scholarly journals Adapting wellbeing research tools for Aboriginal and Torres Strait Islander people with Chronic Kidney Disease

2019 ◽  
Author(s):  
Tricia Nagel ◽  
Michelle Sweet ◽  
Kylie Dingwall ◽  
Stefanie Puszka ◽  
Jaqueline Hughes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Outcome Measures ◽  
Torres Strait Islander ◽  
Research Team ◽  
Torres Strait Islander People ◽  
Stage 4 ◽  
Interpreter Service ◽  
Torres Strait ◽  
Stage 1

Abstract Background There is an acute need to develop wellbeing measures and interventions that are appropriate for Aboriginal and Torres Strait Islander people, including residents of remote communities who have chronic physical conditions. The Kessler 10, Patient Health Questionnaire 9, and EuroQoL are valid, reliable, and commonly used tools to assess various aspects of wellbeing but have not yet been translated to Aboriginal and Torres Strait Islander languages. Similarly, the Stay Strong App is a brief, culturally responsive, e-mental health intervention, but has not been used with Aboriginal and Torres Strait Islander people with Chronic Kidney Disease. Methods We aimed to pilot test the above tools with Aboriginal and Torres Strait Islander Australians with Chronic Kidney Disease Stage 5 (CKD-5) and develop revised versions suitable for use in a clinical trial using a four-stage multi-method approach. Stage 1: Pilot testing of outcome measures and Stay Strong App intervention in a purposive sample of five haemodialysis patients and carers to examine acceptability. Stage 2: Translation of outcome measures through collaboration between the Aboriginal Interpreter Service, Aboriginal and Torres Strait Islander research officers and research team. Stage 3: Conversion of revised outcome measures to electronic format. Stage 4: Collaboration of research team and an Expert Panel in an iterative approach to adapt the Stay Strong App. Results Stage 1: Pilot testing of outcome measures identified three areas of difficulty: explanation of time frames and frequency responses, translation of the terms ‘worthless’ and ‘hopeless’, and fatigue and boredom related to the assessment process. Stage 2: Translation of most items was uncontroversial. Discrepancies between team member views and local interpretations of specific terms were addressed. Final drafts were forwarded to the Aboriginal Interpreter Service for translation. Stage 3: Audio translations in 11 languages were integrated into an interactive Outcome Measures App. Stage 4: A new renal version of the Stay Strong App was developed through research team and expert panel consensus. Conclusion The four-stage approach allowed adaptation of the tools for use within a future trial of wellbeing interventions for Aboriginal and Torres Strait Islander people receiving haemodialysis. Trial registration: ACTRN12617000249358 Registered 17 February 2017.

scholarly journals Adapting wellbeing research tools for Aboriginal and Torres Strait Islander people with Chronic Kidney Disease

2020 ◽  
Author(s):  
Tricia Nagel ◽  
Michelle Sweet ◽  
Kylie Dingwall ◽  
Stefanie Puszka ◽  
Jaqueline Hughes ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Outcome Measures ◽  
Torres Strait Islander ◽  
Research Team ◽  
Expert Panel ◽  
Torres Strait Islander People ◽  
Pilot Testing ◽  
Torres Strait

Abstract Background: Chronic kidney disease is an increasingly common health problem for Aboriginal and Torres Strait Islander people. It is associated with multiple concurrent psychosocial stressors which frequently result in negative impacts on emotional and social wellbeing. There is a need for well-designed intervention studies to provide evidence of effective treatment for comorbid depression or other mental illness in this setting. Attention to early phase piloting and development work has been recommended when testing complex interventions. This paper documents feasibility testing and adaptation of an existing culturally responsive brief wellbeing intervention, the Stay Strong App, and three commonly used wellbeing outcome measures, in preparation for a clinical trial testing effectiveness of the intervention. Methods: The Stay Strong App has not been used in the setting of Chronic Kidney Disease before. It is reviewed and adapted for people with comorbid Chronic Kidney Disease and wellbeing concerns through expert consensus between research team and an Expert Panel. The outcome measures (Kessler 10, Patient Health Questionnaire 9, and EuroQoL) are valid, reliable, and commonly used tools to assess various aspects of wellbeing, which have also not been used in this context before. Feasibility and acceptability are examined and developed through 3 stages: Pilot testing in a purposive sample of five haemodialysis patients and carers; translation of outcome measures through collaboration between the Aboriginal Interpreter Service, Aboriginal and Torres Strait Islander research officers and the research team; and conversion of translated outcome measures to electronic format. Findings: Research team and expert panel consensus led to adaptation of the Stay Strong App for renal patients through selective revision of words and images. Pilot testing identified challenges in delivery of the wellbeing measures leading to word changes and additional prompts, integration of audio translations in 11 local Indigenous languages within an interactive Outcome Measures App, and related research protocol changes. Conclusion: Modelling the complex intervention prior to full-scale testing provided important information about the design of both the outcome measures and the intervention. These changes are likely to better support success in conduct of the clinical trial and future implementation of the intervention in clinical settings.

