scholarly journals Patients’ experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review

2022 ◽  
pp. 112972982110676
Author(s):  
Catherine Fielding ◽  
Louise Bramley ◽  
Carol Stalker ◽  
Sarah Brand ◽  
Suzanne Toft ◽  
...  

Introduction: Cannulation is an essential part of haemodialysis with arteriovenous access. Patients’ experiences of cannulation for haemodialysis are problematic but poorly understood. This review aims to synthesise findings related to patients’ experiences of cannulation for haemodialysis from qualitative studies, providing a fuller description of this phenomenon. Methods: Eligibility criteria defined the inclusion of studies with a population of patients with end-stage kidney disease on haemodialysis. The phenomena of interest was findings related to patients’ experiences of cannulation for haemodialysis and the context was both in-centre and home haemodialysis. MedLine, CINAHL, EMBASE, EMCARE, BNI, PsycInfo and PubMed were last searched between 20/05/2019 and 23/05/2019. The quality of studies was assessed using the using Joanna Briggs Critical Appraisal Checklist for Qualitative Research. Meta-aggregation was used to synthesise findings and CERQual to assess the strength of accumulated findings. Results: This review included 26 studies. The subject of included studies covered cannulation, pain, experiences of vascular access, experiences of haemodialysis and a research priority setting exercise. From these studies, three themes were meta-aggregated: (1) Cannulation for haemodialysis is an unpleasant, abnormal and unique procedure associated with pain, abnormal appearance, vulnerability and dependency. (2) The necessity of cannulation for haemodialysis emphasises the unpleasantness of the procedure. Success had multiple meanings for patients and patients worry about whether the needle insertion will be successful. (3) Patients survive unpleasant, necessary and repetitive cannulation by learning to tolerate cannulation and exerting control over the procedure. Feeling safe can help them tolerate cannulation better and the cannulator can invoke feeling safe. However, some patients still avoid cannulation, due to its unpleasantness. Conclusions: Cannulation is a pervasive procedure that impacts on patients’ experiences of haemodialysis. This review illuminates further patients’ experiences of cannulation for haemodialysis, indicating how improvements can be made to cannulation. Registration: PROSPERO (CRD42019134583).

Author(s):  
Emily K Yeung ◽  
Kevan R Polkinghorne ◽  
Peter G Kerr

Abstract Background Home haemodialysis (HHD) is utilised significantly less often than facility haemodialysis globally with few exceptions despite being associated with improved survival, and better quality of life. Previously, HHD was exclusively offered to younger patients with few comorbidities. However, with the increasing burden of end-stage kidney disease (ESKD) alongside an ageing population, increasing numbers of older patients are being treated with HHD. This study aims to re-evaluate survival and related outcomes in the context of this epidemiological shift. Methods A matched cohort design was used to compare all-cause mortality, transplantation, average biochemical values and graft survival 6 months post-transplant between HHD and facility haemodialysis patients. 181 HHD patients from a major hospital network were included, with 413 facility haemodialysis patients from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) matched by age, gender, and cause of ESKD. Survival analysis and competing risks analysis (for transplantation) were performed. Results After adjusting for BMI, smoking status, racial group, and comorbidities, HHD was associated with significantly reduced risk of death compared to facility HD patients (HR = 0.47, 95% CI 0.30-0.74). Transplantation rates were comparable, with high rates of graft survival at 6 months in both groups. Haemoglobin, calcium, and parathyroid hormone levels did not vary significantly. However, home HD patients had significantly lower phosphate levels. Conclusions In this study, improved survival outcomes were observed in patients on home compared to facility dialysis, with comparable rates of transplantation, graft survival and biochemical control.


Religions ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 576
Author(s):  
Jan A. Ali

From a medical perspective, as well as an ordinary human perspective, organ transplantation is often understood as a process through which health is restored to sick humans and, consequently, their quality of life improved. Organ transplantation is a medical surgical procedure carried out by an expert or a team of experts who remove a failing or diseased organ or organs from the human body and replace it or them with a functioning organ or organs. With such positive portrayal of the process, organ transplantation is highly recommended and encouraged in modern medicine. However, in Islam, the Qur’an and hadiths—the two great texts of the religion—are silent on the subject. In other words, there is no discussion of the subject in the texts and, therefore, it is not clear whether organ transplantation is permissible or not in Islam. Thus, is organ transplantation an accepted modality of treatment that eliminates the patient’s agony from end-stage organ failure, remains an open-ended question. Whilst some Muslim scholars and jurists argue in favour of organ donation and transplantation, there are others who reject the practice as a breach of shari’ah. This paper posits that the subject of organ donation and transplantation in Islam is an unresolved matter without a ubiquitous consensus. The purpose of the paper is to educate the readers about the two key perspectives on the subject, and highlight that more research and a robust academic and sociological debate are needed to resolve the question of organ donation and transplantation in Islam.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Natalia Target ◽  
Cécile Courivaud ◽  
Pierre Antoine Michel ◽  
Salima Daoud ◽  
Michel Thomas

