control group obtained a value of 0,000. So it can be said that there are effects and differences before and after health education is given to hypertension client self management. Conclusion:   Expected by health education obout hypertension can improve self management on hypertension drent.

scholarly journals Interleukin-31 Serum And Pruritus Dimension After Acupuncture Treatment In Hemodialysis Patients: A Randomized Clinical Trial

2021 ◽  
Vol 9 (B) ◽  
pp. 196-201
Author(s):  
Dedi Ardinata ◽  
Rozaimah Zain-Hamid ◽  
Irma. D. Roesyanto-Mahadi ◽  
Hasan Mihardja
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Intervention Group ◽  
Serum Levels ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Placebo Control ◽  
Limited Information ◽  
Before And After ◽  
The Impact

BACKGROUND: Interleukin (IL)-31 serum levels were significantly higher in hemodialysis patients with pruritus, whereas acupuncture in LI11 was shown to improve symptoms of pruritus. However, there is limited information that IL-31 serum levels that correlate with decreased dimensions of the pruritus after acupuncture in LI11 in a hemodialysis patient. AIM: The aim of the study was to demonstrate the impact of acupuncture in LI11 and IL-31 serum level and its correlation with dimensions of the pruritus in hemodialysis patients. METHODS: A randomized clinical trial has been carried out from August 2019 to December 2019 at H. Adam Malik General Hospital, Medan, Indonesia. Sixty patients underwent hemodialysis who were randomly allocated to two groups, one group got acupuncture in Quchi LI11 (intervention group), and the other group got a placebo (control group). IL-31 serum levels and pruritus were measured before and after 6 weeks of acupuncture in both groups. RESULTS: Acupuncture did not significantly reduce IL-31 (p = 0.931) and decreased dimensions: Degree, duration, disability, and distribution of the pruritus between the intervention group and the control group after 6 weeks of acupuncture in LI11. It can be shown that there is no significant correlation between IL-31 serum levels and dimensions of the pruritus. CONCLUSION: This study demonstrates the effect of acupuncture on reducing dimensions of the pruritus not related to IL-31 serum levels. Identifying the action mechanism of acupuncture to minimize pruritus considerably enhances knowledge of the impacts of acupuncture on reducing pruritus in hemodialysis patients.

scholarly journals Intradialytic Muscle Cramp and its Association with Peripheral Arterial Disease in End Stage Renal Disease Patients on Hemodialysis

2014 ◽  
Vol 52 (196) ◽  
pp. 967-971 ◽  
Author(s):  
Madhav Ghimire ◽  
Sanjib Kumar Sharma ◽  
Romila Chimoriya ◽  
Gopal Chandra Das
Keyword(s):  
Peripheral Arterial Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Arterial Disease ◽  
Hemodialysis Patients ◽  
Muscle Cramp ◽  
Muscle Cramps ◽  
Peripheral Arterial ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Muscle cramp is a common intradialytic complication observed in hemodialysis patients. Similarly Peripheral arterial disease is a common condition in the hemodialysis population. No study on intradialytic muscle cramp and its association with Peripheral arterial disease is yet reported from Nepal. Methods: Fifty patients with a diagnosis of End Stage Renal Disease who were on hemodialysis were studied over a period of one year. Muscle cramp was defined clinically as contractions of a large muscle group and Peripheral arterial disease was diagnosed on the basis of the ankle –brachial index. Chi square (X2) test was used to determine the association between Intradialytic Muscle cramps and Peripheral Arterial Disease. Results: A total of 50 End Stage Renal Disease patients were analyzed. The mean age of the patient was 49.81±12.63 years. The major causes of End Stage Renal Disease in the study population was Chronic Glomerulonephritis 40 % (n=20). Muscle cramps were present in 26% (n=13) cases. Peripheral arterial disease was present in 30% (n=15) of patients. However there was no statistically significant association between the presence of Intradialytic Muscle cramps and peripheral arterial disease (p value =0.18) Conclusions: Intradialytic Muscle cramps and peripheral arterial disease were common occurrence in end stage renal disease patients on hemodialysis patients, however there was no association between the presence of intradialytic Muscle cramps and peripheral arterial disease.  Keywords: end stage renal disease; intradialytic muscle cramps; peripheral arterial disease.

scholarly journals Community Pharmacist Services for Hypertensive Patients: A Novel Practice in Shanghai, China

