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SUKEGAWA, MAYO, AKIKO NODA, TARO SOGA, YUKI ADACHI, YOSHINARI TSURUTA, NORIO OZAKI, YASUO KOIKE, and 真代 助川. "COMPARISON OF SLEEP-DISORDERED BREATHING AND HEART RATE VARIABILITY BETWEEN HEMODIALYSIS AND NON-HEMODIALYSIS DAYS IN HEMODIALYSIS PATIENTS." Nagoya University School of Medicine, 2008. http://hdl.handle.net/2237/10544.
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Krueger, Linda. "Wisconsin Hmong experiences with hemodialysis." Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007kruegerl.pdf.
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Fux, Christoph Andreas. "Hemodialysis activates phospholipase A2 enzyme /." [S.l : s.n.], 1994. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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De, Pascale Matilde <1992>. "Novel membranes for hemodialysis application." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amsdottorato.unibo.it/9605/1/DE%20PASCALE_MATILDE_TESI.pdf.
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The present work is focused on the synthesis and characterization of novel materials for hemodialysis applications. Cellulose acetate was chosen as base polymer for the preparation of porous Mixed Matrix Membrane adsorbers (MMMAs) and for the synthesis of hybrid ultrafiltration membranes. Hemodialysis is a renal replacement therapy used to eliminate,the waste products and excess fluids accumulating in the blood of people affected by an end stage renal disease. The main environmental drawback associated to it is the large water consumption. The MMMAs were prepared with the porpoise of eliminating waste metabolites (uremic toxins) from the spent dialysate solution, with the prospective limiting the consumption of water related to the process. Batch tests of MMMAs showed that the removal of uric acid is almost complete while the one of urea and creatinine is limited to a 20/30 %. The thinking behind the concept of MMMAs was aimed to develop a small a lab scale chromatographic cartridge to continuously remove uremic toxins from an aqueous feed solution. The cartridge was packed with MMMAs and tested with a mixture of toxins. Experiments results shown a promising removal capability of the system even if the necessity of a higher surface area to achieve better efficiency is denoted.
The other important issue related to hemodialysis is the assessment of an overall mass transfer rates in hemodialyzers. The mass transfer correlations proposed in literature do not take into account the effect of permeation and are developed for turbulent flow regime. Therefore, hybrid cellulose acetate/Silica ultrafiltration membranes were prepared to characterize a surrogate system of an artificial kidney (AK) in terms of fluid mechanics and mass transfer. The effect of surface roughness and suction on the velocity profiles was determined and a new dimensionless mass transfer correlation accounting for permeation was developed.
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Arnold, Tava L. "Predicting fluid adherence in hemodialysis patients via the illness perception questionaire - revised." unrestricted, 2007. http://etd.gsu.edu/theses/available/etd-11122007-020016/.
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Thesis (Ph. D.)--Georgia State University, 2007.Title from file title page. Roger O. Weed, committee chair; Gregory Brack, Phillip Gagne, Kenneth B. Matheny, committee members. Electronic text (67 p.) : digital, PDF file. Description based on contents viewed on July 11, 2008. Includes bibliographical references (p. 61-67).
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Fredriksson, Victor, and Nataša Pljevaljčić. "Faktorer som bidrar till fatigue hos patienter som mottar hemodialysbehandling : En litteraturöversikt." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-439335.
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Bakgrund: Kronisk njursvikt är ett internationellt problem som ökat i prevalens de senaste decennierna. Vid kronisk njursvikt försämras njurarnas filtrationsförmåga och den optimala behandlingen är njurtransplantation, annars behövs hemodialysbehandling för att rena blodet från avfallsprodukter som njurarna vanligtvis skulle rena. Prevalensen av fatigue vid hemodialysbehandling för kronisk njursvikt är inte helt fastställd men beräknas vara två av tre patienter. Fatigue kan beskrivas som en kronisk trötthet vilket hindrar patienten från att delta i sociala aktiviteter. Psykiska och fysiska faktorer kan ligga till grund för fatigue. Syfte: Syftet med denna litteraturöversikt är att undersöka hur vanligt förekommande fatigue är hos vuxna patienter med kronisk njursvikt som behandlas med hemodialys, samt att beskriva faktorer som kan bidra till fatigue hos dessa patienter. Metod: Litteraturöversikt med tolv artiklar från databaserna PubMed och CINAHL. Kvalitetsgranskningen utfördes med en modifierad kvalitetsgranskningsmall. Resultat: Prevalensen av fatigue varierade mellan 47,1–72,2% i artiklarna. Faktorerna som korrelerade med fatigue var arbetslöshet, lägre inkomst per månad, lägre utbildningsnivå än grundskola, multisjuk, högre BMI än normalt, serumalbumin utanför referensvärden, ångest, träning, stöd från närstående, icke vit etnicitet, längre tid av behandling i månader och år. Slutsats: Fatigue vid hemodialys för behandling av kronisk njursvikt hade en varierande prevalens. Vården bör fokusera på att motverka vissa faktorer så att patientens lidande kan minimeras. Mer forskning behövs för ett definitivt homogent resultat där specifika faktorer kan identifieras. Fler experimentella studier bör utföras för att undersöka om fatigue kan lindras. Nyckelord: Trötthet, Hemodialys och Vuxna.Background: Chronic kidney failure is an international problem that has increased in prevalence in recent decades. In chronic renal failure, the kidneys' filtration ability deteriorates and the optimal treatment is kidney transplantation, otherwise hemodialysis treatment is needed to cleanse the blood of waste products that the kidneys would otherwise need to cleanse. The prevalence of fatigue in hemodialysis treatment for chronic renal failure has not been fully established but is estimated to be two out of three patients. Fatigue can be described as chronic tiredness that prevents the patient from participating in social activities. Mental and physical factors can be the basis of fatigue. Aim: The purpose of this literature review is to investigate the prevalence of fatigue in adult patients with chronic renal failure treated with hemodialysis, and to describe the causes that may contribute to fatigue in these patients. Method: A literature review with twelve articles from the databases PubMed and CINAHL. The quality review was performed with a modified quality review template. Results: The prevalence of fatigue varied between 47.1–72.2% in the articles. The factors that correlated with fatigue were unemployment, lower income per month, lower level of education than primary school, multimorbidity, higher BMI than normal, serum albumin outside reference values, anxiety, exercise, support from relatives, non-white ethnicity, longer duration of treatment for months and years. Conclusion: Fatigue in hemodialysis for the treatment of chronic renal failure had a varying prevalence. Care should focus on counteracting certain factors so that the patient's suffering can be minimized. More research is needed for a definitively homogeneous result where specific factors can be identified. More experimental studies should be performed to investigate whether fatigue can be alleviated.
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Sawatzky, Dale James. "Adjustment to hemodialysis : a relationship study with demographic variables." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26913.
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This study examines the relationships between three aspects of adjustment to hemodialysis (i.e. activity levels, mood states and severity of symptoms) and four demographic variables (i.e. age, occupation, education and length of time on dialysis). The sample consisted of 37 patients on hemodialysis. Activity levels, mood states and severity of symptoms were measured by the activity inventory, profile of mood states and symptom questionnaire, respectively. A personal history questionnaire was employed to assess the demographic variables. The data was analyzed using the Pearson Product-Moment Correlation Method with a one-tailed test of significance.
Activity levels were found to be negatively correlated with age at a statistically significant level, but were not significantly correlated with occupation, education or length of time on dialysis. Total mood disturbance was not significantly correlated with any of the demographic variables. Total severity of symptoms were negatively correlated with education at a statistically significant level, but no significant correlations were discovered between this aspect of adjustment and the other demographic variables. A few supplemental findings were also deemed important. Total severity of symptoms were both negatively correlated with activity levels and positively correlated with mood states at statistically significant levels. However, mood states and activity levels were not significantly correlated. Finally, a significant positive correlation was found between education and occupational level.Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate
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Luik, A. J. "Blood pressure control in hemodialysis patients." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 1998. http://arno.unimaas.nl/show.cgi?fid=5947.
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Slatculescu, Andreea M. "Immune Dysfunction Associated with Hemodialysis Modalities." Thèse, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/30493.
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Infection is a leading cause of death in hemodialysis patients, partly due to dysfunctional immunity. Frequent dialysis therapy improves patient outcomes and quality of life. We hypothesize that extended home hemodialysis (EHHD) also improves immune function compared to conventional in-hospital hemodialysis (CHD); therefore, we designed a prospective matching-cohort clinical study to assess serum inflammatory markers and the functional capacity of monocyte-derived dendritic cells (MDDCs) and T-lymphocytes. Serum CRP was decreased in EHHD patients suggesting that extended dialysis may decrease inflammatory solute/cytokine levels. Compared to controls, MDDCs from hemodialysis patients had similar endocytic capacity, expression of co-stimulatory molecules, and T-cell activation capacity. However, CHD was associated with the highest expression of CD83 and CD40. Activated T-cells in CHD patients also produced significantly more immunosuppressive IL-10 compared to EHHD patients and controls. Therefore, EHHD may improve immune function by decreasing inflammation, MDDC pre-activation, and synthesis of immunosuppressive cytokines.