scholarly journals Adapting wellbeing research tools for Aboriginal and Torres Strait Islander people with Chronic Kidney Disease

2020 ◽  
Author(s):  
Tricia Nagel ◽  
Michelle Sweet ◽  
Kylie Dingwall ◽  
Stefanie Puszka ◽  
Jaquelyne T Hughes ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Outcome Measures ◽  
Torres Strait Islander ◽  
Research Team ◽  
Expert Panel ◽  
Torres Strait Islander People ◽  
Pilot Testing ◽  
Torres Strait

Abstract Background: Chronic kidney disease is an increasingly common health problem for Aboriginal and Torres Strait Islander people. It is associated with multiple concurrent psychosocial stressors frequently resulting in negative impacts on emotional and social wellbeing. There is need for well-designed intervention studies to provide evidence of effective treatment for comorbid depression or other mental illness in this setting. Attention to early phase piloting and development work is recommended when testing complex interventions. This paper documents feasibility testing and adaptation of an existing culturally responsive brief wellbeing intervention, the Stay Strong App, and three commonly used wellbeing outcome measures, in preparation for a clinical trial testing effectiveness of the intervention. Methods: The Stay Strong App, which has not been used in the setting of Chronic Kidney Disease before, is reviewed and adapted for people with comorbid wellbeing concerns through expert consensus between research team and an Expert Panel. The outcome measures (Kessler 10, Patient Health Questionnaire 9, and EuroQoL) are valid, reliable, and commonly used tools to assess various aspects of wellbeing, which have also not been used in this context before. Feasibility and acceptability are examined and developed through 3 stages: Pilot testing in a purposive sample of five haemodialysis patients and carers; translation of outcome measures through collaboration between the Aboriginal Interpreter Service, Aboriginal and Torres Strait Islander research officers and the research team; and conversion of translated outcome measures to electronic format. Results: Research team and expert panel consensus led to adaptation of the Stay Strong App for renal patients through selective revision of words and images. Pilot testing identified challenges in delivery of the wellbeing measures leading to word changes and additional prompts, integration of audio translations in 11 local Indigenous languages within an interactive Outcome Measures App, and related research protocol changes. Conclusion: Modelling the complex intervention prior to full-scale testing provided important information about the design of both the outcome measures and the intervention. These changes are likely to better support success in conduct of the clinical trial and future implementation of the intervention in clinical settings.

scholarly journals Adapting wellbeing research tools for Aboriginal and Torres Strait Islander people with chronic kidney disease

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Tricia Nagel ◽  
Michelle Sweet ◽  
Kylie M. Dingwall ◽  
Stefanie Puszka ◽  
Jaquelyne T. Hughes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Torres Strait Islander ◽  
Torres Strait Islander People ◽  
Torres Strait ◽  
Research Tools

The Epidemic of Chronic Kidney Disease in Patients Referred to a Hematologist for Anemia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5521-5521
Author(s):  
Brian Zimmer ◽  
Dana Wentzel ◽  
James Reed ◽  
Sherrine Eid ◽  
Eliot Friedman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
General Population ◽  
Serum Creatinine ◽  
Strong Association ◽  
Chart Audit ◽  
Stage 4 ◽  
The Mean ◽  
Stage 1

