Effects of a temporal self-regulation theory-based intervention on self-management in hemodialysis patients: A randomized controlled trial.

OBJECTIVE: To investigate the effects of a temporal self-regulation theory-based intervention on self-management in hemodialysis patients. METHODS: A randomized controlled trial was carried out in Lanzhou, China. Participants were randomly allocated to either the intervention group (n = 42) or control group (n = 42). The outcomes of self-management level, interdialytic weight gain, serum potassium and serum phosphorus were collected at baseline (T0), 1 month after intervention (T1), and 2 months after follow-up (T2). RESULTS: After intervention and follow-up, the self-management score of the intervention group was significantly higher than that of the control group, while the interdialytic weight gain, serum potassium, and serum phosphorus were significantly lower. The group and time interaction effects revealed that participants in the intervention group exhibited significantly greater improvement in self-management at T1 and T2. Interdialytic weight gain decreased significantly at T2. Serum potassium levels did not differ significantly at T1 or T2. The changes in serum phosphorus were both significant at T1 and T2. CONCLUSION: This study demonstrated that the temporal self-regulation theory-based intervention was effective in improving hemodialysis patients' self-management. PRACTICE IMPLICATIONS: The findings suggest popularizing and applying this intervention in the clinic to maintain the long-term effectiveness of the intervention effect.

Size correction and deep image optimization in optical coherence tomography angiography with structural image-assisted common parts extraction method.

Tail artifact elimination is essential in optical coherence tomography angiography (OCTA) for the artifacts will prevent the reconstruction of the 3D vessel image. The tail artifacts of superficial vessels obscure the deep vascular signals and cause the signals at different depths to mix with each other. Most tail artifact elimination methods can shorten the tails but have difficulty in determining the lower boundary of the vessels. In this letter, we introduce a technique to extract vascular signals with more accurate vascular boundaries. With the help of structural image, our method can reconstruct the 3D image of the vascular network more precisely and perform better in deep areas. The images of vessels of palm are used to compare our new technique with previous common parts extraction method experimentally. The results show that our method removes the tail artifacts more thoroughly and has a significant advantage in imaging deep vessels.

Perceived stress, social support, and insomnia in hemodialysis patients and their family caregivers: an actor-partner interdependence mediation model analysis.

Objectives: Patients' and caregivers' physical and mental health may interact. The theory of dyadic illness management holds that patients and caregivers should be regarded as a whole in health management. Previous studies have found that hemodialysis patients and their family caregivers experience poor sleep quality. Perceived stress and social support have effects on insomnia. However, the dyadic interaction between perceived stress, social support, and insomnia among hemodialysis patients and caregivers is unclear. This study aimed to explore the mediating role of social support in the association between perceived stress and insomnia in hemodialysis patient-caregiver dyads. Methods: A total of 259 hemodialysis patient-caregiver dyads completed the Chinese Perceived Stress Scales (CPSS), the Perceived Social Support Scale (PSSS), and the Athens Insomnia Scale (AIS) in Lanzhou, China, from May 2022 to July 2022. The actor-partner interdependence mediation model analysis was used for data analysis. Results: In the actor effect, there was a significant positive correlation between perceived stress and insomnia in hemodialysis patients (ß = 0.091, p = 0.001) and their family caregivers (ß = 0.588, p < 0.001). Patient's and caregiver's social support played partial mediating roles in the relationship between caregiver's perceived stress and insomnia (ß = 0.135, p < 0.001 and ß = 0.111, p < 0.001). In the partner effect, caregiver's perceived stress was positively connected with patient's insomnia (ß = 0.915, p < 0.001), and the mediating effect of patient's social support on the relationship between caregiver's perceived stress and patient's insomnia was statistically significant (ß = -0.040, p = 0.046). Conclusion: The perceived stress, social support and insomnia of hemodialysis patients and their family caregivers had interactive effects. Effective dyadic-based interventions should be developed to improve hemodialysis patients' and caregivers' sleep quality.

Effects of perceived stress, self-acceptance and social support on insomnia in hemodialysis patients: A cross-sectional study.

OBJECTIVE: The aim of this study was to explore the influence of perceived stress, self-acceptance and social support on insomnia among hemodialysis patients in China. METHODS: A cross-sectional study was conducted in Gansu, China, from May 2022 to July 2022. The Chinese Perceived Stress Scales (CPSS), Athens Insomnia Scale (AIS), Self-acceptance Questionnaire (SAQ), and Perceived Social Support Scale (PSSS) were evaluated in 610 hemodialysis patients. RESULTS: The prevalence of insomnia among hemodialysis patients was 40.7% in this study. Insomnia was positively correlated with perceived stress (r = 0.742, P < 0.01), and negatively correlated with self-acceptance (r = -0.531, P < 0.01) and social support (r = -0.574, P < 0.01). Self-acceptance played a mediating role in perceived stress and insomnia, with the mediating effect accounting for 13.8% of the total effect. Social support played a moderating role in perceived stress and insomnia (ß = -0.008, t = -5.112, P < 0.001). CONCLUSIONS: The results of this study enrich the research on the influencing factors of insomnia in hemodialysis patients and provide theoretical basis and practical guidance for improving the sleep quality of hemodialysis patients.