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Hemasilpin, Nat. "Toward Optimal Adaptive Control of Hemodialysis." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1378112378.
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Rondinelli, Victoria J. "Caloric requirements in the hemodialysis subject." Thesis, Virginia Polytechnic Institute and State University, 1986. http://hdl.handle.net/10919/101144.
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The nutritional needs of the renal patient vary as the renal function decreases. Little information exists concerning energy requirements for patients on hemodialysis. Renal failure has been called a wasting disease as evidenced by decreased body weight, body fat, arm circumference and serum proteins. This research was designed to help precisely define energy requirements for the hemodialysis subject. Resting energy expenditure (REE) was measured by indirect calorimetry in 17 male hemodialysis subjects whose mean age was 55 years at the Veterans Administration Medical Center in Hampton, Va. The Beckman MMC Horizon System, a portable device which permits the determination of heat production from gas exchange, oxygen consumption and carbon dioxide production was used.
By regression analysis, the measured REE was compared to the basal energy expenditure (BEE): the ideal weight based on the Metropolitan Life Insurance tables, the current weight taken on day of indirect calorimetry, a non-dialysis day, and the post dialysis weight taken immediately after dialysis. A correlation analysis of the dependent variable, IEE, with the current, ideal and post dialysis BBE variable resulted in correlation coefficients of .3783, .0003, and .3946 respectively. None of these correlation coefficients were significantly correlated with the REE. The post dialysis variable had the highest correlation coefficient, and thus the strongest relationship to the REE. While any of the weights studied could be used to determine energy needs for the hemodialysis subject, post dialysis weight may be the most desirable choice.M.S.
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Mahlıçlı, Filiz Yaşar Altınkaya Sacide Alsoy. "Preparation And Characterization of Hemodialysis Membranes/." [s.l.]: [s.n.], 2007. http://library.iyte.edu.tr/tezler/master/kimyamuh/T000605.pdf.
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Singleton, Andrea Dawn Mitchell 1953. "Subjective sleep evaluation in hemodialysis patients." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/291855.
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This descriptive correlational study investigated the relationships between sleep and depression before and after hemodialysis in patients on chronic hemodialysis. Thirty-nine adult patients were tested using the Beck Depression Inventory and the Visual Analog Sleep Scale before and after the first dialysis of the week. Results of testing indicated no significant differences between the quality of sleep before and after hemodialysis treatments. Depression was shown to be present on a mild-moderate level both before and after hemodialysis. Comparison of this study group with other groups tested using the Visual Analog Sleep Scale revealed that this group reports sleep comparable to insomniacs and hospitalized adults. The study has shown that sleep of the chronic hemodialysis patient is not perceived by the individuals to be normal.
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Irvin, Renee A. "Quality of care, asymmetric information, and patient outcomes in U.S. for-profit and not-for-profit renal dialysis facilities /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/7489.
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Curren, Sheila C. "Problem solving and coping strategies leading to salutary outcomes of hemodialysis in well functioning adults." Click here for text online. The Institute of Clinical Social Work Dissertations website, 1997. http://www.icsw.edu/_dissertations/curren_1997.pdf.
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Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 1997.A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.
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Farley, Donna O. "Effects of competition on dialysis facility service levels and patient selection." Santa Monica, CA : Rand, 1993. http://catalog.hathitrust.org/api/volumes/oclc/29674158.html.
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Wramneby, Joel, and Carl Hagström. "Att leva med hemodialys vid kronisk njursjukdomEtt patientperspektiv : Living with hemodialysis with chronic kidney disesaseA patient perspective." Thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-84368.
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Xu, Yunnan. "Statistical Methods for In-session Hemodialysis Monitoring." Diss., Virginia Tech, 2020. http://hdl.handle.net/10919/99037.
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Motivated by real-time monitoring of dialysis, we aim at detecting difference between groups of Raman spectra generated from dialyzates at different time in one session. Baseline correction being a critical procedure in use of Raman Spectra, existing methods may not perform well on dialysis spectra due to nature of dialyzates, which contain numerous chemicals compounds. We first developed a new baseline correction method, Iterative Smoothing-spline with Root Error Adjustment (ISREA), which automatically adjusts intensities and employs smoothing-spline to produce a baseline in each iteration, providing better performance on dialysis spectra than a popular method Goldindec, and better accuracy regardless of types of samples. We proposed a two sample hypothesis testing on groups of baseline-corrected Raman spectra with ISREA. The uniqueness of the test lies in nature of the tested data. Instead of using Raman spectra as curves, we also consider a vector whose elements are peak intensities of biomarkers, meaning the data is regarded as mixed data and that a spectrum curve and a vector compose one observation. Our method tests on equality of the means of the two groups of mixed data. This method is based on asymptotic properties of the covariance of mixed data and FPCA. Simulation studies shows that our method is applicable to small sample size with proper power and size control. Meanwhile, to locate regions that contribute most to significant difference between two groups of univariate functional data, we developed a method to estimate the a sparse coefficient function by using a L1 norm penalty in functional logistic regression, and compared its performance with other methods.Doctor of Philosophy
In U.S., there are more than 709,501 patients with End-Stage Renal Disease (ESRD). For those patients, dialysis is a standard treatment. While dialysis is time-consuming, expensive, and uncomfortable, it requires patients to take three sessions every week in facilities, and each session lasts for four hours regardless of patients' condition. An affordable, fast, and widely-applied technique called Raman spectroscopy draws attention. Spectral data from used dialysate samples collected at different time in one session can give information on the dialysis process and thus make real-time monitoring possible. With spectral data, we want to develop a statistical method that helps real-time monitoring on dialysis. This method can provide physicians with statistical evidence on dialysis process to improve their decision making, therefore increases efficiency of dialysis and better serve patients. On the other hand, Raman spectroscopy demands preprocessing called baseline correction on the raw spectra. A baseline is generated because of the nature of Raman technique and its instrumentation, which adds complexity to the spectra and interfere with analysis. Despite popularity of this technique and many existing baseline correction method, we found performance on dialysate spectra under expectation. Hence, we proposed a baseline correction method called Iterative Smoothing-spline with Root Error Adjustment (ISREA) and ISREA can provide better performance than existing methods. In addition, we come up with a method that is able to detect difference between the two groups of ISREA baseline-corrected spectra from dialysate collected at different time. Furthermore, we proposed and applied sparse functional logistic regression on two groups to locate regions where the significant difference comes from.
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Ferro, Paula Luz, and Fernandez Gloria Del. "Spirituality and compliance correlates of hemodialysis patients." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2663.
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The purpose of a study of spirituality and its relationship to the compliance of hemodialysis patients is to consider changing the approach of the treatment team in the dialysis setting. The interdisciplinary treatment team at the dialysis center consists of physicians, nurses, dietitians, and social workers. One of the many roles of the dialysis social worker is to facilitate the adjustment to and acceptance of the patient's need for dialysis.
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Ricci, Davide <1977>. "Uremic Neuropathy: Epiemiological Study in Hemodialysis Patients." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4452/1/Davide_Ricci_tesi.pdf.
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Background/Aims. Uremic Neuropathy (UN) highly limits the individual self-sufficiency causing near-continuous pain. An estimation of the actual UN prevalence among hemodialysis patients was the aim of the present work.
Methods. We studied 225 prevalent dialysis patients from two Italian Centres. The Michigan Neuropathy Score Instrument (MNSI), already validated in diabetic neuropathy, was used for the diagnosis of UN. It consisted of a questionnaire (MNSI_Q) and a physical-clinical evaluation (MNSI_P). Patients without any disease possibly inducing secondary neuropathy and with MNSI score 3 have been diagnosed as affected by UN.
Electroneurographic (ENG) lower limbs examination was performed in these patients to compare sensory conduction velocities (SCV) and sensory nerve action potentials (SNAP) with the MNSI results.
Results. Thirtyseven patients (16.4%) were identified as being affected by UN, while 9 (4%) presented a score <3 in spite of neuropathic symptoms. In the 37 UN patients a significant correlation was found between MNSI_P and SCV (r2 = 0.1959; p<0.034) as well as SNAP (r2 = 0.3454; p=0.027) both measured by ENG.
Conclusions. UN is an underestimated disease among the dialysis population even though it represents a huge problem in terms of pain and quality of life.
MNSI could represent a valid and simple clinical-instrumental screening test for the early diagnosis of UN in view of an early therapeutic approach.Principale scopo dello studio è la stima della prevalenza della neuropatia uremica nel paziente emodializzato. Sono stati studiati 225 pazienti in emodialisi cronica trisettimanale. Il Michigan Neuropathy Score Instrument (MNSI) è stato utilizzato per la diagnosi di neuropatia. I pazienti con Michigan score > di 3, in assenza di altre patologie potenzialmente causa di neuropatia, hanno ricevuto diagnosi di neuropatia uremica. Trentasette pazienti (16.4%) sono stati clinicamente identificati affetti da neuropatia uremica, mentre 9 (4%) pur lamentando sintomi avevano un Michigan score < di 3. I pazienti con diagnosi di neuropatia uremica sono stati sottoposti a elettroneurografia ed è stata stabilita una correlazione statisticamente significativa fra il Michigan score e la “sensory conduction velocity (SCV)” (r2 = 0.1959; p < 0.034) cosi come fra Michigan score e “sensory nerve action potential (SNAP)” (r2 = 0.3454; p < 0.027). Inoltre lo studio in regressione logistica ha mostrato una correlazione fra neuropatia ed età del paziente (p > 0.001) e sesso femminile (p < 0.036); nessuna correlazione invece fra neuropatia e la tecnica di dialisi utilizzata.
