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      Relación entre los factores de personalidad y el control de la ingesta hídrica en los pacientes en hemodiálisis Translated title: Relationship between personality factors and control of water intake in hemodialysis patients

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          Abstract

          RESUMEN Introducción: La relación entre los aspectos emocionales y físicos, ha sido motivo de estudio de forma recurrente, en los pacientes en hemodiálisis. Objetivo: Analizar la personalidad de los pacientes en hemodiálisis y ver la relación existente entre esta y las variables sexo e ingesta hídrica. Material y Método: Se estudiaron 54 pacientes en hemodiálisis periódicas. Se ha llevado a cabo un estudio descriptivo correlacional de corte transversal. Se administró el inventario de personalidad NEO-FFI. Se recogieron los datos sobre la ganancia hídrica interdiálisis. Se cuantificaron los valores de frecuencia de las puntuaciones obtenidas en el test y se realizó comparación con la población de referencia no ERC, y correlación con las variables sexo y ganancia hídrica interdiálisis. Resultados: Entre los factores de personalidad existen diferencias estadísticamente significativas con respecto a la población de referencia no ERC; por un lado, en el factor de neuroticismo con tendencia a la superioridad (p=0,000), más en mujeres que en hombres; y por otro, en los factores de extroversión (p=0,000) y apertura a la experiencia (p=0,000) con tendencia a la inferioridad. Por otro lado, no se han encontrado diferencias estadísticamente significativas entre los factores analizados, en relación a la ganancia hídrica interdiálisis. Conclusiones: Los pacientes en hemodiálisis tienden a ser inestables emocionalmente, más las mujeres que los hombres, con tendencia a ser introvertidos, con ideas rígidas e intereses reducidos. El control de la ingesta de líquidos no depende de ninguno de los factores estudiados.

          Translated abstract

          ABSTRACT Introduction: The relationship between emotional and physical aspects has been recurrently studied in haemodialysis patients. Objective: To analyse the personality of haemodialysis patients and to determine the relationship between personality and the variables sex and water intake. Material and Method: Fifty-four patients on periodic haemodialysis were studied. A cross-sectional descriptive correlational study was carried out. The NEO-FFI personality inventory was administered. Data on interdialysis water gain were collected. Frequency values of test scores were quantified. Comparisons were made with the non-CKD reference population, and correlations were made with the variables sex and interdialysis water gain. Results: Among the personality factors, statistically significant differences were found with respect to the non-RCD reference population. Regarding the neuroticism factor, a tendency towards superiority was found (p=0.000), more in women than in men; while in the extroversion (p=0.000) and openness to experience (p=0.000) factors, the tendency was towards inferiority. No statistically significant differences were found between the factors analysed in relation to interdialysis water gain. Conclusions: Haemodialysis patients tend to be emotionally unstable, more women than men, with a tendency to be introverted, with rigid ideas and reduced interests. Control of fluid intake does not depend on any of the factors studied.

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          The mortality risk of overhydration in haemodialysis patients

          Background. While cardiovascular events remain the primary form of mortality in haemodialysis (HD) patients, few centres are aware of the impact of the hydration status (HS). The aim of this study was to investigate how the magnitude of the prevailing overhydration influences long-term survival. Methods. We measured the hydration status in 269 prevalent HD patients (28% diabetics, dialysis vintage = 41.2 ± 70 months) in three European centres with a body composition monitor (BCM) that enables quantitative assessment of hydration status and body composition. The survival of these patients was ascertained after a follow-up period of 3.5 years. The cut off threshold for the definition of hyperhydration was set to 15% relative to the extracellular water (ECW), which represents an excess of ECW of ∼2.5 l. Cox-proportional hazard models were used to compare survival according to the baseline hydration status for a set of demographic data, comorbid conditions and other predictors. Results. The median hydration state (HS) before the HD treatment (ΔHSpre) for all patients was 8.6 ± 8.9%. The unadjusted gross annual mortality of all patients was 8.5%. The hyperhydrated subgroup (n = 58) presented ΔHSpre = 19.9 ± 5.3% and a gross mortality of 14.7%. The Cox adjusted hazard ratios (HRs) revealed that age (HRage = 1.05, 1/year; P < 0.001), systolic blood pressure (BPsys) (HRBPsys = 0.986 1/mmHg; P = 0.014), diabetes (HRDia = 2.766; P < 0.001), peripheral vascular disease (PVD) (HRPVD = 1.68; P = 0.045) and relative hydration status (ΔHSpre) (HRΔHSpre = 2.102 P = 0.003) were the only significant predictors of mortality in our patient population. Conclusion. The results of our study indicate that the hydration state is an important and independent predictor of mortality in chronic HD patients secondary only to the presence of diabetes. We believe that it is essential to measure the hydration status objectively and quantitatively in order to obtain a more clearly defined assessment of the prognosis of haemodialysis patients.
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            Compliance in hemodialysis patients: multidimensional measures in search of a gold standard.