Abstract NHANES survey estimates the prevalence of CKD to be approximately 11% in the general population and 25% in the population over 65 years of age, and the prevalence of Chronic Kidney Disease (CKD) associated anemia approaches 75% in Stage 5 CKD. Despite the high prevalence of CKD, and its strong association with anemia, many patients diagnosed with anemia and referred to a hematologist for evaluation frequently have the diagnosis of CKD overlooked, especially if one is using a serum creatinine to assess renal function. A more accurate method of assessing renal function and to appropriately stage CKD is the use of an estimated glomerular filtration rate (eGFR) utilizing the modified MDRD equation. With the realization that CKD clearly has become known as a significant magnifier of cardiovascular risk (CVR), the importance of making the diagnosis of CKD has become quite apparent. Hypothesis: Patients referred to a hematologist for evaluation of anemia represent a population enriched with CKD. A retrospective chart audit was performed on patients being referred to a hematology practice from community physicians for the evaluation of anemia from January 2004 through December 31, 2005. All patients with a prior knowledge of CKD and a history of malignancy or myelodysplastic process were excluded from the study. The cohort consisted of 256 patients (37.5 % male and 62.5 % female) with a mean age of 67.56 ± 15.9 years. The mean serum creatinine was 1.16 ± .74 mg/dL with a mean calculated GFR by the modified MDRD (4 variable) equation of 69.9 ± 34.2 ml/min/1.73 m2. The mean ± SEM serum creatinine by stage of CKD in our patient population is: Stage 1: 0.67 ± 0.14 mg/dL, Stage 2: 0.92 ± 0.15 mg/dL, Stage 3: 1.40 ± 0.29 mg/dL, Stage 4: 2.23 ± 0.53 mg/dL, and Stage 5: 5.2 ± 2.89 mg/dL. Conservatively, we defined CKD as GFR <60 as urinalysis, imaging, or biopsy data were not available. In conclusion, an astounding 42.2 % of patients referred to a hematologist for the evaluation of anemia have CKD as compared to an estimated prevalence of 11 % in the general population reported by K/DOQI. Not only were these patients not aware of their diagnosis of CKD, but, of note also is the fact that 5.1 % were not aware of the presence of advanced CKD (GFR < 30) and 4 patients had Stage 5 CKD without awareness. 55.8 % of the patients over the age of 65 with anemia have CKD as compared to an estimated 25 % of the general population over the age of 65. This information stresses the need to assess all anemia patients for CKD and to appropriately stage them. Given the well accepted association between CKD and CVR, physicians caring for these patients can then stress the need for aggressive pursuit of both traditional and non traditional risk factor reduction to circumvent the significant CVR that is present in this population. Prevalence of Abnormal Renal Function by GFR Frequency Percent *K/DOQI = National Kidney Foundation’s Kidney Disease Outcome Quality Initiative GFR > 90 (Normal /K/DOQI* Stage 1) 51 19.9 GFR 89 - 60 (K/DOQI Stage 2) 97 37.9 GFR 59 - 30 (K/DOQI Stage 3) 95 37.1 GFR 29 - 15 (K/DOQI Stage 4) 9 3.5 GFR < 15 (K/DOQI Stage 5) 4 1.6

Chronic kidney disease

2020 ◽  
pp. 4830-4860
Author(s):  
Alastair Hutchison
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Disease ◽  
Replacement Therapy ◽  
The United States ◽  
Protein Excretion ◽  
Stage 4 ◽  
Ckd Stage ◽  
Stage 1

Chronic kidney disease (CKD) is defined as kidney damage lasting for more than 3 months characterized by structural or functional abnormalities of the kidney, with or without decreased glomerular filtration rate (GFR). CKD has been subdivided into six stages depending on the estimated GFR (eGFR) and degree of proteinuria: CKD stage 1 is eGFR greater than 90 ml/min (per 1.73 m2) with other evidence of renal disease; CKD stage 2 is eGFR 60 to 89 ml/min, with other evidence of renal disease; CKD stage 3a is eGFR 45 to 59 ml/min; CKD stage 3b is eGFR 30 to 44 ml/min; CKD stage 4 is eGFR 15 to 29 ml/min; and CKD stage 5 is eGFR less than 15 ml/min. At each stage the CKD is further categorized according to the degree of proteinuria based on the albumin:creatinine ratio (ACR), from A1 (no increase in protein excretion) to A3 (severe proteinuria). The eGFR is least accurate when the serum creatinine is within or near the normal range. Mild CKD is common, with about 10% of the population of the United States of America having CKD stage 1, 2, or 3 (combined), but advanced CKD is relatively rare (about 0.2% are receiving renal replacement therapy). Patients with CKD stage 1, 2, or 3 are at relatively low risk of progressing to require renal replacement therapy, but are at high risk of death from cardiovascular disease. This chapter discusses the definition, aetiology, and pathophysiology of CKD, followed by sections on the prevention of progression, medical management of the consequences of CKD (including diet, CKD mineral and bone disorders, advanced hyperparathyroidism, and anaemia), and preparation for renal replacement therapy or conservative management of uraemia.

