Good practices for dialysis education, treatment, and eHealth: A scoping review

Abstract

Background Recommendations regarding dialysis education and treatment are provided in various (inter)national guidelines, which should ensure that these are applied uniformly in nephrology and dialysis centers. However, there is much practice variation which could be explained by good practices: practices developed by local health care professionals, which are not evidence-based. Because an overview of good practices is lacking, we performed a scoping review to identify and summarize the available good practices for dialysis education, treatment, and eHealth. Methods Embase, Pubmed, the Cochrane Library, CINAHL databases and Web of Science were searched for relevant articles using all synonyms for the words ‘kidney failure’, ‘dialysis’, and ‘good practice’. Relevant articles were structured according to the categories dialysis education, dialysis treatment or eHealth, and assessed for content and results. Results Nineteen articles (12 for dialysis education, 3 for dialysis treatment, 4 for eHealth) are identified. The good practices for education endorse the importance of providing complete and objective predialysis education, assisting peritoneal dialysis (PD) patients in adequately performing PD, educating hemodialysis (HD) patients on self-management, and talking with dialysis patients about their prognosis. The good practices for dialysis treatment focus mainly on dialysis access devices and general quality improvement of dialysis care. Finally, eHealth is useful for HD and PD and affects both quality of care and health-related quality of life. Conclusion Our scoping review identifies 19 articles describing good practices and their results for dialysis education, dialysis treatment, and eHealth. These good practices could be valuable in addition to guidelines for increasing shared-decision making in predialysis education, using patients’ contribution in the implementation of their dialysis treatment, and advanced care planning.

Conhecimento de enfermeiros intensivistas sobre cuidados a pacientes em hemodiálise

“…O enfermeiro, por meio das etapas do seu processo de trabalho é capaz de identificar problemas, planejar metas e implementar intervenções para o manejo eficaz dos pacientes com alterações renais e prevenção de complicações (Silva et al, 2021). Importa destacar, entretanto, que a carência ou baixo nível de conhecimento pelos enfermeiros pode derivar de falta de engajamento da equipe, alta demanda de atividades, ainda mais considerando o cenário de pandemia de SARS-CoV 2, no qual houveram profissionais afastados, gerando sobrecarga de trabalho dessa categoria profissional de modo a refletir diretamente na qualidade da assistência de enfermagem ao paciente com lesão renal (Himmelfarb et al, 2020;Sluijs et al, 2021;Costa & Shimizu, 2005;Silva & Santos, 2020).…”

“…O campo profissional da enfermagem, assim como qualquer outra área da saúde, enfrenta a necessidade de atualizações constantes devido à rapidez com que a tecnologia e a ciência avançam na busca incessante pela melhor evidência (Robinson et al, 2016). Entretanto, alguns autores sustentam que este descompasso está interligado ao fato de as demandas não serem supridas pelas abordagens educativas, sendo necessária a elaboração e desenvolvimento de atividades multidisciplinares contempladas por simulações realísticas, palestras, oficinas, entre outros métodos de ensino, claramente acompanhadas pelo monitoramento do conteúdo aprendido em serviço, a fim de superar as barreiras culturais sobrepostas no percurso (Himmelfarb et al, 2020;Sluijs et al, 2021).…”

“…As crescentes estatísticas de portadores de diabetes e hipertensão associadas ao envelhecimento da população global mostram que elas predispõem ao desenvolvimento de doenças renais. Com isso, faz-se mister o conhecimento de enfermeiros sobre práticas hemodialíticas para pacientes com DRC, haja vista que os doentes crônicos também podem desenvolver quadros agudos de disfunções metabólicas, fato que comumente os levam a internações em UTI (Ferguson, Tandri, Rigatto & Komenda, 2015;Sluijs et al, 2021).…”

Patient engagement during the transition from nondialysis‐dependent chronic kidney disease to dialysis: A meta‐ethnography

“…For instance, patients who choose peritoneal dialysis should receive training to perform the dialysis until they are able to execute all exchange procedures by themselves. It is also important for patients to follow dietary and fluid restrictions, adhere to their medication regimens, and monitor symptoms and complications promptly, which are associated with better clinical outcomes and quality of life 23 . Several factors contribute to patient engagement during the transition period, including patient‐related factors (e.g., education level, clinical status, motivation), health professional‐related factors (e.g., attitude toward patient engagement, communication), organization‐related factors (e.g., organizational climate and available resources), and lay community‐related factors (e.g., family and peer networks) 24,25 …”

“…It is also important for patients to follow dietary and fluid restrictions, adhere to their medication regimens, and monitor symptoms and complications promptly, which are associated with better clinical outcomes and quality of life. 23 Several factors contribute to patient engagement during the transition period, including patient-related factors (e.g., education level, clinical status, motivation), health professional-related factors (e.g., attitude toward patient engagement, communication), organization-related factors (e.g., organizational climate and available resources), and lay community-related factors (e.g., family and peer networks). 24,25 Previous reviews of patients with CKD 5 have mainly explored the experiences of patients who lived with maintenance dialysis, 26,27 but few reviews have specifically focused on the experiences of patients undergoing the transition from a nondialysis-dependent state to a dialysis-dependent state.…”