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Ricci, Davide <1977>. "Uremic Neuropathy: Epiemiological Study in Hemodialysis Patients." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2012. http://amsdottorato.unibo.it/4452/.
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Background/Aims. Uremic Neuropathy (UN) highly limits the individual self-sufficiency causing near-continuous pain. An estimation of the actual UN prevalence among hemodialysis patients was the aim of the present work.
Methods. We studied 225 prevalent dialysis patients from two Italian Centres. The Michigan Neuropathy Score Instrument (MNSI), already validated in diabetic neuropathy, was used for the diagnosis of UN. It consisted of a questionnaire (MNSI_Q) and a physical-clinical evaluation (MNSI_P). Patients without any disease possibly inducing secondary neuropathy and with MNSI score 3 have been diagnosed as affected by UN.
Electroneurographic (ENG) lower limbs examination was performed in these patients to compare sensory conduction velocities (SCV) and sensory nerve action potentials (SNAP) with the MNSI results.
Results. Thirtyseven patients (16.4%) were identified as being affected by UN, while 9 (4%) presented a score <3 in spite of neuropathic symptoms. In the 37 UN patients a significant correlation was found between MNSI_P and SCV (r2 = 0.1959; p<0.034) as well as SNAP (r2 = 0.3454; p=0.027) both measured by ENG.
Conclusions. UN is an underestimated disease among the dialysis population even though it represents a huge problem in terms of pain and quality of life.
MNSI could represent a valid and simple clinical-instrumental screening test for the early diagnosis of UN in view of an early therapeutic approach.Principale scopo dello studio è la stima della prevalenza della neuropatia uremica nel paziente emodializzato. Sono stati studiati 225 pazienti in emodialisi cronica trisettimanale. Il Michigan Neuropathy Score Instrument (MNSI) è stato utilizzato per la diagnosi di neuropatia. I pazienti con Michigan score > di 3, in assenza di altre patologie potenzialmente causa di neuropatia, hanno ricevuto diagnosi di neuropatia uremica. Trentasette pazienti (16.4%) sono stati clinicamente identificati affetti da neuropatia uremica, mentre 9 (4%) pur lamentando sintomi avevano un Michigan score < di 3. I pazienti con diagnosi di neuropatia uremica sono stati sottoposti a elettroneurografia ed è stata stabilita una correlazione statisticamente significativa fra il Michigan score e la “sensory conduction velocity (SCV)” (r2 = 0.1959; p < 0.034) cosi come fra Michigan score e “sensory nerve action potential (SNAP)” (r2 = 0.3454; p < 0.027). Inoltre lo studio in regressione logistica ha mostrato una correlazione fra neuropatia ed età del paziente (p > 0.001) e sesso femminile (p < 0.036); nessuna correlazione invece fra neuropatia e la tecnica di dialisi utilizzata.
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Nyholm, Cecilia, and Marie Ohlsson. "Hälsa - en möjlighet trots kärlaccess och hemodialys." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-17417.
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Personer som drabbas av kronisk njursjukdom och startar behandling med hemodialys får en förändrad livssituation. Kärlaccess är en förutsättning för behandling och är personens framtida livlina. Sjuksköterskans uppgift är att ge stöd och stärka personens förmåga att uppleva hälsa trots sjukdom. Möjlighet att nå delaktighet och ökad egenvård är olika för varje enskild person och sjuksköterskan behöver bred kunskap för att möta detta behov. Syftet med studien, som utfördes som en litteraturöversikt, var att utifrån patientperspektivet belysa erfarenheter av hur kärlaccess kan påverka hälsan hos personer i hemodialys. Resultatet visade att tillit till sjuksköterskan och till sig själv, kunskap om sig själv och sin sjukdom, viljan att inte känna sig annorlunda och stöd från personer i sin omgivning påverkade hälsan. Tillit till sjuksköterskan behövs för att, trots rädsla vid placering av nålar, kunna vara delaktig i behandling. Stöd och kunskap har betydelse för personens väg mot egenvård. Mer forskning är önskvärd inom området för att belysa upplevelser hos personer med dialys och kärlaccessens betydelse för självständig behandling.The life situation changes for individuals suffering from Chronic Kidney Disease who starts treatment with Hemodialysis. A vascular access is a prerequisite and is the individual’s future lifeline. The nurse’s task is to support and reinforce the individual’s ability to experience health despite disease. The possibility to achieve involvement and increased self-care varies for each individual and the nurse requires extensive knowledge to meet this need. The study was carried out as a literature overview. The purpose was, from a patient perspective, to highlight experience of how vascular access can influence the health of people with hemodialysis.The result showed that trust in the nurse and themselves, knowledge about themselves and their illness, willingness not to feel different and support from the people around them influenced the health. Trust in the nurse is needed to facilitate involvement in the treatment, despite fear when inserting the needles. Support and knowledge is of value in order for the individual towards self-care. More research on this subject is desirable to highlight the experiences of individuals in dialysis and the significance of the vascular access in order to achieve independent treatment.
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Wall, Susanne, and Camilla Henriksson. "Närstående till hemodialyspatienter - litteraturens beskrivning av deras situation och det stöd de efterfrågar." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-19758.
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Kronisk njursjukdom med livsuppehållande hemodialysbehandling medförde förändrade levnadsvillkor för patienter och närstående. Närvaro av närstående var en faktor som positivt påverkade patienten och utan närståendes stöd krävdes större insatser från sjukvården. Till närstående räknas anhöriga, men även andra som har nära relationer med patienten, som till exempel vänner eller grannar. Syftet med denna litteraturstudie var att undersöka hur litteraturen beskriver situationen för närstående till hemodialyspatienter och vilken typ av stöd de efterfrågade, samt att beskriva inkluderade studiers urvalsgrupper. Det är en beskrivande litteraturstudie där 10 kvalitativa artiklar från databasen CINAHL inkluderades. Studiens resultat utmynnade i två huvudkategorier och åtta underkategorier. Situationen för de närstående präglades av oro, rädslor och osäkerhet kopplade till den sjukes hälsotillstånd och hemodialysbehandlingarna som orsakade stora begränsningar. Livssituationen påverkade många av de närståendes relationer, där den vårdande rollen och den sociala isoleringen hade framträdande platser. Resultatet visade att de närstående hade behov av att samtala om existentiella frågor, främst om döden, vilket gav en uppfattning om allvaret i de närståendes livssituation. Det var tydligt att stödet från sjukvården till de närstående upplevdes som mer betydelsefullt än stödet från övrig omgivning. De närstående hade svårigheter att uttrycka önskemål om stöd och efterfrågade initiativ till samtal från sjukvården.Chronic kidney disease with life-sustaining hemodialysis treatment caused changes in living conditions for patients and next of kin. The presence of kin was a factor that positively affected the patient and without relatives support, greater efforts was required from health care. To next of kin families are counted, but also others who have close relationships with the patient, such as friends or neighbors. The purpose of this literature review was to examine how the literature describe the situation for relatives to hemodialysis patients and what type of support they requested, and to describe included studies’ sample groups. It´s a descriptive literature review where 10 qualitative articles from database CINAHL was included. The results of the study led to two main categories and eight subcategories. The situation for the next of kin was marked by anxiety, fears and uncertainties linked to the patient’s state of health and hemodialysis treatments that caused severe limitations. The life situation affected many of the next of kin´s relationships, where the caring role and social isolation had prominent places. The result showed that the relatives had a need to talk about existential questions, mainly about death, which gave an idea of the seriousness of the relatives’ life situation. It was clear that the support from health care to the next of kin was perceived as more important than support from others. The relatives had difficulties in expressing the wishes of support and requested initiate calls from health care.
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Henriksson, Camilla, and Susanne Wall. "Närstående till hemodialyspatienter : litteraturens beskrivning av deras situation och det stöd de efterfrågar." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-19716.
