Objective: The aim of this study was to develop a valid and reliable measurement instrument to identify knowledge, behaviors and attitudes of hemodialysis (HD) patients about fluid control as these patients are inadequate in ensuring and sustaining fluid control. Methods:The sample of this methodological study consisted of 276 HD patients who are being treated in two public and two private hemodialysis centers. The validity of the scale was assessed through content validity, construct validity and similar scale validity and its reliability through item analysis, internal consistency coefficient and testretest. For the content validity of the scale, expert views were assessed through Law she technique and opinions of a Turkish language specialist were obtained. Results: According to the explanatory factor analysis, the scale had 24 items and three sub-dimensions, namely, knowledge, behavior and attitude. The total variance explained was found to be 51.15%. The Cronbach alpha reliability coefficient of the Fluid Control in Hemodialysis Patients Scale (FCHPS) turned out to be 0.88 and Cronbach alpha for its sub-dimensions were 0.92, 0.80 and 0.67, respectively. The correlation value between test and retest was 0.94 (p<0.001). A moderate significant correlation (r=0.58, p<0.001) was found between the scale scores and the scores of the Dialysis Diet and Fluid Restrictions Nonadherence Questionnaire. Conclusion:The "Fluid Control in Hemodialysis Patients Scale" that was developed has high validity and reliability. This scale can be used to measure knowledge, behavior and attitude of hemodialysis patients about fluid restriction.
Tamamlayıcı uygulamaların modern tıpla birleştiği bütünleşik yaklaşımda amaçlanan; iyileştirici bir ortam oluşturmak, bireyi bilinçlendirmek ve kendini iyileştirmede gizli gücünü ortaya çıkarmaktır. Diyabetli hastalarda anksiyete ve stresin azaltılmasında, yaşam kalitesinin artırılmasında ve glukozun kontrolünde Reiki uygulamasının terapotik etkisine yönelik bilimsel çalışma son derece azdır. Bu çalışma diyabetli hastaların tedavisinde Reiki'nin etkileri konusunda yeterince çalışmanın olmaması nedeniyle hem bilgilendirici hem de bundan sonraki çalışmalara yardımcı nitelikte olması amacıyla derlenmiştir.
Hypotension is a common side effect of hemodialysis. 1 Intradialytic hypotension is a common adverse event that occurs in 20% to 50% of all dialysis treatments. 2,3 Dialysis hypotension usually presents in 1 of the 2 ways: as episodic hypotension (symptomatic hypotension), in which a sharp fall in blood pressure (usually late in dialysis) accompanied by signs and symptoms of hypotension are noted, and chronic persistent hypotension, in which systolic blood pressure is less than 90 to 100 mmHg at the onset of dialysis. Chronic persistent hypotension is estimated to occur in 3% to 5% of the dialysis population, whereas episodic hypotension occurs in between 15% and 25% of all dialysis encounters. 4 Chronic persistent hypotension is characterized by high circulating angiotensin II levels and maximal pre-dialysis vasoconstriction. 4,5 Symptomatic hypotension has multiple etiologies. Several studies have shown that a fall in plasma osmolality as ultrafi ltration proceeds compounds extracellular volume depletion because fl uid moves intracellularly. 6,7,8 This has led to the routine use of a higher sodium dialysate concentration with reported favorable outcomes. 9,10 Both of these conditions are therapeutic challenges because ultrafi ltration requirements are diffi cult to achieve in the context of hemodynamic instability. Patients who are frequently hypotensive often feel unwell and spend the interdialytic period "recovering" from the preceding dialysis. 11 Symptomatic hypotension can occur when the so-called dry weight of the patient is not attained. Dry weight cannot be determined exactly in hemodialysis. In practice, the choice of dry weight is most often based solely on clinical criteria. 12 Dialysis hypotension has a multifactorial etiology, including such disparate causes as autonomic dysfunction, 13 decreased plasma osmolality, 6,14,15 a decrease in extracellular fl uid volume with inadequate plasma, 5 decreased cardiac reserve, 16,17 impaired venous compliance, 18 and high plasma nitric oxide levels. 19 If there are no other reasons such as cardiac dysfunction or insuffi ciency of the autonomic nervous system, it is induced when ultrafi ltration exceeds refi lling of the intravascular compartment. 16,20 Intradialytic hypotension associated with declining plasma osmolality due to diffusion contributes to complications that decrease patient's well-being during dialysis. 21,22 Many strategies have been devised to decrease osmolality change through intravenous mannitol, 7 gradient/ramping sodium dialysate, 15,21,23-25 ultrafi ltration profi ling, 26,27 and used with gradient sodium and gradient ultrafi ltration. 7,9,22,28,29 It has been shown that limiting the reduction in plasma osmolality during hemodialysis by selecting a higher sodium concentration of the dialysate improves OBJECTIVE: This study aimed to investigate the effects of dialysate sodium profi ling and gradient ultrafi ltration on hypotension during hemodialysis.METHODS: In this study, a single-blinded, crossover design of 4 different dialysis proto...
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