Effect of a supportive self-care educational intervention on quality of life among patients with end stage renal disease undergoing hemodialysis

End-stage renal disease [ESRD] and its treatments negatively affect quality of life [QOL]. Self-care is a pressing approach for patients to deal with their problems. The deterioration in QOL is particularly evident in the patients who had been on hemodialysis for an extended period of time. Health education is an independent function of nursing practice and is a responsibility of the nursing profession to offer appropriate education. Nursing intervention is directed towards promoting, maintaining, and restoring health status, preventing illness, and supporting people to adapt to the residual effects of illness. The aim of the present study was to evaluate the effect of a supportive self-care educational intervention on QOL among ESRD patients undergoing hemodialysis. It was hypothesized that ESRD patients undergoing hemodialysis who were subjected to a supportive self-care educational intervention would improve their QOL. Participants were 50 patients receiving maintenance hemodialysi s. This study was conducted in the dialysis unit of King Khaled University Hospital, Arriyadh,-Kingdom of Saudi Arabia. A quasi-experimental research design was utilized in this study. The design was implemented before and after applying a supportive self-care educational intervention on one group of ESRD patients to evaluate their QOL during undergoing hemodialysis using an instructional Arabic booklet. Two tools were used to collect data; [I] demographic data sheets, [2] a structured interview questionnaire of the Kidney Disease Quality of Life scale short form KDQOL-SF[TM] 1.3. Results of the present study indicated that there was significant improvement revealed in the scores of all domains of QOL [general health, social and emotional status, illness impact, financial and medical satisfaction] p<0.001, except the physical domain. As well statistically significant associations were found between pre-post-intervention improvements in the total QOL scores. The statistically significant independent predictors of QOL improvement were supportive self-care educational intervention constant attendance, dialysis duration and marital status. The study concluded that implementation of the supportive self-care educational intervention was associated with significant improvement in all domains of QOL, except the physical domain. The study findings implied the necessity of developing supportive self-care educational intervention for HD patients to be implemented on a wider scale and evaluated for further improvement

Early detection and management of pressure ulcers among vulnerable patients at El Manial University Hospital

Pressure ulcers are serious problems that occur frequently in acute and long term facilities. Once they occur, pressure ulcer may lead to sepsis and death. A key to prevention is early detection of patients at-risk with a valid and reliable pressure ulcer risk assessment instrument. The Braden scale is one of the most intensively used tools designed to facilitate that assessment, the cost of treating a hospitalized-acquired pressure ulcer places a significant burden on health care facilities. Associated expenses potentially include increased supplies, equipment, specialty beds, staffing, nutritional support, laboratory testing, and hospital length of stay. So, the purpose of this study is to develop a system for early detection and management of patient at risk for pressure ulcers among vulnerable patients at El Manial university hospital. A quasi-experimental design pre-post test intervention was used. The sample recruited in the study was 100 patients [male and female] and 30 female nurses. Pre-post tests were used to assess the nurse's knowledge and practice toward the care of patients about pressure ulcers. The study results demonstrated that, the teaching sessions for nurses showed a significant improvement in nurse's knowledge and demonstrated a positive change in their performance. Using Braden scale helped nurses to identify the patient at risk for pressure ulcers and assisted them to make decisions about the methods of pressure ulcers prevention to be taken. Patients' observations were made every 72 hours for a minimum of I to a maximum of 4 weeks. The outcomes [presence/absence and stage of pressure ulcer] were documented at each assessment. 29% of subjects developed pressure ulcers. The incidence was 15% for stage I and 14% for stage 11, the Braden scale showed a 66.7% sensitivity, 100% specificity, 66.7% predictive value of positive test and predictive value of negative test was 96.3%, and the cut-off point for classifying the pressure ulcer risk was 18, with overall accuracy 92.5%. The study recommended using the Braden scale in all health care facilities, Also a regular in service education programs for all staff and orientation programs for all new employees are essential about how to use the Braden scale for predicting pressure ulcer risk and for refreshing nurse's knowledge and practice regarding the prevention of pressure ulcers

effect of a teaching program on nutritional practices for hemodialysis patients

Diet is an important factor for patients on hemodialysis [HD] to maintain good nutritional status and to enable the patient to eat palatable and enjoyable diet. Restricting protein, sodium, potassium, and fluid intake help to minimize uremic symptoms, fluid / electrolyte imbalances, accumulation of nitrogenous wastes, and may even postpone the initiation of dialysis for a few months. For patients with chronic renal failure, or ESRD, hemodialysis prevents death. However, it does not cure or reverse. These patients need to use a proper nutritional practice, which is a crucial intervention. The purpose of this study was to evaluate the effect of a teaching program on nutritional practices for patients undergoing hemodialysis. Thirty-five subjects: male [n=16] and female [n=19] patients were selected over a year. The study was conducted at dialysis units both in El-Manial University Hospital and King Fahd Units. A quasi-experimental research design was utilized in this study. One group, pre-post test design was implemented. Three tools were used to collect data; [1] demographic and medical data sheets, [2] assessment sheet, and [3] pre-post test sheet. Results indicated that there was a significant differences between nutritional knowledge scores before and after [34.73+3.46] [3mths, 75.36+3.51; 6mths, 88.31+6.24; F=86.18 at p=0.000] respectively conducting the program. Also, there was an improvement in practicing nutritional dietary habit, which was indicated by increased number of meals from 2-3 meals per day [X[2]=27.5 at p=0.001] and the amount of daily fluid intake decreased to one liter or less [X[2]=19.1 at p=0.001]. Physical examination assessment revealed that hair, nails, tongue and gums status were improved after changing nutritional habits and practice [X[2]=12.9, X2=16.7, X[2]=21.3, X[2]=40.1 at P<0.001, respectively]. A moderate improvement appeared in renal function tests [urea; F=3.388 at P=0.038, Creatinine; F=3.964 at P=0.022]. While serum electrolyte levels were about normal range before and after conducting the program. The study concluded that there was positive impact of the teaching program on the improvement of patient nutritional practices. The findings of this study showed that the education session can have an effect on patients' knowledge and compliance. The study findings implied the necessity of physician, nurse and dietician to devote some of their time to provide HD patients and their family with simple explanation about permitted and omitted food and fluid, and planning for a convenient amount and quality. In addition, distributing a dietary guide would prepare the patient for developing new skills in eating habits to gain satisfaction and increase the pleasures of life

Meeting the challenges of coma consequences: development of an instructional nursing intervention plan for comatose patients

The purpose of this study was to detect the direct cause which lead to complications in comatose patients as well as to construct an instructional nursing intervention plan in order to prevent complications following coma. The results indicated that the highest effect which is most leading to coma complications is the long period of hospital stay [multiple r = 0.3829] followed by old age [multiple r = 0.0906, X = 57.9 + 17.3] and nurses performance [multiple r = 0.0640, 81% were scored as unsatisfactory, 14% need more practice and 5% satisfactory]. The study concluded that there is a positive statistical significant correlation between complication and hospital stay and patients' age. While nurses performance was negatively correlated with the prevalence of complications and low nurse-patient ratio