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Kronisk njursjukdom med livsuppehållande hemodialysbehandling medförde förändrade levnadsvillkor för patienter och närstående. Närvaro av närstående var en faktor som positivt påverkade patienten och utan närståendes stöd krävdes större insatser från sjukvården. Till närstående räknas anhöriga, men även andra som har nära relationer med patienten, som till exempel vänner eller grannar. Syftet med denna litteraturstudie var att undersöka hur litteraturen beskriver situationen för närstående till hemodialyspatienter och vilken typ av stöd de efterfrågade, samt att beskriva inkluderade studiers urvalsgrupper. Det är en beskrivande litteraturstudie där 10 kvalitativa artiklar från databasen CINAHL inkluderades. Studiens resultat utmynnade i två huvudkategorier och åtta underkategorier. Situationen för de närstående präglades av oro, rädslor och osäkerhet kopplade till den sjukes hälsotillstånd och hemodialysbehandlingarna som orsakade stora begränsningar. Livssituationen påverkade många av de närståendes relationer, där den vårdande rollen och den sociala isoleringen hade framträdande platser. Resultatet visade att de närstående hade behov av att samtala om existentiella frågor, främst om döden, vilket gav en uppfattning om allvaret i de närståendes livssituation. Det var tydligt att stödet från sjukvården till de närstående upplevdes som mer betydelsefullt än stödet från övrig omgivning. De närstående hade svårigheter att uttrycka önskemål om stöd och efterfrågade initiativ till samtal från sjukvården.
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Morales, Morales Christel, and Paima Karina Arrieta. "Erfarenheter av stöd hos patienter som behandlas med hemodialys." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-38225.
Full textAbstract:
Hemodialysbehandling innebär omfattande omställningar för patienter. Livet ställs på ända och kan endast hållas ihop med hjälp av stöd i olika former. Patientens behov av stöd skiftar beroende på situation och över tid, varför det är viktigt att stödet är kontinuerligt och behovsbaserat. Syftet med studien var att belysa erfarenheter av stöd hos patienter som behandlas med hemodialys. Perspektiv på stöd analyserades med utgångspunkt i hur patienter beskrev något som underlättade hemodialys och omställningarna behandlingen innebar. En allmän litteraturstudie genomfördes där tio kvalitativa artiklar analyserades. Databearbetning utmynnade i två kategorier som skildrade erfarenheter av stöd hos patienter som genomgick hemodialys. Huvudkategorierna var Trygghet och Bekräftelse med underkategorierna Att få tillgång till information, Att vara oberoende, Att motta tröst och Att bli uppmuntrad. Stödåtgärder som fokuserade på patientens mål och behov istället för enbart på patientens medicinska behov var viktigast. Information framstod som ett återkommande tema. Det framkom i samtliga kategorier men i olika stödsammanhang. I övrigt framträdde stödåtgärder som främjade självständighet, flexibilitet, samhörighet med andra, behovsanpassad kunskap samt relationer som essentiella för patienterna. För att kunna ge individanpassat stöd krävs förmåga att se hela människan och dess omvårdnadsbehov. Mer forskning kring individanpassat stöd framstår som nödvändigt för ökad kunskap.Hemodialysis treatment involves extensive changes for patients. Life is turned upside down and can only be held together with support in different forms. The patient's need for support changes with the situation and over time, why it's important that support is continuous and need-based. The aim of the study was to illuminate the experience of support in patients treated with hemodialysis. Experience of support was analyzed on the basis of how patients described something that facilitated hemodialysis and the changes the treatment involved. A general literature study was conducted where ten qualitative articles were analyzed. Data processing resulted in two categories that described perspective of support in patients undergoing hemodialysis. The main categories were Safety and Confirmation as well as subcategories To gain access to information, To be independent, To receive consolation and To be encouraged. Support measures that allowed patient's goals and needs to be center of focus instead of the patient's medical needs were judged most important. Information emerged as a recurring theme. It appeared in all categories but in different support situations. Further, support measures that promoted independence, flexibility, coherence with other, personalized knowledge and relationships stood out as essential to the patients. In order to provide personalized support, the ability to see the whole person and its nursing needs is required. More research on individualized support appears necessary for increased knowledge.
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Liu, Wa-ling. "A preliminary study into the level of knowledge, attitudes and perceptions of dialysis patients on kideny [sic] transplantation /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B39915153.
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Morley, David B. "The kinetics of middle and small molecule adsorption by collodion-coated activated charcoal /." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=66258.
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Li, So-ching Janet. "Assessing the cognitive function among the elderly dialysis patients a single center study /." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2594907x.
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Lawson, Thomas Kyle Beard Thomas R. "Impact of the dialysis industry on kidney transplants." Auburn, Ala., 2009. http://hdl.handle.net/10415/1988.
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Reid, Deborah Jane. "Folate and zinc status of chronic hemodialysis patients." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/29786.
Full textAbstract:
Folate supplementation at a level of 15 to 35 mg per week is routinely prescribed for many chronic hemodialysis patients in B.C. In recent studies involving these levels of folate supplementation, RBC folate concentrations ranged from near the upper limit of normal to 1.5 times this upper limit. Initially there was research suggesting that high dose folate supplementation impaired zinc absorption but more recent studies refute this hypothesis. A beneficial effect of high dose folate supplementation is lowering of plasma homocysteine levels. This may be desirable since the homocysteinemia observed in chronic renal failure patients may be a factor in their commonly occurring premature vascular disease.
The present study addressed folate needs on a nutritional basis but did not investigate folate's effect on homocysteine levels. The study involved chronic hemodialysis patients and was designed to:
1. assess whether patients consuming the Recommended Nutrient Intake for folate, require a folate supplement to maintain normal folate stores;
2. assess whether patients receiving a supplement of 5 mg of folate per day will have RBC folate levels exceeding the upper limit of the normal range;
3. compare serum zinc concentrations (and in some cases hair zinc levels as well) of patients receiving no zinc supplement or a 22.5 mg per day zinc supplement, to each other and to normal values; 4. assess whether a supplement of 5 mg of folate per day is associated with impaired zinc status;
5. in the event that a 5 mg per day folate supplement is associated with impaired zinc status, assess whether a supplement of 22.5 mg of zinc per day is associated with an improvement in zinc status; and
6. determine average daily energy, protein, folate and zinc intakes of patients.
A 2x2 factorial quasiexperimental design was employed. The study included 21 clinically stable chronic hemodialysis patients between the ages of 25 and 69, who were receiving folate and/or zinc supplements at certain specific levels. Subjects were entered into treatment groups based on the following folate/zinc supplementation levels: no folate, no zinc; no folate, 22.5 mg zinc/day; 5 mg folate/day, no zinc; 5 mg folate/day, 22.5 mg zinc/day. Folate status was assessed using RBC folate concentration. Serum zinc concentration was measured in all subjects. Hair zinc level was determined in 6 of the zinc-supplemented subjects. A food frequency questionnaire was developed to determine dietary folate and zinc intakes. Subjects kept 3 day food records so average daily energy and protein intakes could be determined.
Study results indicated no significant difference in protein intake (g/kg b.w.) or energy intake (expressed as a percent of requirement) among the four treatment groups. Differences in dietary folate intakes among the four treatment groups as well as between zinc-supplemented and non zinc-supplemented subjects, were not significant (p≤0.05). Mean dietary folate intake for all study subjects was 4.2 ug/kg b.w. RBC folate concentration was normal in both treatment groups receiving no supplemental folate. In contrast, the RBC folate concentration for both folate-supplemented groups was approximately 6.5 to 7 times the upper limit of the normal range. The difference between RBC folate concentration for folate supplemented and unsupplemented groups was highly significant (p<0.00001) and remained so when analysis of covariance was done with number of months of folate supplementation as the covariate. RBC folate levels did not differ significantly between zinc-supplemented and unsupplemented groups (p≤0.05). Differences in dietary zinc intakes among the four treatment groups as well as between zinc-supplemented and non zinc-supplemented subjects were not significant (p≤0.05). Mean dietary zinc intake for all study subjects was 9.39 mg/day. Serum zinc levels were below normal in both treatment groups receiving no supplemental zinc. The 22.5 mg zinc, no folate group had a serum zinc concentration near the lower limit of the lower range while that in the 22.5 mg zinc, 5 mg folate group was slightly below normal. When all zinc supplemented subjects were combined, serum zinc concentration was just within the normal range. Hair zinc analysis was conducted in a subgroup of 6 zinc-supplemented subjects and a group of non zinc-supplemented healthy controls. Hair zinc level was significantly higher in the zinc-supplemented subjects than in the controls (p≤O.01).
In conclusion, folate supplementation does not appear to be required on a nutritional basis in clinically stable chronic hemodialysis patients not receiving medications known to affect folate status, who are consuming a diet providing a minimum of 1 g of protein per kg b.w. and 4.6 ug of folate per kg b.w. The low serum zinc concentrations observed in both zinc-supplemented and non zinc-supplemented patients may have been due to a shift of zinc from serum to other "zinc pools" in the body as reported in the literature.Land and Food Systems, Faculty of
Graduate
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Tordoir, Johannes Hendrik Marie. "Noninvasive diagnostic studies of arteriovenous fistulas for hemodialysis." Maastricht : Maastricht : Datawyse ; University Library, Maastricht University [Host], 1989. http://arno.unimaas.nl/show.cgi?fid=5509.
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Olson, Jeffrey Carter. "Design and modeling of a portable hemodialysis system." Thesis, Atlanta, Ga. : Georgia Institute of Technology, 2009. http://hdl.handle.net/1853/28250.
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LEE, MEI-CHEN, and 李美貞. "Effect of Lactic Acid Bacteria on Hemodialysis Quality of Hemodialysis Patients." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/hb6s74.
