scholarly journals HYPNODIALYSIS FOR ANXIETY RELIEF AND ADHERENCE TO MEDICATION, KIDNEY DIET AND FLUID INTAKE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2017 ◽  
Vol 3 (6) ◽  
pp. 712-721
Author(s):  
Siti Hajar Wati ◽  
Mardiyono Mardiyono ◽  
Warijan Warijan

Objective: To examine the effectiveness of hypnodialysis on anxiety levels and adherence to medication, kidney diet and fluid intake in patients with chronic kidney disease.Methods: This was a randomized controlled trial study conducted from November to December 2016. Thirty respondents recruited using simple random sampling, which 17 respondents assigned randomly in the experiment and control group. The Hamilton Anxiety Rating Scale (HARS), Morisky scale, adherence to kidney diet questionnaire, adherence to fluid intake questionnaire were used as instruments for this study. Paired t-test and repeated ANOVA were used for data analysis.Results: Findings showed that there was a statistically significant effect of hypnodialysis in reducing anxiety levels and improving adherence to medication, kidney diet, and fluid intake in patients with chronic kidney disease with p-value 0.000 (<0.05), which its effect started from day 7 (posttest 1).Conclusion: Hypnodialysis may decrease anxiety levels and improve medication adherence, kidney diet and fluid intake. Therefore, hypnodialyis can be anlternative treatment for patients with chronic kidney disease.

2017 ◽  
Vol 3 (4) ◽  
pp. 383-389
Author(s):  
Ary Astuti ◽  
Anggorowati Anggorowati ◽  
Andrew Johan

Background: Patients with chronic kidney disease undergoing hemodialysis suffer changes in lifestyle, which cause physical and psychosocial problems, particularly anxiety. Progressive Muscular Relaxation is considered as an intervention to reduce anxiety.Objective: This study aims to examine the effect of progressive muscular relaxation in in reducing anxiety in patients with chronic kidney disease undergoing hemodialysis.Methods: This study used a quasi-experimental design involved 78 respondents, with 38 randomly assigned in the intervention and control group. The progressive muscular relaxation was performed on 14 muscle groups for 4-week period. Hamilton Anxiety Rating Scale was used to measure anxiety. Univariate, bivariate and multivariate analyses were performed for data analyses.Results: The results showed a statistically significant difference in anxiety values between the intervention and control group with p-value 0.000 (<0.05).Conclusion: There was a significant effect of progressive muscular relaxation in reducing anxiety in patients with chronic kidney disease undergoing hemodialysis. The results of this study is expected to be one reference in making the  progressive muscular relaxation as a nursing intervention in reducing anxiety in patients undergoing hemodialysis. 


2015 ◽  
Vol 66 (Suppl. 3) ◽  
pp. 18-21 ◽  
Author(s):  
William F. Clark ◽  
Jessica M. Sontrop ◽  
Louise Moist ◽  
S.-H. Huang

Increased water intake may slow the progression of chronic kidney disease by lowering vasopressin levels. Prior to initiating a large randomized controlled trial on the effect of increased water intake on renal decline, we conducted a six-week pilot study to examine the safety and feasibility of asking adults with chronic kidney disease to increase their water intake. We randomly assigned 29 patients to either a hydration or a control group. The hydration group was asked to increase water intake by 1 to 1.5 l/day relative to their weight, gender, and 24 h urine osmolality, in addition to usual consumed beverages; the control group was asked to continue with usual fluid intake. After six weeks, the change in urine volume was significantly different between groups (0.9 l/day; p = 0.002) with no change in serum sodium and no serious adverse effects. Similarly, preliminary results of our large clinical trial of the same intervention (489 patients enrolled to date) demonstrated a significant separation between groups on 24 h urine volume (at 12 months the mean difference between groups was 1.2 l/day; p < 0.001) with no serious adverse effects. Serum sodium has remained stable in both groups over follow-up. To our knowledge, this trial is currently the largest of its kind to date; the significant separation between groups with respect to urine volume indicates that we will have scientifically reliable data on the effect of increased fluid intake on renal decline. The analysis of primary and secondary outcomes will be conducted at the conclusion of follow-up in July 2016.


2016 ◽  
Vol 9 (5) ◽  
pp. 67
Author(s):  
Mansoureh Mirzadeh ◽  
Najmeh Shahini ◽  
Masoud Kashani Lotf Abadi ◽  
Maryam Tavakoli ◽  
Arash Javanbakht ◽  
...  

