The health/disease transition process in chronic kidney disease patients: Contributions to nursing care

Abstract

Objective: To identify the facilitating and hindering conditions of the health/disease transition process in a group of patients with Chronic Kidney Disease undergoing hemodialysis treatment based on the theoretical framework of the Transition Theory. Method: A descriptive study implementing a qualitative approach. Data collection occurred through semi-structured interviews conducted between March and April 2018. The Content Analysis Technique was used for analysis and discussion as a methodological framework and the explanatory model of the Transition Theory as a theoretical framework. Results: Twenty-five (25) patients participated in the study. The conditioning factors of the transition process were identified and organized into three thematic categories: Personal conditioning factors in the transition process; Community conditioning factors in the transition process; and Social conditioning factors in the transition process. Conclusion: A predominance of hindering conditioning factors was evidenced in the personal dimension, while facilitating conditioning factors were shown in relation to the community dimension, and finally the conditioning factors were equal regarding the social dimension.

To Explore the Application of PDCA in Hemodialysis Center and Its Effect on the Maintenance of Internal Fistula

“…The excessive expression of inflammatory factors such as TNF- α , IL-1, and IL-6 in the peripheral blood of MHD patients can stimulate the inflammation of the body and then cause a series of pathological changes. However, in hemodialysis treatment, a puncture surgery (even the repeated puncture in special cases) needs to be done for arteriovenous fistula, causing more chance of contact of the vascular with the outside world, thus leading to the greater probability of infection caused by retrograde blood entry of bacteria and the higher risk of microinflammation reactions [ 15 , 16 ]. The results of this study showed that there was no significant difference in the complication rate between the two groups before intervention ( P > 0.05); after intervention, the complication rate of the PDCA group was lower than that of the routine group; there was no significant difference in CRP, IL-1, TNF- α , and IL-6 levels between them before intervention ( P > 0.05).…”

Análise e avaliação do Modelo de Cuidados Geropaliativos segundo critérios de Fawcett

“…Um conceito marcante no modelo é o de "transição", o qual está intimamente relacionado com os conceitos de saúde e bemestar, envolvendo processos psicológicos e emocionais nos quais a pessoa idosa e sua família necessitam de tempo e suporte para se adaptarem a uma realidade em mudança (27) . A teórica reconhece que a transição é, portanto, uma inquietação basilar na disciplina da enfermagem, independentemente da especialidade, por envolver processos de movimento de um estado, condição ou situação para outro, nesse contexto, de uma vida saudável para o conviver com uma doença crônica e ameaçadora da vida, o que demanda uma abordagem dos CP (3,8) .…”

“…O conceito de transição embasa o quarto domínio do modelo, que é caracterizado pelos atos de ajudar pessoas/famílias na transição para uma condição de vida marcada por uma doença crônica ou mudanças no estado funcional da pessoa idosa e até para uma morte digna (3,8,27) .…”

Geropalliative Caring Model analysis and assessment according to Fawcett’s criteria

“…A striking concept in the model is "transition", which is closely related to concepts of health and well-being, involving psychological and emotional processes in which older adults and their families need time and support to adapt to a changing reality (27) . The theorist recognizes that transition is, therefore, a fundamental concern in nursing discipline, regardless of the specialty, as it involves processes of movement from one state, condition or situation to another, in this context, from a healthy life to living with a chronic and life-threatening disease, which demands a PC approach (3,8) .…”

“…The concept of transition underlies the fourth field of the model, which is characterized by acts of helping people/families in transition to a life condition marked by a chronic illness or changes in older adults' functional status and even to a dignified death (3,8,27) .…”