Full textAbstract:
碩士弘光科技大學
營養醫學研究所
107
The purpose of this study was to investigate the relevance of LAB in improving dialysis quality in hemodialysis patients. In the double-blind, randomized controlled trial (RCT) mode, eligible dialysis patients were randomized into groups, the lactic acid bacteria group (LAB), the placebo group and the control group, and then intervened separately. Weeks and foods were stopped for 4 weeks, and the control group did not consume any test substances for observation. Subjects such as basic data, postural measurement, blood sample and clinical symptom scale were collected at 0, 6, 12, 18, 24, and 28 weeks for analysis. The results showed that the 74 patients who completed the trial were 31 males and 43 females with an age of 59.03±0.53 years. The average hemodialysis time was 5.87 ± 4.12 years. After hemodialysis, the average weight was 63.32±13.49 kg, the body mass index was 24.53±4.30 kg/m2, the waist circumference was 89.02±9.07 cm, the hip circumference was 95.56±7.01 cm, the waist-to-hip ratio was 0.93±0.08, and the systolic pressure was 142.48±. 20.05 mmHg, diastolic blood pressure was 69.23±11.77 mmHg. After 24 weeks of consumption of LAB the average PCS decreased by 2.22 pg/dL, which was better than that of the placebo group, which was 0.44 pg/dL, and the improvement rate was 52%, which was lower than that of the control group. After 24 weeks of consumption of LAB in the lactic acid bacteria group, the blood IS decreased by 17.41 pg. / dL, a significant improvement over the placebo group was reduced by 5.68pg/dL with an improvement of 76%. Therefore, the results of this study show that LAB can improve the dialysis quality of dialysis patients.
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Chi-Pin, TSENG, and 曾啟斌. "Study on the Factors Contributing to The Effects of Hemodialysis Among Hemodialysis Patients." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/52125430794158815128.
Full textAbstract:
碩士國立臺灣師範大學
衛生教育研究所
87
The rapid growth of the number of patients undergoing routine hemodialysis calls attention to the need for better understanding of the patient factors that could alter the effects of dialysis for these patients in an effort to improve patient outcome. The patient parameters explored in this study included demographic characteristics, social support, and hemodialysis-related knowledge, attitude, and self-care behaviors. The subjects consisted of 119 chronic hemodialysis patients who ranged in age from 24 to 82 years and were obtained from two hospital-based and two outpatient hemodialysis centers in Taipei. Area. The patients were interviewed by using questionnaires for the above-mentioned parameters and were assessed by their medical practitioners for the general adequacy of hemodialysis. The major findings of this study were as follows: 1. After receiving hemodialysis therapy, over one-half of the subjects reported that they experienced difficulties in handling daily affairs, and over one-third expressed that life was dull, as compared to the days prior to treatment. 2. In terms of social support , hemodialysis patients received greater assistance from family members and health professionals, while friends and relatives were of less help. Female patients and those with Buddhism or Taoism as their religion were reported to enjoy more active support from their families. 3. Generally, patients had inadequate knowledge about hemodialysis and about how to properly take care of themselves. However, they held more positive attitude toward their disease and treatment as they were younger, with stronger social support, and had acquired more knowledge relevant to hemodialysis. 4. Multiple regression analysis indicated that self-care behavior of hemodialysis patients concerning treatment could best be predicted by patients’ attitude toward disease, social support from friends and relatives, and knowledge on hemodialysis. As a whole, these three variables could account for 26% of total variance of hemodialysis self-care behavior. 5. The general adequacy of hemodialysis was significantly associated with patients’ age, socioeconomic status, related knowledge, attitude toward disease, and self-care behavior concerning treatment. Those who were of younger age, higher socioeconomic status, showing better scores of knowledge, attitude and behavior, were found to reveal more encouraging results of hemodialysis profile assessment Among these factors , self-care behavior concerning treatment and age were the most important variables that, interpreting 14% of total variance, could be used to predict patients’ general adequacy of hemodialysis.
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Chen, Lin-hui, and 陳玲慧. "Fuzzy Hemodialysis Quality Support System -Example of Hemodialysis Data Base in Area Hospital." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/15494051891369569601.
Full textAbstract:
碩士國立雲林科技大學
工業工程與管理研究所碩士班
91
Uremia is a symptom occurred by kidneys’ exhaustion. The patient needs long-term dialysis to prolong his life. However, the electrolyte’s disequilibria and the body fluid’s accumulation arisen in the long-term dialysis lead the patient to discomfort, and even to dead. It’s not disregarding for the patient that take which way to prolong his life and improve his life quality further. In this paper, we develop fuzzy Dialysis Quality Evaluation Support System, which has the capability to distinct the dialysis quality（good, bad）. Use the large amount of experiment values, which come from the long-term accumulated dialysis, we build up an expert questionnaire by studying the medical research and interviewing to the related experts, and abstract the dialysis-quality indexes: Kt/V, URR, Albumin, Hct, then establish the membership function of dialysis-quality indexes. Further, we use fuzzy theory to set up the rule-base to provide the useful information for the medical workers serving in clinical care. It will be helpful for the patient if we can predict the patient’s condition and take the proper treatment, we may prevent his illness getting worse and reach the state of the appropriate dialysis treatment. In this paper, we take 128 patients who have being accepted the long-term dialysis at a dialysis-center of an area-scale hospital as the study objects, and then verify their history clinical data diagnosed by the doctors. There are three contributions describing below: 1. Establish the membership function of dialysis quality indexes. 2. Previously, taking the three-months-ago clinical data diagnosed by the doctors and four quality indexes to classify and transform into membership function, we produce the inference rule by fuzzy-similarity operation and threshold selecting. Repeat the whole cycle of learning and testing the data and make the satisfying right identification rate. 3. Developing the assistance system of evaluating the dialysis quality, we can classify the patients’ laboratory data to different kind of treatment quality, and provide the alarm of the clinical treatment for the doctors, and solve the potential risk of the patients.
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Chen, Hsiao-Chin, and 陳曉瑾. "Is Changing Modality from Peritoneal Dialysis to Hemodialysis More Economic Than Just Hemodialysis?" Thesis, 2011. http://ndltd.ncl.edu.tw/handle/02100813541740016076.
Full textAbstract:
碩士國立陽明大學
醫務管理研究所
99
BACKGROUND The incidence and the prevalence of dialysis in Taiwan have remained in top three globally for several years. The overall expenses of dialysis have made up a considerable portion of total government health spending. The Ministry of Health Insurance has put a large amount of effort in encouraging the use of peritoneal dialysis and subsidizing the hospitals and facilities with peritoneal dialysis equipments in order to lower the overall dialysis related expense. However, the decision of choosing peritoneal dialysis or hemodialysis should be based on patient’s needs and preferences. Therefore, it is essential to find out whether the increasing usage of peritoneal dialysis will impose a positive impact on both patients and government health spending in terms of survival rate and overall medical expenses in the long run. PURPOSE The purpose of the study is to discuss the difference in the costs of outpatient services rate, emergency treatment rate, hospitalization rate, and survival rate between the patients who received just hemodialysis treatment, and those who switched from Peritoneal Dialysis to Hemodialysis. METHOD This research uses the diagnosis and therapeutics facts of dialysis treatment taken in Taiwan and analyzes the systematic sampling cohort database of National Health Insurance database from 2003 to 2006. After abstract the first set of records, and eliminate those patients who did dialysis treatments between Jan. and Jun. 2003, we have 62,381 qualified patients’ records. Then we separate these patients into P.D. switched to HD group and sole Hemodialysis group. After matching and fitting into the research, we have finalized P.D. switched HD patients: 158 and Sole Hemodialysis patients: 632. then we use “ chi-square test” and “Fisher’s exact test” to identify the differences of the gender, age, and spread of Elixhauser Comorbidity index. Uses 2 sample t-test to identify the differences of average monthly outpatient services, average cost, emergency visit, and emergency cost to gender, age between the two group and the spread of Elixhauser Comorbidity index. Then use Kaplan-Meier Curve to calculate survival rate and to see if there is any difference shown in long-rank test. Last but not least, we use Generalized linear model to create a regression model of the a patient’s average expense (including number of regular visits and cost, emergency visits and cost, and days of hospitalization and cost) within the 2 years after his/her first visit. Also following Poisson distribution and Negative binomial distribution, and using Cox regression to form the regression model of the dialysis death rate. RESULT After adjusting the Disturbance factors of gender, age, elixhauser comorbidity index, duration of dialysis treatment, the result shows that the number of days of hospitalization of the group of patients who switch from Peritoneal Dialysis to Hemodialysis is 1.42 times more than the group of patients who received just hemodialysis treatment. (42% higher than the group of patients who received hemodialysis therapy in terms of number of days of hospitalization.) It shows a significant statistical difference. (p < 0.001) The total costs of hospitalization of P.D. switched to HD patients is 1.49 times higher than those of HD patients (49% higher than the costs of HD patients), which also shows a significant statistical difference. (p = 0.004). Average monthly cost of hospitalization of patients who switch from PD to HD in two years is higher than those who received just HD. In Cox analysis of mortality rate, the rate of death risk of patients who switch from PD to HD is 1.38 times higher than that of patients who received just HD treatment, which also reach a significant statistical difference. (p = 0.046). The study indicates that the rate of death risk of P.D. switched to HD is 1.38 times higher than HD. CONCLUSION This study shows that both the related costs and mortality rate of the patients who switch from P.D. to HD is higher compared to those who just received HD treatments. Hopefully this study can be a reference for policy makers when making related practices. The sampling of the study is obtained from two-year time frame of patients after they received the dialysis therapy. The number of patients who remain in the sampling decreases relatively due to the time factor. We expect to do a further analysis when extending the time frame.