<p>Smoking habits are common in schizophrenic patients. Nicotine can suppress negative symptoms and cognitive impairments. The aim of this study was to determine the efficacy of bupropion on cognitive function in schizophrenic patients.<strong> </strong>This study is a double blind randomized controlled trial in a large referral psychiatric university hospital in Iran. Ninety smoker schizophrenic patients were randomly allocated (based on DSM -IV TR criteria) in two groups (46 patients for case group and 44 patients in control group). They get risperidone up to 6 mg/d and bupropion up to 400 mg/d .clinical assessment (Positive and Negative Syndrome Scale (PANSS), Brief psychiatric rating scale (BPRS) were taken in beginning of study, 14<sup>th</sup> and 28<sup>th</sup> days of study. Cognitive assessment (Stroop, Digit Span, and Wechsler, Wisconsin) were taken in begging of study, the days 2<sup>nd</sup>, 7<sup>th</sup>, 14<sup>th</sup>, 28<sup>th</sup>. All data were analyzed by SPSS Ver. 17 with analytic and descriptive tests. Mean age of patients was 37.66±1.01. Mean duration of disorder was 11.63±.98 years. The scores were significantly lower at the day 28<sup>th</sup> compared to the beginning of the study in both groups in Wechsler, Stroop color word , Stroop word , Stroop color , BPRS, PANSS p value ≤0.05 .The difference between the two treatments was not significant as indicated by the effect of group, the between-subjects factor<strong> </strong><strong>p </strong>value ≥0.05. In this study, the side effects were examined and there was no significant difference between the two groups p value ≥0.05.<strong> </strong>Augmentation of bupropion to routine treatment improves cognitive symptoms of schizophrenia in abstinence of tobacco.</p>


2020 ◽  
Vol 20 (2) ◽  
Author(s):  
Maryatun Hasan

Abstrak. Penyakit ginjal kronis (PGK) merupakan penyakit yang dapat mengakibatkan penderitanya mengalami stress jangka panjang dan akhirnya bermanifestasi menjadi depresi. Depresi yang ditimbulkan dapat mempengaruhi perilaku pasien dalam hal pengaturan cairan sehingga dapat berakibat terhadap peningkatan Interdialytic Weight Gain (IDWG). Jika IDWG meningkat maka akan menimbulkan komplikasi yang dapat menghambat keberhasilan terapi hemodialisis.  Penelitian ini bertujuan untuk mengetahui gambaran tingkat depresi terhadap terjadinya peningkatan Interdialytic Weight Gain pada pasien PGK yang menjalani hemodialisis di RSUDZA Banda Aceh. Jenis penelitian ini adalah deskriptif analitik dengan pendekatan cross sectional. Pengumpulan data dilakukan pada bulan Desember 2019 menggunakan teknik accidental sampling dengan responden adalah pasien di unit hemodialisis RSUDZA Banda Aceh. Pengumpulan data dilakukan dengan menggunakan kuesioner Hamilton Rating Scale for Depression kemudian dilakukan analisis univariat untuk mengatahui gambaran dari penelitian dan bivariat dengan menggunakan uji korelasi Spearman. Berdasarkan hasil analisis statistik dengan menggunakan uji Spearman, didapatkan p value sebesar 0,000 (p0,05) dengan koefisien korelasi Spearman sebesar 0,729. Hal ini menunjukkan adanya hubungan yang signifikan antara tingkat depresi dengan peningkatan IDWG pada pasien PGK yang menjalani hemodialisis di RSUDZA Banda Aceh.Kata Kunci: Penyakit Ginjal Kronis, Hemodialisis, Depresi, Interdialytic Weight GainAbstract. Chronic kidney diasease (CKD) might cause stress which generally leads to depression. Depression is correlated to significant impairment in a patient's daily life, such as excessive Interdialytic Weight Gain (IDWG) caused by an overload of fluids. Excessive Interdialytic Weight Gain might also cause other complications that are able to interfere the process of hemodialysis therapy. The objective of this research was to identify the overview of and the correlation between depression types and Interdialytic Weight Gain (IDWG) of the chronic kidney disease patients undergoing hemodialysis therapy in dr. Zainoel Abidin Regional Public Hospital of Banda Aceh. This descriptive analytical research was conducted by means of a cross-sectional study approach. The data were collected in December 2019 by using an accidental sampling technique. The data were collected by distributing the Hamilton Rating Scale for Depression. Those data were then analyzed by using a univariate data analysis and a bivariate data analysis, especially the Spearman Correlation Coefficient. Based on the statistical analysis with the Spearman test, p-value of 0.000 (p0.05) with a Spearmen Correlation Coefficient of 0.729 was found. Hence, a significant correlation between depression levels or types and IDWG in chronic kidney disease patients undergoing hemodialysis in dr. Zainoel Abidin Regional Public Hospital of Banda Aceh was indicated.Keywords: Chronic Kidney Disease, hemodialysis, Depression, Interdialytic Weight Gain


2021 ◽  
Author(s):  
Mohammad Habibur Rahman Sarker ◽  
Michiko Moriyama ◽  
Harun Ur Rashid ◽  
Md Moshiur Rahman ◽  
Mohammod Jobayer Chisti ◽  
...  

