ABSTRACT
Objective To explore the effects of cognitive impairment on the self-management ability and self-management behavior among the patients of end stage renal disease (ESRD) with maintenance hemodialysis (MHD).Methods 134 MHD patients were divided into the non cognitive impairment group(62 subjects) and cognitive impairment group(72 subjects) according to Montreal cognitive assessment (MoCA)scores,to asses and analyze the level of hemodialysis knowledge,hemodialysis adherence,self-management ability and self-management behavior between the two groups.Results The rates of hemodialysis skipping behavior and the rates of hemodialysis shorting behavior in cognitive impairment group (respectively,18.06％,22.22％) were higher than that in non cognitive impairment group(respectively,6.45％,8.06％) with significant difference (x2 =4.0495,5.0526,all P＜0.05).The cognitive impairment group had significantly less total score (respectively,16.62 ± 1.99,51.32± 9.92,56.99±8.3) in the level of hemodialysis knowledge,the self-management ability and the self-management behavior compared with the non cognitive impairment group(respectively,18.48±2.03,63.69±10.16,78.54± 10.28) (t=5.3448,7.1172,13.4140,all P＜0.05).Conclusion Cognitive impairment can produce an effect on the level of hemodialysis knowledge and hemodialysis adherence.Cognitive impairment can also reduce the function of self-management ability and self-management behavior and make badly further effect on curative effect of hemodialysis.
ABSTRACT
ObjectiveTo evaluate the application of quantitative sensory testing(QST) in hemodialysis (HD) patients with peripheral neuropathy.MethodsThe values of the quantitative sensory testing and sensory conduction velocity at different locations of extremities in 40 cases of the HD patients and 40 normal persons were recorded.ResultsAccording to the control group,without symptoms group and with symptoms group,the thermal threshold(TT) and vibratory threshold (VT) at the four different locations of extremities were increased,thresholds of the later two groups were significantly higher than those of normal controls (P ＜ 0.05 ).Especially finger warm and vibratory thresholds,hypothenar heat pain thresholds,instep heat pain and vibratory thresholds,calf cold pain and vibratory thresholds were significantly difference between with symptoms group and normal control group (P＜0.01 ).Finger cool and warm thresholds,instep heat pain thresholds,thresholds of calf warm,cold pain and heat pain,and vibratory thresholds at the four different locations of extremities were significantly difference between wthout symptoms group and with symptoms group (P＜ 0.05).The SCV values of the median nerve,tibial nerve and lateral popliteal nerve were significantly difference between HD patients group and normal control(P ＜0.05 ).The total abnormal rate of QST was 65％,with symptoms group was 77.27％,total abnormal rate of SCV was 55.0％,with symptoms group was 68.18％.The total abnormal rate of QST were significantly higher than those of SCV (P＜0.01 ).ConclusionQST is a sensitive method for diagnosis of uremic neuropathy.