Determinants of Nephrology Provider Engagement in Comprehensive Pre-Dialysis Discussions with Older Adults: Scale Development and Psychometric Evaluation.

Comprehensive pre-dialysis discussions between providers and older adults over age 75 years are needed but often lacking. The aim of this study was to develop an instrument to assess behavioral determinants of nephrology provider use of comprehensive pre-dialysis discussions with older adults. Study design consisted of cross-sectional development of the instrument and preliminary psychometric evaluation. Items were based on an integrated literature review, expert clinician input, and the Theory of Planned Behavior. Nephrologists, nurse practitioners, and physician assistants completed the instrument (n = 71). Baseline demographic data, exploratory factor analysis, and Cronbach's alpha were analyzed. Initial factor analysis using principal components analysis and subsequent orthogonal rotation revealed loading on a four-factor model. Cronbach's alphas for the instrument/items were 0.89/0.83 to 0.94. Variance explained by the four factors was 58%.

Mental Health and Health-Related Quality of Life Among Nephrology Nurses: A Survey-Based Cross-Sectional Study.

Nephrology nurses face health and wellness challenges due to significant work-related stressors. This survey, conducted online between July 24 and August 17, 2020, assessed the psychological well-being of nephrology nurses in the United States during the COVID-19 pandemic (n = 393). Respondents reported feeling burned out from work (62%), symptoms of anxiety (47% with Generalized Anxiety Disorder-7 [GAD-7] scores ≥ 5), and major depressive episodes (16% with Patient Health Questionnaire-2 [PHQ-2] scores ≥ 3). Fifty-six percent (56%) of survey respondents reported caring for COVID-19 patients, and 62% were somewhat or very worried about COVID-19. Factors, including high workload, age, race, and the COVID-19 pandemic, may partially explain the high proportion of nephrology nurses who reported symptoms of burnout, anxiety, and depression.

Nurses Need to Publish Scholarly Articles: Overcoming Reticence to Sharing Valuable Experience.

This article is part of the "Exploring the Evidence: Focusing on the Fundamentals" series. It provides nephrology nurses with basic principles related to writing for publication, information regarding different types of professional articles that may be used for the dissemination of nursing knowledge, as well as steps to follow and issues to consider in the planning and preparation of a manuscript.

Maximizing New Technologies to Treat Depression.

In an era of rapid technological evolution, mental healthcare providers are tapping into technology that offers feasible and effective alternatives to reach patients who suffer from depression. This paper provides a brief history and description of current technologies, frequently used taxonomies, and specific applications for the assessment and treatment of depression. These include online healthcare communities and social media, automated screening, wearable technology, and virtual reality therapy. A review of a secondary analysis that incorporated technology used with patients experiencing depressive symptoms is provided and future trends in mHealth or cellular-based technologies to treat depression are explored.

Improving the Care of Patients with Chronic Kidney Disease Using Group Visits: A Pilot Study to Reflect an Emphasis on the Patients Rather Than the Disease.

This two-group, repeated-measures experimental study assessed the efficacy of a nurse practitioner-facilitated chronic kidney disease (CKD) group visit (GV) model versus usual nephrology care for patients with Stage 4 CKD. The study enrolled patients from two sites of an outpatient nephrology practice (n = 30) and randomized subjects to usual care (n = 14) or to the GV model (n = 16). Data regarding CKD knowledge, self-efficacy/disease self-management, and physiologic measures were collected at baseline, 6 months, and 9 months. Satisfaction was obtained at 6 months and 9 months. Usual nephrology office visit components were maintained during six monthly GVs, with group discussions of CKD-related topies. Results indicated a statistical improvement in CKD knowledge for both groups (F[1.498, 34.446] = 6.363, p = 0.008). An upward trend in mean scores for self-management subscales and self-efficacy scores was demonstrated in the GV patients, with no improvement found in the usual care group. Twenty-six of 30 patients completed the study, with 92% attendance in the GV group. GV satisfaction was high.

Adult anemia: determine clinical significance.

Severity of adult anemia does not reliably indicate its origin or clinical significance. Causes range from dietary insufficiency to occult bleeding and from chronic disease processes to hemolysis. NPs can identify the different types of anemia with a thorough history, physical examination, and appropriate laboratory testing.