BACKGROUND Despite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh. OBJECTIVE The aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD. METHODS A parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients’ increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio. RESULTS Enrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients’ mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group. CONCLUSIONS It is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD. CLINICALTRIAL ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30191


Author(s):  
Sydney C W Tang ◽  
Kam Wa Chan ◽  
Dennis K M Ip ◽  
Desmond Y H Yap ◽  
Maggie K M Ma ◽  
...  

Abstract Background The potential long-term safety and efficacy of aliskiren in nondiabetic chronic kidney disease (CKD) are unknown. We sought to investigate the renoprotective effect of aliskiren on nondiabetic CKD patients. Methods In this open-label, parallel, randomized controlled trial, nondiabetic CKD Stages 3–4 patients were randomized to receive aliskiren added to an angiotensin II receptor blocker (ARB) at the maximal tolerated dose, or ARB alone. Primary outcome was the rate of change in estimated glomerular filtration rate (eGFR). Secondary endpoints included rate of change in urine protein-to-creatinine ratio (UPCR), cardiovascular events and hyperkalemia. Composite renal outcomes of doubling of baseline serum creatinine or a 40% reduction in eGFR or incident end-stage renal disease or death were analyzed as post hoc analysis. Results Seventy-six patients were randomized: 37 to aliskiren (mean age 55.1 ± 11.1 years) and 39 to control (mean age 55.0 ± 9.4 years). Their baseline demographics were comparable to eGFR (31.9 ± 9.0 versus 27.7 ± 9.0 mL/min/1.73 m2, P = 0.05) and UPCR (30.7 ± 12.6 versus 47.8 ± 2.8 mg/mmol, P = 0.33) for treatment versus control subjects. After 144 weeks of follow-up, there was no difference in the rate of eGFR change between groups. Six patients in the aliskiren group and seven in the control group reached the renal composite endpoint (16.2% versus 17.9%, P = 0.84). The cardiovascular event rate was 10.8% versus 2.6% (P = 0.217). The hyperkalemia rate was 18.9% versus 5.1% with an adjusted hazard ratio of 7.71 (95% confidence interval 1.14 to 52.3, P = 0.04) for the aliskiren arm. Conclusion Aliskiren neither conferred additional renoprotective benefit nor increased adverse events, except for more hyperkalemia in nondiabetic CKD patients.


2018 ◽  
Vol 4 (2) ◽  
pp. 256-262
Author(s):  
Kristiana Prasetya Handayani ◽  
Andrew Johan ◽  
Chandra Bagus Ropyanto

Background: Patients who will have cardiac catheterization mostly experience anxiety. Unresolved anxiety may have a harmful effect such as increasing frequency of heart, breathing and blood pressure as well as risks of complication. Music is considered effective in reducing anxiety.Objective: This study aims to examine the effect of Sundanese zither (kacapi) music therapy on anxiety level in pre-cardiac catheterization patients.Methods: This was a quasi-experimental study. Fifty-six respondents were selected using consecutive sampling technique, which 28 respondents assigned in the experiment group and control group. Anxiety was measured using Hamilton Anxiety rating Scale (HARS). Data were analyzed using Wilcoxon and Mann-Whitney test.Results: The results showed an average decrease in anxiety value in the experiment group of 10.28, and in the control group of 3.25. Mann-Whitney test results obtained p value <0.001, which indicated that there was a significant difference of mean decrease between the experiment group and the control group.Conclusion: This study proves that the intervention of Sundanese kacapi music significantly decreasing anxiety levels (p <0.001) in pre-cardiac catheterization patients. It is suggested that Sundanese kacapi music can be used as an alternative therapy in the independent nursing interventions.     


2020 ◽  
Vol 13 (4) ◽  
pp. 365-372
Author(s):  
Andoko Andoko ◽  
Ermawati Ermawati