scholarly journals Chronic Kidney Disease-CKD

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Vipul J. Kakkad
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Energy Level ◽  
Serum Creatinine ◽  
Clinical Improvement ◽  
Clinical Evaluation ◽  
Well Being ◽  
Ozone Therapy ◽  
Stage 4 ◽  
Stage 1

Total Number of CKD patients treated with OZONE THERAPY (rectal or IV saline): 40 (Most of them are under the treatment of Nephrologists) Two categories: - Serum Creatine 3 till 14 (Stage 4-5) No. of pts.17 1) Improvement observed for Stage 1-2-3 that is 1st category: On the basis of Clinical evaluation & Pathological criteria, 100% pts. improvement, with stable patho & physiological criteria, for more than 18 months 2) Improvement observed - for Stage 4-5 that is 2nd category: - On the basis of Clinical evaluation & Pathological criteria, 80% pts. Improved - Clinically & Pathologically. (Stable for > 3 months). - No improvement was observed in 20% of pts. 60% patients have shown Clinical & Pathological improvement & maintained for 6-12months. 80% patients have shown Clinical & Pathological improvement & maintained for 3-6 months. Clinical improvement as follows: - Anorexia decreased - Sense of well-being improved - Energy level increased - Edema decreased - No changes in weight except +/- 1kg. Pathological improvement: - Hb improved - Serum Creatinine & Serum BUN reduction - Proteinuria decreased. Ozone rectal insufflation are found to be more effective than IV ozone saline. Conclusion: Patients who received rectal ozone continuously for more then 10 procedures are better improved and could maintain the improvement.

scholarly journals MIF associated with pulmonary hypertension susceptibility and severity in non-dialysis Chronic kidney disease patients

2020 ◽  
Vol 18 ◽  
pp. 205873922096119
Author(s):  
Jianhua Wu ◽  
Naifeng Guo ◽  
Xiaolan Chen
Keyword(s):  
Chronic Kidney Disease ◽  
Pulmonary Hypertension ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Control Group ◽  
Stage 4 ◽  
Stage 1

Pulmonary hypertension (PAH) is one of the more serious complications of Chronic kidney disease (CKD), and its exact pathogenesis has not been clarified. As an upstream proinflammatory factor, macrophage migration inhibitor (MIF) is involved in the occurrence and development of many diseases. This study aimed to detect the relationship between serum MIF and PAH in non-dialysis CKD patients. A total of 382 non-dialysis CKD patients were enrolled in this study. Bio-Plex cytokine assay was used to detect MIF. CKD patients were divided into the PAH group and non-PAH group according to echocardiographic results. Relative risk was determined by logistic regression analysis. The pulmonary artery pressure in the CKD group was higher than that in the control group ( p < 0.01). Pulmonary arterial pressure was higher in stage 4 to 5 CKD patients than in Stage 1 to 3 CKD patients ( p < 0. 01), and the incidence of PAH was also increased ( p < 0. 01). MIF in the CKD group were higher than in the control group ( p < 0.05). MIF in CKD patients with PAH were higher than those without PAH ( p < 0.05). Multivariate logistic regression analysis showed that MIF is correlated with PAH (OR = 10.745; 95% CI 2.288–89.447, p < 0.05). PAH is common in non-dialysis CKD patients, and with the deterioration of kidney disease, the incidence of PAH is gradually increased, indicating that MIF plays an important role in the development of PAH in CKD patients.

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