Patient Education: An Efficient Adjuvant Therapy for Hyperphosphatemia in Hemodialysis Patients

Sun, Chaomin; Chang, Ko‐Wei; Chen, Sue Hsien; Chang, Chiz Tzung; Wu, Mai Szu

doi:10.1080/08860220701742047

Cited by 26 publications

(43 citation statements)

References 14 publications

(29 reference statements)

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“…An earlier study also reported the same finding (31). Comfort-based interventions may improve psychospiritual and environmental conditions of patients because these interventions help patients feel that nurses are supporting them, caring for them, and attempting to alleviate their problems and improve their comfort.…”

Section: Discussionsupporting

confidence: 58%

“…Similarly, other studies reported that back massage alleviates the effects of discomforting factors such as pain, nausea, itching, and muscle cramps (5,36,37). The positive effects of back massage are attributed to the improvements in blood flow and lymphatic drainage, reduction of serum cortisol level, and increases in serum serotonin and dopamine levels (5,20,28,31,36,37). As an inexpensive and noninvasive complementary modality, massage can also facilitate patient care and improve nursepatient communication (37).…”

Section: Discussionmentioning

confidence: 99%

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The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

2017

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Background: Providing patients with comfort is the basis of nursing care and a favorable outcome of nursing care measures. Comfort is of special importance to hemodialysis patients because they spend a large part of their lives in hemodialysis units and are constantly dealing with different physical and mental health problems. This study aimed to evaluate the effects of comfort-based interventions (back massage along with patient and family education) on the level of comfort among hemodialysis patients. Methods: As a randomized controlled trial, this study was undertaken in 2016 in the hemodialysis unit of Shahid Chamran hospital, Ferdows, Iran. A convenience sample of forty hemodialysis patients was recruited. Patients were alternately allocated to control or intervention groups based on their hemodialysis days. The hospice comfort questionnaire was completed for all participants at the beginning and at the end of the study. This questionnaire showed that the comfort needs of patients were related to muscle cramps, headache, back pain, nausea, lack of knowledge about arteriovenous fistula care, dietary and treatment regimens, itching, rest and sleep disorders, and impaired comfort. Patients in the intervention group received massage as well as patient and family education in six consecutive hemodialysis sessions, while their counterparts in the control group solely received the routine care services of the study setting. The SPSS software (v. 18.0) was used for data analysis through running the paired-and the independent-sample t tests. The significance level was set at less than 0.05. Results: The mean scores of comfort and its environmental and psychospiritual dimensions significantly increased in the intervention group (P < 0.001). Significant increases were also observed in the mean scores of comfort and its psychospiritual dimension in the control group (P < 0.05). Before the intervention, there were no significant differences between the groups respecting the mean values of comfort and its dimensions (P > 0.05). However, after the intervention, there were significant between-group differences in the mean scores of comfort and its environmental dimension as well as in the pretest-posttest mean difference for the environmental dimension of comfort.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

2017

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“…Hörl used an individual and flexible approach with his patients and concluded that this method is more efficacious (18) . Another study reduced levels of phosphorus when intensive and individualized care was applied (19) . In this study, the patients were considered apt after obtaining 100% of correct answers in the evaluation questionnaire; the educational meetings of 30 minutes were kept until they achieved this mark (19) .…”

Section: Discussionmentioning

confidence: 99%

“…Another study reduced levels of phosphorus when intensive and individualized care was applied (19) . In this study, the patients were considered apt after obtaining 100% of correct answers in the evaluation questionnaire; the educational meetings of 30 minutes were kept until they achieved this mark (19) . In this study, guidance was provided to small groups; teaching was not individualized.…”

Section: Discussionmentioning

confidence: 99%

Avaliação de programa de ensino-aprendizagem sobre metabolismo de cálcio e fósforo para pacientes em hemodiálise