The effects of guided imagery on fatigue in patients with chronic kidney disease undergoing hemodialysisBackground: Kidney and urinary tract diseases contribute 850,000 mortality rates placing them as the disease burden in the world. One of the general nursing problems suffered from chronic kidney disease patients who undergo hemodialysis is fatigue. The intervention that can be given to overcome the fatigue on the clients is a relaxation therapy strategy. A well-recommended therapy to relieve the fatigue is known as guided imagery.Purpose: Knowing the effect of guided imagery on fatigue in patients with chronic kidney disease undergoing hemodialysis.Methods: A quantitative with a quasi experiment technique and nonequivalent control group design. The population of this study included 67 patients registered with chronic kidney disease undergoing hemodialysis at the hospital. The purposive sampling technique took 32 people. The samples were distributed into two groups; 16 people in each group. The analysis was a thorough T-Test.Result: Finding that the mean of the fatigue levels of experiment and control groups were different. The mean score before the intervention was 0.352, while the score after the intervention was 2.000 (p-value 0.025).Conclusion: There was the effect of guided imagery on fatigue in patients with chronic kidney disease undergoing hemodialysis. Chronic kidney disease patients who undergo hemodialysis should independently and regularly do relaxation therapy because this therapy is easy to apply and proven effective to reduce fatigue.Keywords: Guided Imagery; Fatigue; Chronic Kidney Disease; HemodialysisPendahuluan: Penyakit ginjal dan saluran perkemihan berkontribusi menjadi beban penyakit di dunia dengan sekitar 850.000 kematian setiap tahun. Masalah keperawatan yang banyak dihadapi pasien gagal ginjal kronik yang menjalani hemodialisa umumnya adalah fatigue (kelemahan). Intervensi keperawatan untuk membantu klien dalam mengatasi masalah kelemahan diantaranya melalui strategi pemberian terapi relaksasi. Salah terapi relaksasi yang dipercaya dapat membantu mengatasi fatigue adalah guided imagery.Tujuan: Diketahuinya pengaruh guided imagery terhadap tingkat fatigue pasien gagal ginjal kronik yang menjalani hemodialisis.Metode: Penelitian kuantitatif, desain quasi eksperiment dengan rancangan nonequivalent control group design. Populasi pasien gagal ginjal kronik yang menjalani hemodialisa yang berjumlah 67 orang, besar sampel yang diambil sebanyak 32 orang yang terbagi dalam 2 kelompok, masing-masing kelompok sebanyak 16 orang, teknik pengambilan sampel menggunakan purposive sampling. Analisis menggunakan uji t-test.Hasil: Didapatkan selisih rata-rata tingkat fatigue antara kelompok intervensi dengan kelompok kontrol sebelum perlakuan adalah 0,352 dan setelah perlakuan 2,000 (p-value 0,025).Simpulan: Ada pengaruh guided imagery terhadap tingkat fatigue pasien gagal ginjal kronik yang menjalani hemodialisis. Bagi pasien gagal ginjal kronik yang menjalani hemodialisa hendaknya dapat mempergunakan terapi relaksasi secara mandiri dan teratur karena selain mudah dilakukan, terapi ini telah terbukti efektif dalam menurunkan tingkat kelelahan.


Author(s):  
Dileep Singh Nirwan ◽  
R. K. Vyas ◽  
Sunil Jain

Background: Chronic diseases are a leading cause of morbidity and mortality in India. Globally, chronic kidney disease is the 12th cause of death and the 17th cause of disability, respectively. CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more, irrespective of cause. The present study aimed to find out correlation between serum urea, creatinine and C-reactive protein (CRP) level among patients suffering from chronic kidney disease in an urban based tertiary care hospital in Bikaner, western Rajasthan, India.Methods: This study was conducted at Sardar Patel Medical College and Associated Hospitals at Bikaner, Rajasthan from August 2015 to December 2016. There were 50 cases and 50 controls in the age groups from 10 to 60 yearrs. We took fresh samples and performed required tests following standard protocol. CRP has been done by Antigen Antibody reaction (latex method). RFT has been performed on semi-automatic analyzer.Results: Levels of serum urea and creatinine were significantly raised in CKD patients (p-value<0.005) and CRP level was raised in 52% cases. While 48% cases having normal level %), which requires further study.  Renal function tests were significantly higher in cases than controls.Conclusions: Serum creatinine and urea level were significantly higher in cases as compared to control group.


2019 ◽  
Author(s):  
Chandra Bagus Ropyanto ◽  
Sumarsih . ◽  
Niken Safitri Dyan Kusumaningrum ◽  
Wahyu Hidayati

Background: Nausea is a common complaint of patients with chronic kidney disease due to an accumulation of urea. Hemodialysis therapy has some side effects that play a role in increasing nausea. The use of pharmacological treatment to deal with nausea may bring a risk of aggravating the work of the kidneys, and thus its administration should be limited. Benson relaxation is a complementary therapy which reduces nausea by increasing the relaxation response that affects the nausea center in the brain. Objectives: This study aims to determine the effects of Benson relaxation technique on decreasing nausea. Methods: This study used a pre-posttest quasiexperimental research design with a control group. The samples were 30 patients recruited using consecutive sampling and were divided into the intervention group (n=15)andthecontrolgroup(n=15).Nauseawasmeasuredusinganumericratingscale. Theresultsshowedthattherewasadecreaseinthemeanofnauseaintheintervention group from 7.13 to 2.26, with p-value = 0.001. The mean value slightly decreased in the control group from 7.20 to 6.40, with p-value = 0.001. Conclusions: Benson relaxation affected the decrease of nausea in patients undergoing hemodialysis. Based on the results of this study, it is expected that nurses apply Benson relaxation technique as a non-pharmacological therapy to decrease nausea in hemodialysis patients.


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