            The gold standard to assess the compliance of hemodialysis (HD) patients has not been established. Compliance parameters should be easily measured and verified, reproducible, clearly interpretable, and accurate. They should have meaning for the patient, clear pathophysiological significance unrelated to other factors, and be related to important outcomes. There is poor correlation of subjective and objective measures and poor correlation of laboratory compliance measures. Different factors have been associated with differential compliance in different patient populations, depending on the measures assessed. Recently, behavioral measures of compliance with dialysis prescription, such as shortening or skipping HD treatments, have been developed. New data confirm that many compliance measures, including both laboratory and behavioral compliance indices, are associated with patient outcomes. It is the duty of the nephrologist and staff to make the importance of compliance understandable to patients. It is important for the health care team to understand patients' expectations and attitudes about their illness and their beliefs about the efficacy and importance of the treatment, as well as patients' demographic, medical, psychological, familial, and socioeconomic status, before realistically evaluating compliance. Such knowledge and approaches may be critical in achieving mutually agreed on compliance goals. We suggest that although assessment of indirect indices is useful, behavioral compliance measures that quantify shortening and skipping behaviors generally should be used in HD patients. Hopefully, analyses of results that control for multiple potentially confounding factors and effective interventions to improve compliance will be developed in the near future.
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              El papel de la depresión, la ansiedad, el estrés y la adhesión al tratamiento en la calidad de vida relacionada con la salud en pacientes en diálisis: revisión sistemática de la literatura

              La calidad de vida relacionada con la salud (CVRS) ha sido ampliamente estudiada en el ámbito de los pacientes en diálisis. Sin embargo, son pocos los trabajos que incluyen las relaciones de variables psicosociales y de adhesión al tratamiento con la CVRS. El objetivo de esta revisión es sintetizar sistemáticamente la información disponible sobre el rol que las variables psicológicas (depresión, ansiedad y estrés) y la adhesión al tratamiento tienen sobre la CVRS de los pacientes en diálisis a través de una revisión narrativa sistemática. Se seleccionaron los estudios que incluyeron y relacionaron en sus resultados variables psicológicas (al menos una de ellas: depresión, ansiedad o estrés percibido), adhesión al tratamiento y CVRS en población adulta en tratamiento con diálisis debido a su enfermedad renal crónica avanzada (ERCA). Los estudios incluidos debían incorporar en su protocolo de evaluación instrumentos estandarizados. Se efectuaron búsquedas en las bases de datos MedLINE y PsycINFO de enero de 2002 a agosto de 2012. Se incluyeron 38 estudios en esta revisión y fueron sometidos a una evaluación de la calidad metodológica. La revisión ha permitido observar que un 100 % de los trabajos identifica una asociación negativa entre indicadores de ansiedad, depresión y estrés con la CVRS, reflejando que dichas variables son factores de riesgo para la calidad de vida. La adhesión al tratamiento ha sido asociada con factores psicológicos y con la CVRS en un 8 % (N = 3) de los estudios incluidos, mostrándose un factor de protección para la calidad de vida en el 66 % de los estudios (2 de 3) que incluyeron la variable adhesión. Considerando el efecto de dichas variables sobre la CVRS, es importante detectar precozmente indicadores de ansiedad, estrés y depresión o dificultades para cumplir con el tratamiento en la población ERCA en diálisis. Esto permitirá intervenir a tiempo antes de que la CVRS se vea mermada.
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                Author and article information

                Journal
                enefro
                Enfermería Nefrológica
                Enferm Nefrol
                Sociedad Española de Enfermería Nefrológica (Madrid, Madrid, Spain )
                2254-2884
                2255-3517
                June 2022
                : 25
                : 2
                : 150-155
                Affiliations
                [1] Sevilla orgnameCentro de Diálisis Sierra Este España
                Article
                S2254-28842022000200150 S2254-2884(22)02500200150
                10.37551/52254-28842022016
                50f9afc2-5a8b-43b4-93b6-5facf85049ff

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 12 March 2022
                : 14 February 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 6
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                SciELO Spain

                Categories
                Originales

                hemodialysis,personalidad,hemodiálisis,psicología,ganancia hídrica interdiálisis,personality,psychology,interdialytic fluid gain

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