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      Ser paciente renal crónico desde la perspectiva de la enfermera: una mirada existencialista en el desvelar de la evidencia cualitativa Translated title: Being a chronic kidney patient from the nursing perspective: an existentialist look at the qualitative evidence approach

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          Abstract

          Resumen Objetivo: Este estudio pretende desvelar la evidencia cualitativa del paciente con enfermedad renal crónica a través de la percepción del equipo de enfermería nefrológica bajo una mirada existencialista. Material y Método: Se trata de un estudio cualitativo, exploratorio-descriptivo, con análisis basado en la teoría humanista de Paterson y Zderard y de la filosofía existencialista. Los trabajos de campo se hicieron en el servicio de nefrología en el sur de Brasil y un centro de hemodiálisis en Lorca en España. La muestra fue 12 profesionales del equipo enfermería. El estudio de los datos se realizó mediante análisis de contenido, con la identificación de categorías centrales. Resultados/Discusión: Se identificaron tres categorías centrales: ser paciente; aceptar la enfermedad y establecer vínculos. El ser paciente se desvela como un ser cuidado que requiere atención de enfermería especializada, para el tratamiento de los síntomas físicos, pero también desde una mirada atenta y acogedora de sus necesidades emocionales. La aceptación de la enfermedad por parte de éste resulta clave para ser consciente de su existencia. Para ello el profesional de Enfermería debe establecer vínculos con el ser cuidado. Consideraciones finales: Al desvelar esta nueva realidad y la necesidad de realizar una terapia renal sustitutiva, el ser cuidado presenta sentimientos de miedo, tristeza, desesperanza, sufrimiento por la pérdida de autonomía. Sin embargo, también se perciben sentimientos positivos como: confianza, al establecer un vínculo con el equipo de enfermería, y de esperanza y alegría ante la posibilidad de un trasplante y recuperación de su autonomía.

          Translated abstract

          Abstract Objective: This study aims to reveal the qualitative evidence of the patient with chronic kidney disease through the perception of the nephrology nursing team from an existential perspective. Material and Method: Qualitative exploratory-descriptive study, with analysis based on the Paterson and Zderard’s humanist theory and the existentialist philosophy. The field work was carried out in a nephrology service in southern Brazil and a hemodialysis center in Lorca, Spain. The sample was 12 professionals from the nursing team. The study of the data was done through content analysis, with the identification of central categories. Results/Discussion: Three central categories were identified: being patient; accept the disease and establish links. Being a patient reveals itself as a caring being that requires specialized nursing care, for the treatment of physical symptoms, but also from an attentive and welcoming view of their emotional needs. Acceptance of the disease by the patient is key to being aware of his/her existence. For this, the nursing professional must establish links with being cared for. Final considerations: When unveiling this new reality as well as the need to perform renal replacement therapy, the person cared for presents feelings of fear, sadness, hopelessness, suffering due to the loss of autonomy. However, positive feelings such as confidence are also perceived when establishing a bond with the nursing team, and of hope and joy at the possibility of a transplant and recovery of autonomy.

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          Most cited references30

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          Standards for reporting qualitative research: a synthesis of recommendations.

          Standards for reporting exist for many types of quantitative research, but currently none exist for the broad spectrum of qualitative research. The purpose of the present study was to formulate and define standards for reporting qualitative research while preserving the requisite flexibility to accommodate various paradigms, approaches, and methods.
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            A systematic analysis of world-wide population-based data on the global burden of chronic kidney disease in 2010

            Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Here we estimated the global prevalence and absolute burden of CKD in 2010 by pooling data from population-based studies. We searched MEDLINE (January 1990 to December 2014), International Society of Nephrology Global Outreach Program funded projects, and bibliographies of retrieved articles and selected 33 studies reporting gender- and age-specific prevalence of CKD in representative population samples. The age standardized global prevalence of CKD stages 1–5 in adults aged 20 and older was 10.4% in men (95% confidence interval 9.3–11.9%) and 11.8% in women (11.2–12.6%). This consisted of 8.6% men (7.3–9.8%) and 9.6% women (7.7–11.1%) in high-income countries, and 10.6% men (9.4–13.1%) and 12.5% women (11.8–14.0%) in low- and middle-income countries. The total number of adults with CKD was 225.7 million (205.7–257.4 million) men and 271.8 million (258.0–293.7 million) women. This consisted of 48.3 million (42.3–53.3 million) men and 61.7 million (50.4–69.9 million) women in high-income countries, and 177.4 million (159.2–215.9 million) men and 210.1 million (200.8–231.7 million) women in low- and middle-income countries. Thus, CKD is an important global-health challenge, especially in low- and middle-income countries. National and international efforts for prevention, detection, and treatment of CKD are needed to reduce its morbidity and mortality worldwide.
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              Beyond quality of life: a cross sectional study on the mental health of patients with chronic kidney disease undergoing dialysis and their caregivers

              Background Patients with terminal chronic kidney disease (CKDT) requiring renal replacement therapies (RRT) undergo important changes in living habits and frequently need caregiving. These patients and their caregivers are risk groups for the development of physical and psychological symptoms. This study aimed to evaluate the prevalence of anxiety, depression, stress, fatigue, social support, and quality of life in patients with CKD and their caregivers. Method This cross sectional study was conducted with 21 patients and their caregivers, from January to September 2015. We included patients aged over 18 years, with at least 6 months on dialysis treatment, and caregivers who were family members. The participants’ social, demographic, clinical, laboratory, and psychological variables were evaluated. A descriptive analysis and an examination of the association between patients and caregivers were performed. Results Among patients, we observed that 38.1% had symptoms that indicated anxiety and depression. The average score for practical social support was 3.15 ± 0.769 and that for emotional social support was 3.16 ± 0.79. As for fatigue, 14.3% of patients reported being ‘extremely tired’ and 14.3% reported that they engaged in all the activities they usually performed before the illness. Further, 57.1% presented stress, and of these, 66.7% were at the resistance stage, with predominance of psychological symptoms in 60.0%. The quality of life domain in terms of functional capacity (FC) presented a correlation with haemoglobin level (r = 0.581, p = 0.006) and non-anaemic patients presented better FC. Among caregivers, we observed symptoms that indicated anxiety and depression in 33.3% of the sample. Caregivers exhibited an average score of 2.88 ± 0.77 for practical social support and 3.0 ± 0.72 for emotional social support. Further, 14.3% reported being ‘extremely tired’ and 28.8% reported that they engaged in all activities that they usually performed before the patient’s illness. When comparing the two groups (patients vs. caregivers), we observed that they presented similar results for the presence of anxiety, depression, and fatigue. Caregivers received less social support than patients did. Both groups presented similar predominance of stress levels; however, patients presented more predominance of psychological symptoms. With reference to quality of life, patients and caregivers presented similar results on the social aspects, vitality, mental health, and mental domains. Conclusion The mental health characteristics of patients and caregivers were similar, and within the context of dialysis for renal disease, both must undergo specific interventions.
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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 2021
                : 24
                : 2
                : 139-147
                Affiliations
                [2] Murcia Murcia orgnameUniversidad Católica San Antonio orgdiv1Grupo de investigación “Pensamiento y lenguaje enfermero en el contexto social” Spain
                [1] Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul orgdiv1Grupo de investigación NECE Brazil
                Article
                S2254-28842021000200139 S2254-2884(21)02400200139
                10.37551/s2254-28842021013
                87ffd0ed-21d5-4f13-86c5-00c275c9d1d8

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

                History
                : 02 April 2021
                : 12 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 9
                Product

                SciELO Spain

                Categories
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                qualitative research,renal insufficiency chronic,existentialism,nursing,investigación cualitativa,insuficiencia renal crónica,existencialismo,enfermería

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