Araujo

Figueiredo

d'Avila

2010

Rev. esc. enferm. USP

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Estudo de corte avaliando efeitos de programa de ensino-aprendizagem sobre o metabolismo e controle de níveis séricos de cálcio (Ca), fósforo (PO4), paratormônio (PTH), produto Ca x PO4, em 33 pacientes estáveis em HD, randomizados para dois grupos: Controle (n=17) e Intervenção (n=16). O grupo Controle recebeu informação sobre acesso vascular: a Intervenção sobre metabolismo de Ca, PO4 e PTH. Mudanças de conhecimento avaliadas por testes pré e pós-classe; adesão à terapia por dosagens laboratoriais seriadas. Não houve mudança significativa de conhecimento em qualquer grupo [Intervenção: 8/17 vs. 14/17 pacientes competentes no pré e pós-teste, respectivamente (P<0.001); Controle: 11/16 vs. 13/16 pacientes competentes, respectivamente (P<0.001)]. Houve redução de PO4 e produto Ca x PO4 entre tempos 0 e 1 em ambos os grupos e entre tempos 1 e 2 no grupo Controle. Concluiu-se que o programa não induziu mudança de conhecimento ou comportamento e que os programas de ensino-aprendizagem para renais crônicos devem ser contínuos.

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“…Few medical staff or nurses have additional qualifications in teaching, yet there seems little doubt that time spent with the patient is beneficial and several studies have shown that patient education programs are associated with an improvement in serum phosphate control, [92][93][94] although repeated reinforcement is required. 95 Most adults are aware of the importance of controlling blood pressure, cholesterol, and body mass index, even if they do not have any illness. However, they are very unlikely to have come across any public health messages concerning phosphate, and therefore it is incumbent on the CKD team to provide appropriate education.…”

Section: Patient Education To Assist Control Of Serum Phosphatementioning

confidence: 99%

Oral phosphate binders

Hutchison

2009

Kidney International

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Hyperphosphatemia is an inevitable consequence of end-stage chronic kidney disease and is present in the majority of dialysis patients. Hyperphosphatemia is observationally and statistically associated with increased cardiovascular mortality among dialysis patients. Dietary restriction of phosphate and current dialysis modalities are not sufficiently effective to maintain serum phosphate levels within the recommended range, so the majority of dialysis patients require oral phosphate binders. However, the benefits of achieving the recommended range have yet to be shown prospectively. Unfortunately, conventional phosphate binders are not reliably effective and are associated with a range of limitations and side effects. Aluminum-containing agents are highly efficient but no longer widely used because of proven toxicity. Calcium-based salts are inexpensive, effective, and most widely used, but there is now concern about their association with hypercalcemia and vascular calcification. Sevelamer hydrochloride is associated with fewer adverse effects, but a large pill burden and high cost are limiting factors to its wider use. Lanthanum carbonate is another non-aluminum, calcium-free phosphate binder. Preclinical and clinical studies have shown a good safety profile, and it appears to be well tolerated and effective in reducing phosphate levels in dialysis patients; however, it is similarly expensive. Data on its safety profile over 6 years of treatment are now published. Achievement of opinion-based guidelines appears to have become an end in itself. Dialysis patient outcomes are worse than outcomes for many types of cancer, yet prospective, outcome-based randomized controlled trials are not being undertaken for reasons that are difficult to explain.

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Patient Education: An Efficient Adjuvant Therapy for Hyperphosphatemia in Hemodialysis Patients

Abstract: Patient education could be helpful and efficient in hyperphosphatemic control in dialysis patients. The patient education should be given before the serum iPTH level getting high.

Cited by 26 publications

References 14 publications

The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

The Effects of Comfort-Based Interventions (Back Massage and Patient and Family Education) on the Level of Comfort Among Hemodialysis Patients

Avaliação de programa de ensino-aprendizagem sobre metabolismo de cálcio e fósforo para pacientes em hemodiálise

Oral phosphate binders

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