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Chen, Ying Shun, and 陳盈勳. "Clinical Evaluation of Optimal Hemodialysis." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/83319111615454242005.
Full textAbstract:
碩士中原大學
醫學工程學系
87
For the patients receiving long-term hemodialysis treatment, the disequilibrium syndromes during the dialysis process, which might eventually imperil their lives, has always been the most disturbing problem. The so-called disequilibrium syndrome refers to the epiphenomenoms during the dialysis treatment, including nausea, vomiting, headache, dizziness, convulsion, hypotension or hypertension. Theoretically, the reason for such complications can be attributed to the prompt decrease in density of extracellular fluid solute during dialysis that is far below the density of intercellular fluids. In recent years, Doc. Lee and Doc. Chang have employed a method of higher accuracy Two-Pool Model, and introduced a new concept of optimal dialysis. By controlling blood flow rate or dialysate flow rate step by step, patients receive the dialysis treatment while the density between extracellular and intercellular fluids is maintained at a lower level. This method has come by preliminary clinical evidence and our research center has been committed to the development of optimal dialysis systems. A complete set of software for blood dialysis treatment have been tested and proven effective both in theory and clinic simulations, and the primal prototype of dialysis machine central monitor/control system have also been perfected by our research center. This research follows the original design of blood dialysis center''s central monitor/ control system but improves its control interface so that the whole control system is more convenient to operate. Meanwhile, published literatures are consulted, the new concept of optimal dialysis is applied and the developed software of dialysis treatment is exploited to put this system into clinical use-control the dialysis machine. As for clinical experiments, we examine the dialysis machine''s mass transfer performance, then make evaluations of different dialysis strategies on three long-term hemodialysis patients. Dialysis strategies are divided as traditional and optimal dialysis treatment strategies and nursing staff can choose either strategy subject to the patient''s habitus or conditions. After two weeks of experiments, it is found that the optimal dialysis treatment strategy can clearly relieve the patients of the disequilibrium symptoms during their dialysis process, and therefore the optimal dialysis theory and this system are proven to be practical and feasible.
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Wu, Ching Wen, and 吳錦玟. "Symptom clusters of hemodialysis patients." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/76748794732561045638.
Full textAbstract:
碩士長庚大學
護理學系
98
The purposes of this study were to establish the symptom clusters and to explore the relationship between symptom clusters and quality of life among hemodialysis patients. Using cross-sectional research design, patients with chronic renal failure on initial hemodialysis were recruited from a medical center during December 2008 to September 2009. A total number of 416 patients participated in this study. Data was collected using structured interviews including the symptom distress scale and Quality of Life Short-Form 36 (SF-36). The results revealed that the average age of patients was 60.6 years old (SD=16.1, Range=20-93) and the top five most severe symptoms were fatigue (1.44 ± 0.72), muscle weakness (1.26 ± 0.84), decreased urine output (1.25 ± 0.79), nerves (1.14 ± 0.83) and anxiety (1.11 ± 0.82). On the other hand, factor analysis demonstrated four symptom clusters: neuromuscular and other related symptom, psychological symptom, cardiopulmonary symptom, and gastrointestinal symptom cluster, which explained the total variance of 53.53%. The average score of quality of life was 35.85 (± 14.54), indicating the medium to lower level of quality of life. All clusters showed strong negative associations with the SF-36 score (p<0.01), where the higher the degree of distress leads to the worse quality of life. Lastly, a multiple linear regression was conducted to explore the relationship between symptom clusters and quality of life among hemodialysis patients. These variables, age (β=-0.18, p<0.01), neuromuscular and other related symptom cluster (β=-0.24, p<0.01), psychological symptom cluster (β=-0.28, p<0.01) and cardiopulmonary symptom cluster (β=-0.13, p<0.05), explained 40% variation of quality of life. The results of this study could help health care providers to understand the relationship between symptom clusters and quality of life of hemodialysis patients. Then, symptom clusters assessment and treatment could be provided to relieve patients’ discomfort and improve their quality of life in the early stage.
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Lun, Huang Mei, and 黃美倫. "Symptom Clusters in Hemodialysis Patients." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/13461545880834730937.
Full textAbstract:
碩士國防醫學院
護理研究所
98
The chronic kidney disease (CKD) is one of ten leading causes of death in Taiwan during past two decades. Patients with chronic kidney disease are not only distressed by their experience with symptoms, but also have adverse effects on their functional status (FS) and quality of life (QOL). Until now, there were no specific studies about impact of diverse coexistence symptoms on hemodialysis (HD) patients during the past years. The purpose of this study was to derive symptom clusters of HD patients and discuss their relationships to FS and QOL. This study was a descriptive, and cross-sectional correlation design. The subjects was recruited from HD center in hospitals and HD clinics in Taipei area, Taiwan. The structured questionnaires including demographics, Symptom Assessment Scale, Karnofsky Performance Scale, and the WHOQOL- BREF Taiwan Version were used to collect data. There were 300 eligible participants in the study. The analysis of descriptive statistics were presented as mean, standard deviation, median, frequency, and percentage. Spearman rank correlation and general linear model (GLM) were used for analyzing the data in the inferential statistics. Factor analysis was used to identify symptom clusters based on patients’ experience with symptoms. P<.05 was considered as the statistically significant. The results of study were as follows: 1. The first five common symptoms of HD patients were fatigue, skin itching, dry mouth, waking up during the night, and difficulty falling asleep. The first five serious symptoms were difficulty falling asleep, sexual dysfunction, waking up during the night, pain, and reduced sexual desire. The first five distressed symptoms were difficulty falling asleep, sexual dysfunction, pain, waking up during the night, and limbs weakness. 2. The results of FS study showed that most HD patients could perform self-care activities. Analysis of the QOL of HD patients, the “environmental domain” and the ”physical domain” got the highest and lowest score, respectively. 3. The majority of correlations between symptoms and symptoms among HD patients were significant, except for sexual dysfunction and reduced sexual desire were not correlated with other symptoms well. 4. There were six clusters in the symptoms of HD patients. The cluster 1 was “sleep-related symptoms”, including difficulty falling asleep, waking up during the night, dry mouth, muscle cramps, and skin itching. The cluster 2 was “activity-related symptoms”, including blurred vision, limbs weakness, pain, constipation, and fatigue. The cluster 3 was “psychology-related symptoms”, including nervousness and anxiety, feel depressed and bad mood. The cluster 4 was “cardiopulmonary-related symptoms”, including difficulty breathing, chest tightness, and restless legs. The cluster 5 was “gastrointestinal-related symptoms”, including vomiting and nausea. The cluster 6 was “sex-related symptoms”, including reduced sexual desire and sexual dysfunction. 5. The symptom clusters of HD patients were less relevant with demographics characteristics. Only “sleep-related symptoms” cluster negatively correlated with FS in HD patients. Except for “gastrointestinal-related symptoms”, all the other five symptom clusters in our study had negative correlations with QOL in HD patients. In conclusion, understanding symptom clusters in HD patients is very important for nursing practice, education, and research. Moreover, evidences from this study will be a reference for healthcare providers in taking care of patients on maintenance HD.
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Moreira, Hugo Miguel Gouveia Pais. "Vitamin K in hemodialysis patients." Master's thesis, 2021. https://hdl.handle.net/10216/134483.
Full textAbstract:
Os doentes hemodialisados por doença renal geralmente apresentam défices de vitamina K no sangue, provavelmente devido às dietas a que são sujeitos. De facto, devido à sua patologia, estes doentes devem reduzir a ingestão de
produtos ricos em sódio e potássio, como queijos e vegetais verdes, que são
ricos em vitamina K.
Como esta vitamina atua como cofator da carboxilase dependente de vitamina K, as proteínas que dependem desta enzima, tais como a matrix Gla protein (MGP), osteocalcin (OC), growth arrest specific protein 6 (Gas6) e a Gla-rich protein (GRP), vão ficar descarboxiladas e inativadas. Isto resultará num conjunto de alterações, como alterações fenotípicas das células do endotélio vascular que se transformam em células osteocondrogénicas, processo apelidado de calcificação vascular.
A calcificação vascular será depois responsável pelo aumento da rigidez dos
vasos sanguíneos, músculo e válvulas cardíacas, e contribuirá também para o
aceleramento do processo aterosclerótico. Compreende-se então que seja
considerada um fator de risco sobretudo para a mortalidade e morbilidade
cardiovascular.