2021 ◽  
Vol 58 ◽  
pp. 004695802110208
Author(s):  
Qian Liu ◽  
Xiaoyan Zhu ◽  
Mei Shen ◽  
Jianping Wu ◽  
Shuqin Chen ◽  
...  
Keyword(s):  
Community Pharmacist ◽  
Intervention Group ◽  
Community Pharmacists ◽  
Self Management ◽  
Hypertension Status ◽  
Hypertensive Patients ◽  
Management Group ◽  
Before And After ◽  
Pharmacist Services ◽  
Health Deterioration

For Chinese community pharmacists, there is a lack of guidance before and after the drug treatment process for community residents. This study aimed to investigate community pharmacists’ role in hypertension management. One hundred ninety-six hypertensive patients were randomly selected from the studied community. For patients in the intervention group, monthly meetings were scheduled with a community pharmacist. Patients in the non-intervention group received standard care from their physicians. In the intervention group, the percentage using information from pharmacists increased significantly, from 54.3% to 94.2% ( P < .05). Awareness of self-management was also enhanced, with community self-management group attendance increasing from 53.4% to 77.7% ( P < .05), but the non-intervention group did not change significantly. Hypertensive patients’ beliefs about community pharmacists also improved significantly. Hypertension status also showed a significant improvement, whereas for participants without intervention, it worsened over time. In addition to increasing knowledge regarding drug use, care provided by community pharmacists can also significantly improve blood pressure status. For those who did not receive intervention, a disproportionate level of health deterioration could be seen.

Microbiota Quality and Mitochondrial Activity Link with Occurrence of Muscle Cramps in Hemodialysis Patients using Citrate Dialysate: A Pilot Study

2018 ◽  
Vol 46 (4) ◽  
pp. 301-308 ◽  
Author(s):  
Pierre-Yves Durand ◽  
Carole Nicco ◽  
Didier Serteyn ◽  
David Attaf ◽  
Marvin Edeas
Keyword(s):  
Gut Microbiota ◽  
Hemodialysis Patients ◽  
Muscle Cramp ◽  
Mitochondrial Activity ◽  
Common Complication ◽  
Muscle Cramps ◽  
Markers Of Oxidative Stress ◽  
Stage Renal Disease ◽  
End Stage ◽  
Microbiota Diversity

Background/Aims: Hemodialysis-associated muscle cramp (HAMC) is a common complication under citrate dialysate (CD) occurring in 30% of cases. Our objectives were to assess the gut microbiota quality, mitochondrial activity, and to investigate their possible relationship with HAMC. Methods: Ten end-stage renal disease patients (78.9 ± 2.1 years) treated by hemodialysis (HD) with CD were enrolled and then classified according to the frequency of HAMCs: “frequent HAMCs group” (n = 5) and “absence of HAMCs group” (n = 5). Gut microbiota quality, mitochondrial activity, and some markers of oxidative stress (OS) were investigated. Results: In patients with cramps, gut microbiota diversity seemed lower and some genera including Helicobacter, Lachnospira, Roseburia, and Haemophilus seemed over-expressed, a significant increase of citratemia and significant lowering mitochondrial function were observed. No difference was observed on the OS markers. Conclusion: This first clinical study revealed a possible dysbiosis of microbiota and a mitochondrial dysfunction into HD patients with cramps under CD compared to patients without cramp.

scholarly journals The Effect of Resilience Training on Stress, Anxiety, Depression, and Quality of Life of Hemodialysis Patients: A Randomized Controlled Clinical Trial

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mehdi Amirkhani ◽  
Nasrin Shokrpour ◽  
Leila Bazrafcan ◽  
Ameneh Modreki ◽  
Shima Sheidai
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Intervention Group ◽  
Hemodialysis Patients ◽  
T Test ◽  
Controlled Clinical Trial ◽  
Before And After ◽  
Resilience Training ◽  
Anxiety Depression

