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How hemodialysis patients manage dietary and fluid intake? A descriptive qualitative study

Mon, 01 Jan 2024 00:00:00 GMT

Title: How hemodialysis patients manage dietary and fluid intake? A descriptive qualitative study Authors: Putri Lenggogeni, Devia; Malini, Hema; Ariany Maisa, Esthika; Mahathir, Mahathir Abstract: Background: Managing dietary and fluid intake for hemodialysis patients is crucial, but it is also challenging. Non-compliance to diet and fluid intake restriction may increase a patient’s morbidity and mortality. Exploring the experiences of hemodialysis patients who successfully manage those regimens may provide new insight to develop more effective strategies. Purpose: The study aimed to explore the experiences of hemodialysis patients who successfully manage the dietary and fluid intake restrictions. Methods: A descriptive qualitative study was applied. Semi–structured interviews were conducted with 15 hemodialysis patients purposively recruited from a hemodialysis unit of a public hospital in West Sumatera, Indonesia. Interviews were transcribed verbatim and thematically analyzed to describe the phenomenon of hemodialysis patients. The study was reported following the COREQ guidelines. Results: Most participants in this study are female, aged between 38 – 63 years and length of hemodialysis 4 months – 6 years. The finding of this study was that the essential themes that explained how hemodialysis patients adhere to fluid and dietary restrictions are 1) strategies for restricting fluid and dietary intake, 2) motivation to restrict fluid and dietary intake, 3) fear of the effects of non-adherence to fluid and dietary restrictions and 4) social support. Conclusion: Hemodialysis patients who successfully manage the dietary and fluid intake restriction employed various strategies, including maintaining motivation, facing fear of potential complications, and seeking social support. It is important for healthcare professionals to include those aspects when they provide education to the hemodialysis patients. Further study is warranted to explore the long-term impact of these strategies on patient outcomes and the development of educational programs that incorporate psychological and social support components to improve hemodialysis patients’ adherence and quality of life.

The psychometric properties of Indonesian Version of WHO Quality of Life 100 in tuberculosis patients

Mon, 01 Jan 2024 00:00:00 GMT

Title: The psychometric properties of Indonesian Version of WHO Quality of Life 100 in tuberculosis patients Authors: Yuliyanti, Sri; Azzam, Rohman; Rayasari, Fitrian Abstract: Background: Tuberculosis has an impact not only on physical health but also on psychological well-being and economic and social status, as well as causing stigma, which results in a decreased quality of life. Quality of life assessment can improve nurses’ understanding of patients’ burdens, disease processes, and needs during treatment, which will help design appropriate tuberculosis intervention programs. Purpose: This study was to obtain a valid and reliable Indonesian version of the WHOQOL-100 instrument for tuberculosis patients. Methods: This study is a psychometric study. According to the WHO guidelines, the original WHOQOL-100 instrument was translated using a forward and backward procedure. Two hundred and seventy-four tuberculosis patients treated at PMI Bogor Hospital completed the questionnaire. Construct validity was tested using exploratory factor analysis with principal component analysis and varimax rotation, and reliability using Cronbach’s alpha test on the WHOQOL-100 instrument. Results: WHOQOL-100 Indonesia version has six domains, with 17 facets, and most questions have a loading factor ≥ 0.4. Of the 100 items, 31 were extracted that were related to freedom, physical safety and security, health and social care, participation and opportunities for relaxation activities, physical environment, and transportation. The overall valid question item reliability test results are α = 0.816. Conclusion: This study produced a shorter version of the English version of the WHOQOL-100 instrument, valid and reliable for use in Indonesia

More with document work, less with patient care: An institutional ethnography of discharge planning practices for diabetic patients

Mon, 01 Jan 2024 00:00:00 GMT

Title: More with document work, less with patient care: An institutional ethnography of discharge planning practices for diabetic patients Authors: Kurniawan, Titis; Nilmanat, Kittikorn; Boonyasopun, Umaporn; Ganefianty, Amelia Abstract: Background: Diabetic patients required comprehensive discharge planning. However, this is a complex and challenging process. Nurses play significant roles and experience tensions in operating the everyday discharge planning practices. Purpose: to explore how nurses’ everyday activities in providing DP for diabetic patients were regulated by the ruling relations operating in the hospital as an institutional context. Methods: This institutional ethnography study applied phone-call interviews with 18 participants, participant observation, and document review to collect the data. Data analysis was concurrently conducted with the data collection processes following the institutional ethnography analytical approach. Trustworthiness was established. Results: The everyday discharge planning practices for diabetic patients follow the flow of patient care. Nurses perceived these practices to be problematic as the initial assessment form did not guide the discharge education, which was informal and unstructured, and documentation was burdensome. The hospital accreditation, nurse ward manager, and the registered nurse were identified as the ruling relations that regulate those practices through the hospitals’ standards and forms, monitoring, and completeness principle. Conclusion: The hospital’s forms, monitoring, and completeness principles are activated as the ruling relation that regulates the discharge planning practices for diabetic patients for satisfying good hospital service quality through standards and forms, monitoring, and completeness principles. This situation drives nurses to work more closely with the documents. Further study is crucial to identify a strategy to effectively bridge discharge planning practices and documentations works

Correlation between Neutrophil/ Lymphocyte Ratio (NLR), lipid profile, lesion location and vascular cognitive impairment in acute ischemic stroke patients

Mon, 01 Jan 2024 00:00:00 GMT

Title: Correlation between Neutrophil/ Lymphocyte Ratio (NLR), lipid profile, lesion location and vascular cognitive impairment in acute ischemic stroke patients Authors: Ristinawati, Ira; Tan, Kenneth; Benedictus, Benedictus Abstract: Background: Stroke is the leading cause of long-term disability with significant clinical and socioeconomic impact worldwide. Hyperlipidemia and inflammation play major roles in ischemic stroke. This research focuses on the correlation of three factors, namely Neutrophil-Lymphocyte Ratio (NLR), lipid profile, and lesion location, with vascular cognitive impairment (VCI). These factors may serve as potential predictors for VCI. Purpose: This research aims to study the correlation between NLR, lipid profile, and lesion location with vascular cognitive impairment. In addition, this research aims to explore those potential biomarkers as predictors of vascular cognitive impairment. Methods: This was a cross-sectional study which included 107 patients diagnosed with ischemic stroke from February 2022 to January 2023 with a history of admission to the hospital within 72 hours. After they signed an informed consent form, every patient had history taking, physical exam, lipid profile, routine blood test, Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina) on the first hospital day. Statistical tests were done with Spearman correlation method. Results: The data distribution was not normal for INR and MoCA-INA values (p<0.05). Total cholesterol was insignificantly (p=0.092) correlated with MoCA-INA score with low correlation value (r=-0.293). HDL was significantly (p=0.035) correlated with MoCA-INA score with moderate correlation value (r=0.461). LDL was significantly (p=0.028) correlated with MoCA-INA score with low correlation value (r=-0.387). Triglycerides was insignificantly (p=0.440) correlated with MoCA-INA score with very weak correlation value (r=-0.137). NLR was significantly (p=0.015) correlated with MoCA-INA score with moderate correlation value (r=-0.412). Conclusions: Lipid profile is correlated with cognitive impairment in poststroke patients, with HDL being a protective factor, and LDL as risk factor. NLR was associated with worse cognitive function and LDL was directly proportional to NLR. Lesion location reporting was highly heterogeneous and more uniformed reporting is recommended for future research.