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      Experience of humanistic nursing in hemodialysis nursing for patients with diabetic kidney disease

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          Abstract

          BACKGROUND

          Diabetic kidney disease (DKD) is a prevalent complication of diabetes that often requires hemodialysis for treatment. In the field of nursing, there is a growing recognition of the importance of humanistic care, which focuses on the holistic needs of patients, including their emotional, psychological, and social well-being. However, the application of humanistic nursing in the context of hemodialysis for DKD patients remains relatively unexplored.

          AIM

          To explore the experience of humanistic nursing in hemodialysis nursing for DKD patients.

          METHODS

          Ninety-six DKD patients treated with hemodialysis from March 2020 to June 2022 were included in the study and divided into the control cluster (48 cases) and the study cluster (48 cases) according to different nursing methods; the control cluster was given routine nursing and the study cluster was given humanized nursing. The variances of negative emotion mark, blood glucose, renal function, the incidence of complications, life mark and nursing satisfaction before and after nur-sing were contrasted between the two clusters.

          RESULTS

          No significant difference in negative emotion markers between the two clusters were observed before nursing ( P > 0.05), and the negative emotion markers of the two clusters decreased after nursing. The Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale markers were lower in the study cluster than the control cluster. The healing rate of patients in the study cluster was significantly higher than the control cluster (97.92% vs 85.42%, P < 0.05). Blood glucose parameters were not significantly different between the groups prior to nursing ( P > 0.05). However, after nursing, blood urea nitrogen and serum creatinine (SCr) levels in the study cluster were lower than those in the control cluster ( P < 0.05). The incidence rate of complications was significantly lower in the study group compared to the control cluster (6.25% vs 20.83%, P < 0.05). There was no significant difference in the life markers between the two clusters before nursing. While the life markers increased after nursing for both groups, the 36-item health scale markers in the study cluster were higher than those within the control cluster ( P < 0.05). Finally, the nursing satisfaction rate was 93.75% in the study cluster, compared to 75% in the control cluster ( P < 0.05).

          CONCLUSION

          In hemodialysis for DKD patients, the implementation of humanistic nursing achieved ideal results, effectively reducing patients’ psychological negative emotion markers so that they can actively cooperate with the diagnosis and nursing, facilitate the control of blood glucose and the maintenance of residual renal function, reduce the occurrence of complications, and finally enhance the life quality and nursing satisfaction of patients. It is worthy of being widely popularized and applied.

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          Most cited references26

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          Epidemiology and treatment of depression in patients with chronic medical illness

          Wayne. J. Katon (2011)
          There is a bidirectional relationship between depression and chronic medical disorders. The adverse health risk behaviors and psychobiological changes associated with depression increase the risk for chronic medical disorders, and biological changes and complications associated with chronic medical disorders may precipitate depressive episodes. Comorbid depression is associated with increased medical symptom burden, functional impairment, medical costs, poor adherence to self-care regimens, and increased risk of morbidity and mortality in patients with chronic medical disorders. Depression may worsen the course of medical disorders because of its effect on proinflammatory factors, hypothalamic-pituitary axis, autonomic nervous system, and metabolic factors, in addition to being associated with a higher risk of obesity, sedentary lifestyle, smoking, and poor adherence to medical regimens. Both evidence-based psychotherapies and antidepressant medication are efficacious treatments for depression. Collaborative depression care has been shown to be an effective way to deliver these treatments to large primary care populations with depression and chronic medical illness.
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            Cost-effectiveness of Interventions to Manage Diabetes: Has the Evidence Changed Since 2008?