Abstract Background Home haemodialysis (HHD), has shown improved clinical outcomes, as well as a better quality of life, compared to conventional in-centre haemodialysis (ICHD) but still has a global low prevalence among end-stage renal disease patients. Haemodialysis (HD) patients tend to be sedentary but only few studies, mainly in North American ICHD patients, have evaluated the level of activity in HD patients. Methods SeCoIA is an observational, longitudinal, prospective, international, multicentric, study, conducted in metropolitan France and Belgium. The main objective of the study is to quantify the physical activity measured by the total daily number of steps, in HHD patients compared to ICHD patients. The SeCoIA study will include 80 HHD patients and 80 ICHD patients,. Secondary objectives will be to characterize the HHD population and to confirm HHD efficiency on clinical parameters, as well as quality of life (QoL), in current practice. Physical activity will be measured by a 3-axis accelerometer. Accelerometers have been shown to provide accurate information, on both physical activity and sedentary behaviour. Patients will be instructed to wear the device and complete a patient diary 7 consecutive days after inclusion and the first week of each month for 12 months. Decision to undergo HDD or ICHD is independent of the study and follow-up frequency remains at the discretion of the physician/centre. QoL and quality of sleep will be respectively assessed by the Kidney Disease Quality of Life 1.2 (KDQOL™) and the Pittsburg Sleep Quality index (PSQI) questionnaires at inclusion, 6- and 12-month visits. Patients presenting a restless leg syndrome (RLS) will also complete the International Restless Legs Syndrome rating scale (IRLS) questionnaire. Discussion The SeCoIA study will be the first large cohort study (160 patients) evaluating physical activity, objectively measured with a 3-axis accelerometer, in HHD versus ICHD patients. The present study will also include a comparison of QoL with a focus on RLS between HHD and ICHD. It is anticipated that HHD patients will have an improved physical activity and QoL which should encourage physicians to further promote HHD. Trial registration Clinical trial NCT03737578 study registered on November 9, 2018 (Retrospectively registered).


2013 ◽  
pp. 77-90
Author(s):  
Yen Nguyen Thi Hoang

This paper focuses on the understanding of service quality in the context of Vietnamese universities. It proposes an approach for measuring the quality of the higher education service provided by universities in Vietnam. Firstly, an exploratory study was conducted. Then, the set of items which were generated became the subject of a questionnaire that was then administered to 675 students of a Vietnamese university to determine the dimensions of higher education service quality in this context. The obtained results permit us to appropriate a measurement scale which is slightly different from the SERVQUAL scale widely known as the standard for measuring service quality. The results also show that tangible elements, responsiveness and assurance seem to be three specific dimensions of the higher education service of Vietnamese universities.


Moreana ◽  
2002 ◽  
Vol 39 (Number 149) (1) ◽  
pp. 41-60 ◽  
Author(s):  
Eugenio M. Olivares Merino
Keyword(s):  

The recent reprinting of Álvaro de Silva’s 1998 edition of a selection of More’s letters prompts the author to examine the subject of Spanish translations of More, and of de Silva’s general commentary on More’s correspondence and on his relationship to other humanists. The author reflects on aspects of More’s personality as exposed in his letters and uses what he finds as a corrective to several biographical misconceptions. He points out the strengths and weaknesses of de Silva’s work and compares it with that of other translators, particularly Elizabeth Rogers, and notes the particularly Spanish quality of de Silva’s edition.


2016 ◽  
Vol 2 (2) ◽  
pp. 81
Author(s):  
Arkadiusz Urbanek

The aspiration to keep the synergy in relations between majorities and minorities repeatedly emerges as the cause of conflicts in social relations. It is also a subject of the interest of the multicultural education, particularly in countries of Eastern Europe, building contacts with the culturally and ethnically diverse groups to a wider scale. Relations in culturally, religiously and ethnic diverse societies, are becoming more and more related to the personal attitudes and a given policy. These issues acquire in the prison circumstances even greater significance, as given moods and personal attitudes of the prison staff create the pragmatic aspects of the professional activities addressed to the sentenced. Additionally, the key role is played by the quality of the penitentiary policy and the legal culture. The article presents the comparative analysis of the research carried out in 2016 amongst the prison staff in Poland. The subject of the research concerned attitudes that influence the decisive processes. The personal relations have been analyzed in the context of the relation with the sentenced Muslims. The aim of the research was not only to reveal the quality of the decisions concerning the sentenced Muslims, but also the sources of such decisions. The latter, in consequence, may shift, as the research results prove, towards synergy or discrimination. The diversification of the discrimination was one of the intriguing aspects, disclosed at various levels that not always explicitly concerned the discrimination of the minority.