O elevado número de pacientes afetados por esta complicação resulta numa
necessidade de procura de uma terapêutica capaz de tratar o défice de vitamina K e consequentemente retardar a evolução do processo de calcificação. A hipótese de suplementar estes doentes com vitamina K pode ser importante e protetora para o desenvolvimento da calcificação vascular. Assim, neste artigo de revisão pretendemos analisar vários estudos que têm sido realizados com este objetivo e perceber se o uso desta terapêutica pode ter utilidade na gestão e tratamento do doente hemodialisado.Hemodialysis patients with kidney disease usually have vitamin K deficits in their blood, probably due to their diets. In fact, due to their pathology, these patients must reduce their intake of products rich in sodium and potassium, such as cheeses and green vegetables, which are rich in vitamin K. As this vitamin acts as a cofactor for vitamin K-dependent carboxylase, proteins that depend on this enzyme, such as matrix Gla protein (MGP), osteocalcin (OC), growth arrest specific protein 6 (Gas6) and Gla-rich protein (GRP), will be decarboxylated and inactivated. This will result in a set of changes, such as phenotypic changes in the cells of the vascular endothelium that turn into osteochondrogenic cells, a process called vascular calcification. Vascular calcification will then be responsible for increasing the stiffness of blood vessels, muscle and heart valves, and will also contribute to the acceleration of the atherosclerotic process. So, this is considered a risk factor especially for cardiovascular mortality and morbidity. The high number of patients affected by this complication results in a need to search for a therapy capable of treating vitamin K deficiency and consequently delaying the evolution of the calcification process. The possibility of supplementing these patients with vitamin K may be important and protective for the development of vascular calcification. Thus, in this article review weintend to analyze several studies that have been carried out with this objective and to understand if the use of this therapy can be useful in the management and treatment of hemodialysis patients.
41
Moreira, Hugo Miguel Gouveia Pais. "Vitamin K in hemodialysis patients." Dissertação, 2021. https://hdl.handle.net/10216/134483.
Full textAbstract:
Os doentes hemodialisados por doença renal geralmente apresentam défices de vitamina K no sangue, provavelmente devido às dietas a que são sujeitos. De facto, devido à sua patologia, estes doentes devem reduzir a ingestão de
produtos ricos em sódio e potássio, como queijos e vegetais verdes, que são
ricos em vitamina K.
Como esta vitamina atua como cofator da carboxilase dependente de vitamina K, as proteínas que dependem desta enzima, tais como a matrix Gla protein (MGP), osteocalcin (OC), growth arrest specific protein 6 (Gas6) e a Gla-rich protein (GRP), vão ficar descarboxiladas e inativadas. Isto resultará num conjunto de alterações, como alterações fenotípicas das células do endotélio vascular que se transformam em células osteocondrogénicas, processo apelidado de calcificação vascular.
A calcificação vascular será depois responsável pelo aumento da rigidez dos
vasos sanguíneos, músculo e válvulas cardíacas, e contribuirá também para o
aceleramento do processo aterosclerótico. Compreende-se então que seja
considerada um fator de risco sobretudo para a mortalidade e morbilidade
cardiovascular.
O elevado número de pacientes afetados por esta complicação resulta numa
necessidade de procura de uma terapêutica capaz de tratar o défice de vitamina K e consequentemente retardar a evolução do processo de calcificação. A hipótese de suplementar estes doentes com vitamina K pode ser importante e protetora para o desenvolvimento da calcificação vascular. Assim, neste artigo de revisão pretendemos analisar vários estudos que têm sido realizados com este objetivo e perceber se o uso desta terapêutica pode ter utilidade na gestão e tratamento do doente hemodialisado.Hemodialysis patients with kidney disease usually have vitamin K deficits in their blood, probably due to their diets. In fact, due to their pathology, these patients must reduce their intake of products rich in sodium and potassium, such as cheeses and green vegetables, which are rich in vitamin K. As this vitamin acts as a cofactor for vitamin K-dependent carboxylase, proteins that depend on this enzyme, such as matrix Gla protein (MGP), osteocalcin (OC), growth arrest specific protein 6 (Gas6) and Gla-rich protein (GRP), will be decarboxylated and inactivated. This will result in a set of changes, such as phenotypic changes in the cells of the vascular endothelium that turn into osteochondrogenic cells, a process called vascular calcification. Vascular calcification will then be responsible for increasing the stiffness of blood vessels, muscle and heart valves, and will also contribute to the acceleration of the atherosclerotic process. So, this is considered a risk factor especially for cardiovascular mortality and morbidity. The high number of patients affected by this complication results in a need to search for a therapy capable of treating vitamin K deficiency and consequently delaying the evolution of the calcification process. The possibility of supplementing these patients with vitamin K may be important and protective for the development of vascular calcification. Thus, in this article review weintend to analyze several studies that have been carried out with this objective and to understand if the use of this therapy can be useful in the management and treatment of hemodialysis patients.
42
Buss, Mary Lou. "Use of self-efficacy and brief interventions to improve adherence in dialysis patients." 2009. http://proquest.umi.com/pqdweb?did=1932327681&sid=5&Fmt=2&clientId=14215&RQT=309&VName=PQD.
Full textAbstract:
Thesis (Ph.D.)--University of Nebraska-Lincoln, 2009.Title from title screen (site viewed March 2, 2010). PDF text: x, 96 p. : col. ill. ; 471 K. UMI publication number: AAT 3386834. Includes bibliographical references. Also available in microfilm and microfiche formats.
43
Dang, Thi-Loan, and Thi-Loan Dang. "The Vietnamese Hemodialysis Stressor Scale and Jalowiec Coping Scale for Hemodialysis Patients:Translation and Psychometric Testing." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/ug7y6n.
Full textAbstract:
碩士臺北醫學大學
護理學研究所
102
Objective: There are no available Vietnamese instruments to assess stressors experienced by and coping methods/strategies used by hemodialysis patients. The aim of the current study was to generate the Vietnamese-version of the Jalowiec Coping Scale (JCS-V) and Hemodialysis Stressor Scale (HSS-V) and to test their psychometric properties. Methods: A total of 180 hemodialysis patients were recruited from the nephrology and dialysis units in two hospitals at Hanoi, Vietnam. After translating the instruments, we conducted psychometric testing including internal consistency, test-retest reliability, and construct validity. Construct validity of the JCS-V and HSS-V were established by performing exploratory factor analyses and testing the correlations between the Vietnamese instruments and Short Form 36 (SF-36) Health Survey Vietnamese version. Results: The Vietnamese translations captured the content of the original instruments. Internal consistency reliability (Cronbach α) of the overall HSS-V and its two subscales were satisfactory: overall (0.91), physiological (0.77), psychosocial (0.90). The Cronbach α values for the eight subscales in the JCS-V use/effectiveness scales ranged from 0.33 to 0.88. Test-retest reliability of the two Vietnamese instruments were satisfactory (HSS-V: ICC = 0.92 – 0.93; JCS-V: ICC = 0.78 – 0.96). Construct validity of the HSS-V was confirmed by significant negative relationships between the scores on the HSS-V and SF-36 Health Survey Vietnamese version (r = -0.17 to -0.33, p < 0.05). Exploratory factor analysis of the HSS-V resulted in a four-factor model (dependency, limitation/changes, physical symptoms, family reversal) which explained 56.7 % of the total variance. Exploratory factor analysis of the JCS-V resulted in a four-factor model (problem-solving, avoidance, give-up, support seeking) which explained 45.4% of the total variance. Conclusion: Reliability and validity of the HSS-V were acceptable. For the JCS-V, only the test-retest reliability was satisfactory. Five of the eight subscales in the JCS-V showed moderate to high internal consistency. Construct validity of the JCS-V was not confirmed by testing hypothesized relationship. Further studies are needed to retest the psychometric properties of the JCS-V.
44
Lee, Chia Jung, and 李佳容. "The investigation on Hemodialysis Patient's Switching Cost, Switching Intention and After Switch Satisfaction in Hemodialysis Center." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/99905110112229355005.
Full textAbstract:
碩士長庚大學
管理學院碩士學位學程在職專班經營管理組
101
This study aims to investigate hemodialysis patient’s switching inten-tion, switching cost and after-switch satisfaction. The research subjects are the patients at the nine Hemodialysis Centers in Taipei, NewTaipei, Taoyuan and HsinChu city. In total 450 copies of questionnaire are dis-tributed, in which 408 copies of is effective questionnaires are responded with effective response rate at 90.67%. The results show, that hemodialysis patient’s perceived 'setup cost' and 'uncertainty uncertainty cost' are high, an outcome that causes the first three factors of switching intention in sequence are doctor's attitude, doctor's skill and more flexible dialysis sessions. Group entertainment activity and nutritious meals service are not among the factors of switching intention. With regard to after-switch satisfaction, what are listed in the first three items include hospitalization transfer service, attitude of attendant physician and attitude of nurses. This study suggests that dialysis centers should endeavor to train medical care staff to have a deeper understanding of patient's condition, increasing the uncertainty of next switched center, improving doctors’ skills in services and exquisiteness of center's flexible service, hence in-creasing the patient's switching cost and decreasing switching intention and behavior.
