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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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Dialysis01:15

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Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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Hemodialysis III: Nursing Management01:25

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The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
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Hemodialysis II: Procedure and Complications01:24

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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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Conflict when making decisions about dialysis modality.

Nien-Hsin Chen1, Yu-Ping Lin2, Shu-Yuan Liang3

  • 1Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Shalunhu, Houlong Township, Miaoli County, Taiwan.

Journal of Clinical Nursing
|May 26, 2017
PubMed
Summary
This summary is machine-generated.

Patients with end-stage renal disease experience high decisional conflict when choosing dialysis. Factors like low self-efficacy, lack of education, and poor knowledge increase this conflict, impacting treatment choices.

Keywords:
decision self-efficacydecisional conflictdialysis modalityend-stage renal diseasepredialysis educationsocial support

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Area of Science:

  • Nephrology
  • Healthcare Decision-Making
  • Patient Education

Background:

  • End-stage renal disease (ESRD) patients face complex decisions regarding dialysis modality (hemodialysis vs. peritoneal dialysis).
  • Decisional conflict arises from uncertainty, potentially leading to choices misaligned with patient values and negative outcomes.
  • Addressing factors contributing to decisional conflict is crucial for informed decision-making and improved healthcare quality.

Purpose of the Study:

  • To investigate decisional conflict in ESRD patients choosing dialysis modality.
  • To identify influencing factors including demographics, predialysis education, dialysis knowledge, decision self-efficacy, and social support.

Main Methods:

  • A predictive correlational, cross-sectional study design was employed.
  • Seventy ESRD patients from two Taiwanese hospitals completed questionnaires assessing demographics, dialysis knowledge, decision self-efficacy, social support, and decisional conflict.

Main Results:

  • The average decisional conflict score was 29.26 (SD=22.18).
  • Decision self-efficacy, dialysis modality choice, predialysis education, professional support, and dialysis knowledge collectively explained 76.4% of the variance in decisional conflict.

Conclusions:

  • Lower decision self-efficacy, inadequate predialysis education on both dialysis types, limited dialysis knowledge, and perceived insufficient professional support are associated with higher decisional conflict.
  • Healthcare providers should enhance patient decision self-efficacy, offer comprehensive predialysis education for both hemodialysis and peritoneal dialysis, improve dialysis knowledge, and ensure adequate professional support.