Coping trajectory of social isolation in individuals with maintenance haemodialysis: A descriptive qualitative study.

Background: : The number of individuals undergoing maintenance haemodialysis has continued to increase in recent years. This treatment method can lead to social isolation, which has a significant impact on an individual's health. Unfortunately, research on this issue is insufficient, and no effective interventions have been developed. Moreover, existing research lacks attention to and understanding of patient aspirations-a critical area that warrants further exploration. Objectives: : We aimed to reveal the natural coping trajectory of individuals undergoing maintenance haemodialysis in the context of social isolation to provide a useful reference for further research and the development of effective interventions. Design: : This was a descriptive qualitative study. Setting s: This study was conducted at a haemodialysis centre in a provincial capital city of northern China. Participants: Using maximum variant and purposive sampling, we recruited 15 patients undergoing maintenance haemodialysis. Methods: : The interviews were transcribed verbatim, and data were analysed using deductive content analysis. Results: Three themes were identified: (a) prerequisites for coping with social isolation; (b) maintaining the bond between coping and social isolation; and (c) the results of coping with social isolation. These themes revealed the natural trajectory of individuals undergoing maintenance haemodialysis in dealing with social isolation. Conclusion: : We interpreted the findings to mean that it was necessary to establish a three-way linkage among family, hospitals, and society to develop multicomponent and multilevel intervention measures. Tweetable abstract: : A study of the response of individuals undergoing maintenance haemodialysis to social isolation revealed their coping trajectory and conveyed their aspirations.

Systematic Review and Meta-analyses: Dietary Behavior Interventions in Non-dialysis Chronic Kidney Disease.

Evidence of the effectiveness of dietary behavior interventions in patients with non-dialysis chronic kidney disease is limited. We aim to determine the benefits and barriers of dietary behavior interventions for this population. Eligible studies were obtained from databases including PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL. Six studies including 432 participants were identified. Overall, dietary behavior interventions significant improved adherence to protein intake (2.64, 95% CI 1.33, 5.23, I2 = 0) and renal function (eGFR) (2.97, 95% CI 2.59, 3.35, I2 = 0). Moreover, dietary behavior interventions indicated a significant opportunity to promote adherence to sodium-restricted diets (SRD), blood pressure (BP), self-efficacy, and quality of life (QoL) in non-dialysis CKD patients. However, there is still need to determine dietary behavior intervention programs in large sample and amount of studies, develop reliable instruments to measure dietary adherence, and thereafter, provide more reliable results for clinical practice.

Nonpharmacological Interventions for Depressive Symptoms in End-Stage Renal Disease: A Systematic Review.

Depressive symptoms are common in patients with end-stage renal disease, which can affect treatment and prognosis. We aimed to evaluate the effects of nonpharmacological interventions for depressive symptoms in end-stage renal disease. Eligible studies were identified using PubMed, Web of Science, the Cochrane Library, Embase, and PsycNET (up to March 2019). We identified 24 studies including 1,376 patients. We found that psychological intervention (-0.60, 95% confidence interval [CI] = [-0.87, -0.33]), exercise (-1.13, 95% CI = [-1.56, -0.69]), and manual acupressure (-0.26, 95% CI = [-0.50, 0.03]) were associated with a significant effect on depressive symptoms. However, few studies reported adverse events, and conclusions about safety should be drawn cautiously. While the available data show that nonpharmacological interventions are potential strategies to alleviate depressive symptoms of patients with end-stage renal disease, recommendation of the most efficacious interventions for this population will require future randomized controlled trials with large-scale, long-term intervention.

Exercise interventions on patients with end-stage renal disease: a systematic review.

OBJECTIVE:: This study aimed to conduct an up-to-date systematic review of the literature to evaluate the effects of exercise on fatigue, anxiety, depression, physical activity, and quality of life (QOL) in patients with end-stage renal disease. DATA SOURCES:: We searched PubMed (October 2018), Embase (from 1966 to October 2018), Web of Science (from 1900 to October 2018), The Cochrane Library (October 2018), and references of papers. METHODS:: This study includes randomized controlled trials that analyzed the combined effects of exercise intervention on patients with end-stage renal disease. Two reviewers independently screened the retrieved records, extracted data, and assessed the risk of bias for inclusion in the study. The effects of exercise intervention were conducted in the meta-analysis using RevMan 5.3 software. RESULTS:: A total of 614 participants were included in 13 randomized controlled studies. The study revealed that exercise can improve fatigue, anxiety, depression, physical activity, and QOL. The effect value results were as follows: (1) fatigue, -0.97 (95% confidence interval (CI) -1.32 to -0.62, P < 0.00001); (2) anxiety, -0.78 (95% CI -1.17 to -0.39, P < 0.0001); (3) depression, -0.85 (95% CI -1.13 to -0.56, P < 0.00001) (4) physical activity, 38.15 (95% CI 21.20 to 55.10, P < 0.0001); (5) QOL, the physical component of the 36-item Short-Form Health Survey (SF-36), 4.73 (95% CI 1.92 to 7.54, P = 0.0010); and (6) the mental component of the SF-36, 3.42 (95% CI 0.27 to 6.56, P = 0.03). CONCLUSION:: Exercise intervention is more effective in fatigue, anxiety, depression, physical activity, and QOL. However, large-scale randomized controlled trials are needed to confirm the appropriate types of exercise and optimal time for patients with end-stage renal disease.