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      Factors related to preparedness for emergency hemodialysis in the event of a natural disaster

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          Abstract

          This study aimed to explore patients’ preparedness for emergency hemodialysis in the event of a natural disaster and to determine the factors affecting such preparedness.

          A cross-sectional study was conducted in undergoing hemodialysis at dialysis facilities in Sapporo, Hokkaido. The participants were a cohort of 256 outpatients aged 20 years or older, 186 (72.7%) were male, and the average age was 61.9 ± 10.9 years. The participants were divided into those who had prepared for emergency dialysis treatment and those who had not. Cross tabulations were performed on the 2 groups using the following participant attributes: preparedness for dialysis during a disaster, knowledge of how to protect themselves during a disaster, and intention to dialyze and evacuate during a disaster, followed by binomial logistic regression analysis.

          Of the 256 study patients, 184 (71.9%) were not prepared for dialysis treatment. In logistic regression models, patients who were not prepared for dialysis treatment were found to have higher odds of being employed (odds ratio (OR): 2.469; 95% confidence interval (CI): 1.205-5.058), not being aware of disaster information acquisition methods in the event of a disaster (OR: 4.580, 95%; CI: 2.048-10.241), did not receive explanations on proper disaster response from dialysis facility staff (OR: 2.557, 95%; CI: 1.319-4.954), and believing that their family away from home would not be concerned about them (OR: 2.021; 95% CI: 1.062-3.847).

          Disaster preparedness in patients undergoing dialysis remain inadequate. Dialysis facilities need to strengthen their explanations of disaster response, particularly with regard to working, middle-aged people.

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          Personal disaster preparedness: an integrative review of the literature.

          Experts generally agree that individuals will require partial or complete self-sufficiency for at least the first 72 hours following a disaster. In the face of pervasive environmental and weather hazards, emerging biological threats, and growing population densities in urban areas, personal preparedness is critical. However, disaster planners and policymakers require further information to create meaningful improvements to this aspect of disaster preparedness. A systematic review of the literature was conducted to determine the state of evidence concerning personal disaster preparedness. The purpose of this integrative review is to describe and analyze the professional literature as an intended basis for advancing the field of disaster management research and practice. Included in the review were 36 studies that met the predetermined inclusion criteria. The current evidence indicates that factors influencing preparedness attitudes and behaviors are complex and multifaceted, including demographic characteristics, trust in government efforts, previous exposure to a disaster, and number of dependents in a household. Furthermore, certain population groups, households, and individuals have different disaster preparedness needs and vulnerabilities. This constellation of findings has significant implications for community and national emergency planning and policymaking.
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            Missed dialysis sessions and hospitalization in hemodialysis patients after Hurricane Katrina.

            In order to evaluate the factors that contributed to missed dialysis sessions and increased hospitalizations of hemodialysis patients after Hurricane Katrina, we contacted 386 patients from 9 New Orleans hemodialysis units. Data were collected through structured telephone interviews on socio-demographics, dialysis factors, and evacuation characteristics. Overall, 44% of patients reported missing at least one and almost 17% reported missing 3 or more dialysis sessions. The likelihood of missing 3 or more sessions was greater for those whose dialysis vintage was less than 2 years compared to those for whom it was 5 or more years, who had 38 or fewer billed dialysis sessions compared to those who had 39 or more in the 3 months before the storm, who lived alone before the storm, who were unaware of their dialysis facility's emergency plans, who did not evacuate prior to hurricane landfall, and who were placed in a shelter. The adjusted odds ratio of hospitalization among patients who missed 3 or more compared to those who did not miss any dialysis sessions was 2.16 (95% CI: 1.05-4.43). These findings suggest that when preparing for future disasters more emphasis needs to be placed on patient awareness and early execution of emergency plans.
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              Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005.

              The active 2005 hurricane season alerted Americans to the pressing need for a more effective response to mass casualty incidents. The kidney patient community was particularly affected. Ninety-four dialysis facilities in the Gulf Coast states closed for at least 1 wk in the aftermath of Hurricane Katrina, and additional units were affected by evacuation of dialysis patients. Dialysis units along the Gulf Coast were also affected by Hurricanes Rita and Wilma. Existing emergency response plans were inadequate in providing continuity of care for kidney patients. The Kashmir, South Asia, earthquake of October 2005 killed 97,000 individuals. Building collapse was associated with widespread crush injury, and many patients required temporary hemodialysis. Several regions of the United States have the potential for catastrophic earthquakes. The Kidney Community Emergency Response Coalition has recently issued recommendations for patients, dialysis facilities, and providers, with a goal to improve care of kidney patients in future domestic disasters. With suitable planning, the nephrology community can do much to ensure the continuity of medical care for kidney patients in the face of a wide range of possible natural and human-made disasters.
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                Author and article information

                Contributors
                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                17 June 2022
                17 June 2022
                : 101
                : 24
                : e29288
                Affiliations
                [a ]Department of Nursing, Kinjo University, Hakusan, Ishikawa, Japan
                [b ]Division of Health Sciences, Doctoral Course of Graduate School of Medical Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
                [c ]Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
                [d ]School of Nursing, Kanazawa Medical University, Kahoku, Ishikawa, Japan
                [e ]Department of Nursing, Toyama Prefectural University, Toyama, Toyama, Japan.
                Author notes
                []Correspondence: Reiko Nihonyanagi, Kinjo University, Kinjo Daigaku, Hakusan, Ishikawa, Japan (e-mail: reikon.nihonyanagi@ 123456gmail.com ).
                Article
                MD-D-21-08130 29288
                10.1097/MD.0000000000029288
                9276223
                35713432
                115ea07b-4823-45af-9b2f-d5216138cb70
                Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

                History
                : 5 December 2021
                : 25 March 2022
                : 25 March 2022
                Categories
                5200
                Research Article
                Observational Study
                Custom metadata
                TRUE

                disaster preparedness,disasters,hemodialysis,emergency
                disaster preparedness, disasters, hemodialysis, emergency

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