45
Wolff, Susanne Hawthorne. "Effects of reprocessing on hemodialysis membranes." 2005. http://etda.libraries.psu.edu/theses/approved/WorldWideIndex/ETD-873/index.html.
Full text
46
Ning, Gangmin Henning Günter. "Online detection of hemodialysis induced hypotension /." 2001. http://www.gbv.de/dms/ilmenau/toc/333273583ning.PDF.
Full text
47
Shy, Hung Pin, and 施鴻斌. "Quantitative Study of Long-Term Hemodialysis." Thesis, 1994. http://ndltd.ncl.edu.tw/handle/81728167017260811940.
Full textAbstract:
碩士中原大學
醫學工程學系
82
It is a goal to suffer from uremic syndrome and improve dia- lysis therapies for many patients kept alive by maintenance hemodialysis. In this study, quantitative study of long-term hemodialysis for chronic renal failure patient is proposed. The model equa- tions based on two-compartment model. The control parameter selected for targeting is time-average blood nitrogen concentra- tion (TAC). During dialysis treatment, conventional or optimal dialysis is allowed to operate. The results of theoretical cal- culation depict that long-term quantitative dialysis strategy can control stability of the patient's blood urea nitrogen (BUN) con- centration, the optimal dialysis has the advantage of operating at a lower and smoother solute concentration difference between the intra- and extracellular fluid, and by sectional procedure the reduction of TAC value can avoid condition of dialysis treat- ment change too much suddently when predialysis concentrtion over normal value in this week. In process of the experiment has two stages, the first stage is determination of the parameters, and the second stage is execution and discuses for long-term dialysis. In the first stage, the result of the experiment depicts that intercompartment mass transfer coefficient (Kc) is 349∼693 for BUN and 316∼561 for creatinine (Cr). the comparison of postdialysis concentration between the model predicted and clinical show that the average absolute error is 13.7% for BUN and 10.7% for Cr. In the second stage,the theoretical control parameter TAC is 46 for L.J. patient. The absolute errors of predialysis and postdialysis concentrations between model predicted and clinical are within 6%. These parameters and analysis may be found useful in the determination of future therapeutic strategy for each chronic renal failure patient.
48
Huang, Kuan-Sung, and 黃冠崧. "The Behavior of Solutes in Hemodialysis." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/50068415622561048543.
Full textAbstract:
碩士中原大學
生物醫學工程研究所
100
Hemodialysis is the most comment method for the treatment of patients with end-stage renal failure (ESRD). The principle of hemodialysis is to remove uremic toxins from uremic patients through diffusion and convection. This dissertation includes two parts. First part of this dissertation is to discuss about the characteristics of clearance for hemodialyzers based on ISO regulation ISO8637:2010. The tested hemodialyzers were produced in Taiwan. The models of the tested hemodialyzers were 160 and 180. The results for all of the evaluations were obtained by performing 3 hemodialyzers for each model. The evaluations for hemodialyzers covered all necessary indices including blood flow, dialysate flow, K0A, and clearance of blood urea, creatinine, phosphorous ion as well as vitamin B12. Under constant dialysate flow rate (500 mL/min) and different blood flow rates (200, 300, 350, 400 and 500 mL/min), we found that mean K0A values for hemodialyzer model 160 and 180 are 824, 588, 518, 320 mL/min and 894, 624, 549, 316 mL/min, respectively based on the clearance of above dialysate solutes. In addition, we calculated the theoretical clearance values for above two hemodialyzers by using theoretical equations. The variable between theoretical clearance values and experimental clearance values is less than 5%. This result shows that the theoretical equations may be applied in clinical use in calculating clearance values for hemodialyzer. Second part of my dissertation is to discuss the potential use of ferric pyrophosphate and epigallocatechin gallate (EGCG) in dialysate. The experimental results showed that addition of ferric pyrophosphate into dialysate (iron dialysate) is capable of inducing the increase of oxidative stress during hemodialysis. Meanwhile, addition of ferric pyrophosphate and EGCG into dialysate (iron-EGCG dialysate) can reduce oxidative stress induced by iron. This result may be due to the diffusion of EGCG from dialysate to blood, leading to increase antioxidant potential of blood and decrease oxidative damage induced by iron. We suggest that these findings could be an effective method for improving oxidative stress in patients with hemodialysis.
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Chiu, Yi-Fang, and 邱怡芳. "The association between HemoDialysis Eating Index（HDEI) and the risk factors of cardiovascular disease in hemodialysis patients." Thesis, 2013. http://ndltd.ncl.edu.tw/handle/74407515739254838146.
Full textAbstract:
碩士臺北醫學大學
保健營養學研究所
101
The United States Renal Data Systems (USRDS) 2012 reported that incidence of end stage renal disease in Taiwan is the second of the world and prevalence of end dtage renal disease in Taiwan is the highest of the world. Taiwan Society of Nephrology proposed that cardiovascular disease (CVD) is the first cause of death of hemodialysis (HD) patients in Taiwan, about 32-42%. Incorrected dietary intake is one of the reasons that lead to cardiovascular disease. The dietary index can be used to assess the overall diet, its combination of nutrients and food, and to quantify the quality of diet. The higher dietary index indicates the better quality diet and lower disease risk. However, hemodialysis patients’s diet quality recommendation is different from the general public. Most of dietary index assess the diet quality and quantity of general healthy population, not for HD patients. Purpose: In accordance with Taiwan Daily Food Guide (DOH, 2011) and HD dietary recommendation (NKF), we developed the HemoDialysis Eating Index (HDEI) to assess the diet quality and quantity of the HD patients. To study out the correlation between HemoDialysis Eating Index (HDEI) score and cardiovascular disease risk in hemodialysis patients. Subject and method: This is a cross-sectional study. One hundred and eight subjects (including 54 females and 54 males) were recruited in 2010 from Taipei Medical University Hospital and Wan Fang Hospital Hemodialysis Center, and collected subjects’ cardiovascular disease risk factor including blood pressure, fasting blood lipid profiles (total cholesterol, triglyceride), blood glucose, white blood cell count, nutritional status markers (albumin, creatinine, hemoglobin), calcium, phosphate, potassium and cardiothoracic ratio. To calculate HDEI scores according to subjects’ dietary data (1 dialysis day, 1 non-dialysis day and 1 weekend). HDEI scores is composed by 12 food components including vegetable, fruit, total grains, whole grain, high protein food, the percentage of high biological value protein food, red/white meat, fish, oil, wihout saturated fatty acid or trans fatty acid food, nuts, duration of multivitamin use. The score range is from 5 to 100, and the higher score, the better dietary quality. SAS 9.3 for windows was used for statistical analysis. p < 0.05 was considered significant. Result: The average HDEI score is 72.5. HDEI score significantly positive correlated with serum albumin level (p < 0.05). HDEI components in accordance with Taiwan Daily Food Guide (2011) and HD dietary recommendation (NKF), and each component of HDEI can response CVD risk factor. Those score of fruits, oil and duration of multivitamin use were significantly positive correlated with serum albumin level (p < 0.05). Score of fruits, total grains and saturated fatty acid or trans-fatty acid food were significantly negative correlated with serum phosphate level (p < 0.05). Score of saturated fatty acid or trans-fatty acid food were significantly negative correlated with serum total cholesterol level (p < 0.05). After 2 months, the higher score of HDEI decrease total cholesterol level, increase hemoglobin level and decrease hypoalbuminemia risk. Conclusion: HDEI response the quality and quantity of the diet in hemodialysis patients, and predict CVD risk factors.
50
Chuang, Li-Ching, and 莊莉菁. "The effectiveness of exercise program during hemodialysis on fatigue,physical activity and physical capacity in hemodialysis patients." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/89816490478003219164.
Full textAbstract:
碩士國立陽明大學
臨床護理研究所
94
The purpose of this study was to examine the effects of exercise program during hemodialysis on fatigue, physical activity and physical capacity in hemodialysis patient. This research is a quasi-experimental design. 45 Patients were selected using purposive sampling at hemodialysis unit of a major medical center in northern Taiwan. They were assigned 19 patients into the experimental group and 26 patients into the control group. For 8weeks ,the experimental group received exercise program during hemodialysis three times a week and 30 minutes each times, the control group didn’t receive any instruction related to exercise。Before and after 4weeks、8weeks of exercise program ,each subject was required to complete the questionnaire of fatigue and scale of physical activity. Seven patients of experimental group also received graded exercise tolerance test. The data were coded and analyzed by using the SPSS for Windows 11.5 version software. The statistical methods included frequency distribution, percentage, mean, standard deviation, chi-square, t-test,Mann-Whitney U test、Wilcoxon signed ranks test、Spearman Rank-order correlation. The results of this study demonstrated that patients in the experimental group significantly improved their levels of fatigue(p<.05),physical activity(p<.05)and exercise capacity(p<.05)more than patients in the control group. Fatigue was significantly and negatively associated with physical activity. The findings may serve as a reference for clinical care and providing suggestions for the exercise training therapy for hemodialysis patients. It is hope that the intervention can enhance patient’s motivate to perform and improve quality of life.