            Karen R Siegel, Mohammed Ali, Xilin Zhou … (2020)
            OBJECTIVE To synthesize updated evidence on the cost-effectiveness (CE) of interventions to manage diabetes, its complications, and comorbidities. RESEARCH DESIGN AND METHODS We conducted a systematic literature review of studies from high-income countries evaluating the CE of diabetes management interventions recommended by the American Diabetes Association (ADA) and published in English between June 2008 and July 2017. We also incorporated studies from a previous CE review from the period 1985–2008. We classified the interventions based on their strength of evidence (strong, supportive, or uncertain) and levels of CE: cost-saving (more health benefit at a lower cost), very cost-effective (≤$25,000 per life year gained [LYG] or quality-adjusted life year [QALY]), cost-effective ($25,001–$50,000 per LYG or QALY), marginally cost-effective ($50,001–$100,000 per LYG or QALY), or not cost-effective (&gt;$100,000 per LYG or QALY). Costs were measured in 2017 U.S. dollars. RESULTS Seventy-three new studies met our inclusion criteria. These were combined with 49 studies from the previous review to yield 122 studies over the period 1985–2017. A large majority of the ADA-recommended interventions remain cost-effective. Specifically, we found strong evidence that the following ADA-recommended interventions are cost-saving or very cost-effective: In the cost-saving category are 1) ACE inhibitor (ACEI)/angiotensin receptor blocker (ARB) therapy for intensive hypertension management compared with standard hypertension management, 2) ACEI/ARB therapy to prevent chronic kidney disease and/or end-stage renal disease in people with albuminuria compared with no ACEI/ARB therapy, 3) comprehensive foot care and patient education to prevent and treat foot ulcers among those at moderate/high risk of developing foot ulcers, 4) telemedicine for diabetic retinopathy screening compared with office screening, and 5) bariatric surgery compared with no surgery for individuals with type 2 diabetes (T2D) and obesity (BMI ≥30 kg/m2). In the very cost-effective category are 1) intensive glycemic management (targeting A1C &lt;7%) compared with conventional glycemic management (targeting an A1C level of 8–10%) for individuals with newly diagnosed T2D, 2) multicomponent interventions (involving behavior change/education and pharmacological therapy targeting hyperglycemia, hypertension, dyslipidemia, microalbuminuria, nephropathy/retinopathy, secondary prevention of cardiovascular disease with aspirin) compared with usual care, 3) statin therapy compared with no statin therapy for individuals with T2D and history of cardiovascular disease, 4) diabetes self-management education and support compared with usual care, 5) T2D screening every 3 years starting at age 45 years compared with no screening, 6) integrated, patient-centered care compared with usual care, 7) smoking cessation compared with no smoking cessation, 8) daily aspirin use as primary prevention for cardiovascular complications compared with usual care, 9) self-monitoring of blood glucose three times per day compared with once per day among those using insulin, 10) intensive glycemic management compared with conventional insulin therapy for T2D among adults aged ≥50 years, and 11) collaborative care for depression compared with usual care. CONCLUSIONS Complementing professional treatment recommendations, our systematic review provides an updated understanding of the potential value of interventions to manage diabetes and its complications and can assist clinicians and payers in prioritizing interventions and health care resources.
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              Hemodialysis-induced cardiovascular disease.

              Shadi Ahmadmehrabi, W. H. Wilson Tang (2018)
              More than half of all deaths among end stage renal disease (ESRD) patients are due to cardiovascular disease (CVD). Cardiovascular changes secondary to renal dysfunction, including fluid overload, uremic cardiomyopathy, secondary hyperparathyroidism, anemia, altered lipid metabolism, and accumulation of gut microbiota-derived uremic toxins like trimethylamine N-oxidase, contribute to the high risk for CVD in the ESRD population. In addition, conventional hemodialysis (HD) itself poses myocardial stress and injury on the already compromised cardiovascular system in uremic patients. This review will provide an overview of cardiovascular changes in chronic kidney disease and ESRD, a description of reported mechanisms for HD-induced myocardial injury, comparison of HD with other treatment modalities in the context of CVD, and possible management strategies.
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                Author and article information

                Contributors
                Xiao-Ying Chai
                Xiao-Yan Bao
                Ying Dai
                Xing-Xing Dai
                Yu Zhang
                Yu-Ling Yang
                Journal
                Journal ID (nlm-ta): World J Diabetes
                Journal ID (publisher-id): WJD
                Title: World Journal of Diabetes
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 1948-9358
                Publication date (Print): 15 February 2024
                Publication date (Electronic): 15 February 2024
                Volume: 15
                Issue: 2
                Pages: 186-195
                Affiliations
                Department of Nephrology, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
                Department of Hemodialysis, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
                Department of Endocrinology, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
                Department of Nephrology, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
                Department of Endocrinology, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
                Department of Nephrology, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China. xyingchai@ 123456163.com
                Author notes

                Author contributions: Chai XY performed experiments and wrote the manuscript; Bao XY designed the study and revised the manuscript; Dai Y was involved in analytical tools; Dai XX and Zhang Y collected the human material; Zhang Y served as scientific advisor; Yang YL is the guarantor.

                Supported by 2021 Wuxi Nursing Association Nursing Scientific Research Project Fund, No. Q202106.

                Corresponding author: Yu-Ling Yang, MAMS, Associate Chief Nurse, Department of Nephrology, The Affiliated Hospital of Jiangnan University, No. 1000 Hefeng Road, Binhu District, Wuxi 214000, Jiangsu Province, China. xyingchai@ 123456163.com

                Article
                Other ID: jWJD.v15.i2.pg186 Publisher-manuscript ID: 85996
                DOI: 10.4239/wjd.v15.i2.186
                PMC ID: 10921157
                PubMed ID: 38464378
                SO-VID: 3e330b9a-5863-4413-b2fb-8e0f8be8c853
                Copyright © ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                Date received : 1 June 2023
                Date revision received : 5 August 2023
                Date accepted : 27 December 2023
                Categories
                Subject: Case Control Study

                Keywords: diabetic kidney disease,hemodialysis,humanistic nursing,incidence of complication,effect
                Data availability:
                Keywords: diabetic kidney disease, hemodialysis, humanistic nursing, incidence of complication, effect

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