2019 ◽  
Author(s):  
Nur Tsalits Fahman Mughni

Teaching materials by integrating local culture makes easier for students to understand the subject matter in the learning process. The aims of the study is to measure the effectiveness of teaching materials based on local wisdom of agriculture in Binjai in improving the students problem solving abilities. The research method was a quasi experimental which use non equivalent control group in the pretest posttest design. The sample of study were students of Senior High School grade X in Binjai that consisted of experiment group which used teaching materials based on local wisdom of agriculture in Binjai and control group that used student handbooks. Teaching materials are tested by material experts and technology experts to ensure the quality of teaching materials. Data collection was conducted through test. The results showed that the teaching materials based on local wisdom of agriculture in Binjai effective in improving students problem solving abilities in the experimental group students based on the results of N gain value was 0.67 which has medium criteria. It means teaching materials based on agricultural local wisdom of agriculture in Binjai can be used as one of the teaching materials in learning activities.


2020 ◽  
Vol 3 (2) ◽  
pp. 147-150
Author(s):  
Kaczynski RE ◽  
Asaad Y ◽  
Valentin-Capeles N ◽  
Battista J

We discuss a case of a 58 year old male who presented for left upper extremity steal syndrome including ischemic monomelic neuropathy (IMN) 1.5 months after arteriovenous fistula creation. He presented after three surgical attempts to salvage his fistula with rest pain, complete loss of function with contracture of the 4th and 5th digits, and loss of sensation in the ulnar distribution for more than three weeks. At our institution, he underwent surgical ligation of the distal fistula and creation of a new fistula proximally, resulting in complete resolution of his vascular steal symptoms almost immediately despite the chronicity prior to surgical presentation. Our patient provides a unique perspective regarding dialysis access salvage versus patient quality of life. The patients’ functional status and pain levels should take precedence over salvage of an arteriovenous access site, and early ligation of the access should be completed prior to chronic IMN development. However, if a patient presents late along the IMN course, we recommend strong consideration of access ligation in order to attempt to regain the full neurovascular function of the extremity as we experienced in our patient.


Author(s):  
Sri Winarsih

This study aims to determine the appropriate steps in carrying out academic supervision so as to be able to improve the pedagogical competence of teachers, especially in the learning process which in turn will affect the improvement of the quality of education.The study was conducted in two cycles. Each cycle has different planning, implementation, observation and reflection. Research subjects of the principal and teacher. The school principal with his academic supervision measures, while the Kunto Darussalam Elementary School 017 teacher as an object as well as the subject in providing academic supervision treatment. Data collection techniques through class supervision with stages of supervising teachers in the learning process and observation of classroom learning, to record important events related to research, especially at the time of the processlearning takes place.Data analysis techniques that guide data processing using a percentage (%) of achievement with 100 constants. And to see the interpertation using score interpertation criteria to strengthen the interpretation in conclusions as follows: 80% - 100% (Very Good), 66% - 79 % (Good), 56% - 65% (Enough), and 40% - 55% (Less).The results showed that the ability of teachers in the implementation of the learning process experienced an increase in the percentage at each stage, from the first cycle reached an average of 63% (sufficient) and in the second cycle reached an average of 68% (good). There is an increase in teacher's ability by 5% from cycle I. In detail there is a significant increase in the initial condition of the school when compared to the final condition in the second cycle. The accuracy of teachers entering the class increased by 48%, the use of learning media increased by 32%, varied methods increased by 31%, and learning strategies increased by 36%.


2019 ◽  
Vol 20 (10) ◽  
pp. 835-844 ◽  
Author(s):  
Francis Micheal ◽  
Mohanlal Sayana ◽  
Balamurali Musuvathi Motial

Background: The concept of evaluating bioequivalence has changed over a period of time. Currently, the Average Bioequivalence approach (ABE) is the gold standard tool for the evaluation of generics. Of late, many debates had arisen about employing ABE approach for the appraisal of all drug categories. This review aims to examine the limitations of ABE approach and the significances of Population Bioequivalence (PBE) and Individual Bioequivalence (IBE) approach, current regulatory thinking for assessing different categories of the drug, whether they are adequately assessed, and the evaluation is in the right direction. Methods: We carried out an organized search of bibliographic databases for peer-reviewed research literatures, regulatory recommendations, guidance documents using a focused review question and eligibility criteria. The standard tools were used to appraise the quality of retrieved documents and to make sure the authenticity of the data. Results: In total 73 references were used in the review, the majority of the references (guidance documents) were from the different regulatory agencies and product-specific guidance. There were 29 product-specific guidance from USFDA and EMA. The limitations of the ABE approach were discussed in detail along with the significances of Population Bioequivalence (PBE) approach and Individual Bioequivalence (IBE) approaches. Conclusion: It is apparent from the review that IBE approach is a precise method for evaluating the drugs as it answers drug interchangeability (prescribability and switchability). IBE approach is followed by PBE approach and ABE approach for the evaluation of different categories of drugs in terms of precision.


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