Self-management experiences of haemodialysis patients with self-regulatory fatigue: A phenomenological study.

AIM: To understand the real experiences of self-management in haemodialysis patients with self-regulatory fatigue, and to explore the influencing factors and coping strategies for patients with decreased self-management. DESIGN: A qualitative study was carried out using the phenomenological analysis method. METHODS: From 5 January to 25 February, 2022, semi-structured interviews were conducted with 18 haemodialysis patients in Lanzhou, China. Thematic analysis of the data was performed using the NVivo 12 software based on the 7 steps of Colaizzi's method. The study reporting followed the SRQR checklist. RESULTS: Five themes and 13 sub-themes were identified. The main themes were difficulties in fluid restrictions and emotional management, hard to adhere to long-term self-management, uncertainty about self-management, influencing factors are complex and diverse and coping strategies should be further improved. CONCLUSION: This study revealed the difficulties, uncertainty, influencing facts and coping strategies of self-management among haemodialysis patients with self-regulatory fatigue. A targeted program should be developed and implemented according to the characteristics of patients to reduce the level of self-regulatory fatigue and improve self-management. IMPACT: Self-regulatory fatigue has a significant impact on the self-management behaviour of haemodialysis patients. Understanding the real experiences of self-management in haemodialysis patients with self-regulatory fatigue enables medical staff to correctly identify the occurrence of self-regulatory fatigue in time and help patients adopt positive coping strategies to keep effective self-management behaviour. PATIENT OR PUBLIC CONTRIBUTION: Haemodialysis patients who met the inclusion criteria were recruited to participate in the study from a blood purification centre in Lanzhou, China.

The effects of exercise training interventions on depression in hemodialysis patients.

Purpose: Depression considerably influences the clinical outcomes, treatment compliance, quality of life, and mortality of hemodialysis patients. Exercise plays a beneficial role in depressive patients, but its quantitative effects remain elusive. This study aimed to summarize the effects of exercise training on depression in patients with end-stage renal disease undergoing hemodialysis. Methods: The PUBMED, EMBASE, and Cochrane Library databases were systematically searched from inception to April 2023 to identify published articles reporting the effect of exercise training on the depression level of patients with End-Stage Renal Disease undergoing hemodialysis. Data were extracted from the included studies using predefined data fields by two independent researchers. The Cochrane Handbook for Systematic Reviews of Interventions and Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies were employed for quality evaluation. Results: A total of 22 studies enrolling 1,059 patients who participated in exercise interventions were included. Hemodialysis patients exhibited superior outcomes with intradialytic exercise (SMD = -0.80, 95% CI: -1.10 to -0.49) and lower levels of depression following aerobic exercise (SMD = -0.93, 95%CI: -1.32 to -0.55) compared to combined exercise (c - 0.85, 95% CI: -1.29 to -0.41) and resistance exercise (SMD = -0.40, 95%CI: -0.96 to 0.17). Regarding exercise duration, patients manifested lower depression levels when engaging in exercise activities for a duration exceeding 6 months (SMD = -0.92, 95% CI: -1.67 to -0.17). Concerning the duration of a single exercise session, the most significant improvement was noted when the exercise duration exceeded 60 min (SMD = -1.47, 95% CI: -1.87 to -1.06). Conclusion: Our study determined that exercise can alleviate depression symptoms in hemodialysis patients. This study established the varying impacts of different exercise parameters on the reduction of depression levels in hemodialysis patients and is anticipated to lay a theoretical reference for clinicians and nurses to devise tailored exercise strategies for interventions in patients with depression. Systematic review registration: https://www.crd.york.ac.uk/prospero/, This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database, with registration number CRD42023434181.

Tail artifacts removal of three-dimensional optical coherence tomography angiography with common parts extraction method.

In optical coherence tomography angiography (OCTA), each blood vessel has a tail artifact. These tails of superficial vessels will shadow underlying the deep vascular images and make it difficult to reconstruct the three-dimensional (3D) image of the vessels. As 3D structure can provide much more information than two-dimensional (2D) images, it is important to develop a method to remove the artifacts. In this letter, we introduce an image processing technique based on common parts extraction to remove the artifacts. With the help of subtraction operation and erode operation, our method can reconstruct the 3D image of vascular network by extracting the common parts of adjacent B-Scan OCTA images. Vessels of palm are used as samples to experimentally demonstrate our technique. In the 3D image, we can see the interesting phenomenon that the ends of the blood vessels which close to the surface of the skin point toward the surface.