Background: Today, the prevalence of psychological problems such as stress, anxiety, and depression in hemodialysis patients has increased and affected their quality of life. Objectives: Given the relationship between resilience interventions and psychological problems, this study aimed to investigate the effect of resilience training on stress, anxiety, depression, and quality of life in hemodialysis patients. Methods: This was a controlled clinical trial study on 57 hemodialysis patients referred to Fasa city hemodialysis centers from October to December 2019. Patients were selected using a simple sampling method and divided into two groups of intervention (n = 29) and control (n = 28) using the block randomization method. In 12 sessions of a 90-minute workshop, the intervention group was taught resilience skills by a clinical psychologist. Before and after the intervention, stress, anxiety, depression, and quality of life were measured using the Depression anxiety stress scale (DASS) 21 and SF-36 questionnaires. Data were analyzed with Statistical Package for the Social Sciences (SPSS) software version 20 using t-test, Kolmogorov-Smirnov, and chi-Square tests. Results: According to the paired t-test, the patients’ mean score of stress, anxiety, and quality of life significantly decreased in the intervention group (P < 0.001), whereas depression score did not significantly change after the intervention (P = 0.689). The difference in the mean scores of stress, anxiety, depression, and quality of patients' life was not significant in the intervention group before the intervention and in the control group before and after the intervention (P > 0.05). Conclusions: Resilience training reduced stress and anxiety in hemodialysis patients and improved their quality of life. Thus the use of resilience intervention programs along with other methods for hemodialysis patients' care and treatment programs is recommended as a non-invasive, non-pharmacological, inexpensive, and cost-effective method without complications.

Effects of use of an eHealth platform e-Vita for COPD patients on disease specific quality of life domains

2020 ◽  
Keyword(s):  
Quality Of Life ◽  
Functional State ◽  
Mental State ◽  
Self Management ◽  
Copd Patients ◽  
Before And After ◽  
Ehealth Intervention ◽  
The Impact ◽  
Disease Specific

Background: Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients’ involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings. Aim: The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients. Methods: We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the eHealth intervention. Results: Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually used the eHealth platform (n = 123). The decrease of CCQ-symptoms was 0,20% before the intervention and 0,27% after the intervention; this difference was statistically significant (P=0.027). The decrease of CCQ-mental was 0,97% before the intervention and after the intervention there was an increase of 0,017%; this difference was statistically significant (P=0,01). No significant difference was found in the slopes of CCQ (P=0,12) and CCQ-function (P=0,11) before and after the intervention. Conclusion: The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. In conclusion, this study shows that after the introduction of the COPD platform, patients experienced fewer symptoms, but their mental state deteriorated slightly at the same time. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.

A patient-centered mobile intervention to promote self-management and improve patient outcomes in chronic heart failure: The ManageHF4Life trial (Preprint)

2020 ◽  
Author(s):  
Michael P. Dorsch ◽  
Karen B. Farris ◽  
Brigid E. Rowell ◽  
Scott L. Hummel ◽  
Todd M. Koelling
Keyword(s):  
Heart Failure ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Control Group ◽  
Patient Centered ◽  
Self Monitoring ◽  
Heart Failure Questionnaire

BACKGROUND Successful management of heart failure (HF) involves guideline based medical therapy as well as self-care behavior. As a result, the management of HF is moving toward a proactive real-time technological model of assisting patients with monitoring and self-management. OBJECTIVE Evaluate the effectiveness of a mobile application intervention that enhances self-monitoring on health-related quality of life, self-management, and reduces HF readmissions. METHODS A single-center randomized controlled trial was performed. Patients greater than 45 years of age and admitted for acute decompensated HF or recently discharged in the past 4 weeks were included. The intervention group used a mobile application (App). The intervention prompted daily self-monitoring and promoted self-management. The control group (No App) received usual care. The primary outcome was the change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) from baseline to 6 and 12 weeks. Secondary outcomes were the Self-Care Heart Failure Index (SCHFI) questionnaire and recurrent HF admissions. RESULTS Eighty-three patients were enrolled and completed all baseline assessments. Baseline characteristics were similar between groups with the exception of HF etiology. The App group had a reduced MLHFQ at 6 weeks (37.5 ± 3.5 vs. 48.2 ± 3.7, P=0.039) but not at 12 weeks (44.2 ± 4 vs. 45.9 ± 4, P=0.778) compared to No App. There was no effect of the App on the SCHFI at 6 or 12 weeks. The time to first HF admission was not statistically different between the App versus No App groups (HR 0.89, 95% CI 0.39-2.02, P=0.781) over 12 weeks. CONCLUSIONS The mobile application intervention improved MLHFQ at 6 weeks, but did not sustain its effects at 12 weeks. No effect was seen on HF self-care. Further research is needed to enhance engagement in the application for a longer period of time and to determine if the application can reduce HF admissions in a larger study. CLINICALTRIAL NCT03149510

scholarly journals A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Rank Test ◽  
Diabetic Patients ◽  
Effective Measure ◽  
Before And After ◽  
Patients With Diabetes ◽  
Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

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