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S 22 Parallel Session
Programme of the Session
Title: Open Forum
GS: Ian Walsh (UK)
Care in Renal Cancer
O 47
From empirical to evidence-based complexity evaluation of patients
Francesco Pelliccia (Germany)
O 48
Comparison of socioeconomic situation of Turkish and Syrian haemodialysis patients
Aydin Nazan (Turkey)
O 49
Evaluating how technology is used by people with chronic kidney disease
Ann Bonner (Australia)
O 50
Active aging on hemodialysis: an adapted low intensity exercise programme in elderly patients
Anna Junqué (Spain)
Abstracts
GUEST SPEAKER
Care in Renal Cancer
I. Walsh
Abstract is not available
BIOGRAHPY OF THE GUEST SPEAKER
O 47
From empirical to evidence-based complexity evaluation of patients
F. Pelliccia1, C. Miriunis1, M.T. Parisotto1
1Fresenius Medical Care, Nursing Coordination, Bad Homburg, Germany
Background
The relationship between the patient complexity and the outcome is usually empirically determined from large data sets. A Nursing Patient Review (NPR) staging tool has been developed to measure the complexity and the prognosis of patients in the dialysis unit based on a multi-professional clinical evaluation.
An objective patients' classification is the baseline for an effective patient care plan based on their specific needs.
Objectives
To develop a staging system to classify the patients from fully independent to fully complex.
Methods
To validate the staging system, a retrospective observational study was conducted. Pearson correlation (95% CI) and Kaplan-Mayer cumulative survival were used for statistical analysis.
Results
Clinical data was extracted and analysed for 795 patients (mean age 68.5 years; 307 females) from 27,543 treatments. The patients were staged according to their complexity between minimally complex to complex.
Age (r=0.44; P<0.0001) and treatment complication frequency (r=0.28; P<0.0001) showed stronger correlations with NPR stage.
Patients’ follow-up (period of two years) results showed that the more complex the patients are, the lower their probability of survival over a longer period (NPR1: 96.5% vs NPR5: 74.9%).
Conclusion/Application to practice
These findings demonstrate that it is possible to create an instrument that is statistically valid and clinically coherent that can be accepted, used and endorsed by all clinical staff.
The NPR staging system provides a complexity stage, from a variety of clinical variables.
The derived stage can also be considered as a mean of predicting the likelihood of patient mortality.
O 48
Comparison of socio-economic situation of Turkish and Syrian haemodialysis patients
N. Aydin1, C. Dogan1, F. Turan1, Y. Vardar2, E. Balci2, E. Yilmaz1, M. Yilmaz1, A. Kudu1, S. Yucel1, S. Apaydin1
1Haemodialysis, Bakirkoy Dr.Sadi Konuk Education and Research Hospital Haemodialysis Unit., Istanbul, Turkey; 2Haemodialysis, Bagcilar Education and Research Hospital, Istanbul, Turkey
Background
Turkey is hosting nearly 2.5 million Syrian refugees and providing them health, education and food aid.
Objectives
The aim was to compare socio-economic situations including living situations and income distribution between Syrian and socially underprivileged Turkish haemodialysis patients.
Methods
We compared 23 Syrian patients with 82 Turkish, socially underprivileged dialysis patients with regard to “Income Distribution and Living Condition” questionnaire that has been made by Turkish Statistical Institute. The questionnaire forms were answered by the patient in the observation of nurses.
Results
There were 82 Turkish (41 Male, mean age 55,13±18 years) and 23 Syrians (11 Male, mean age 34,1±12,3 years) patients. Syrian patients were younger and better educated (table 1). Compliance with haemodialysis sessions was lower in refugees (p=0.002) and also temporary haemodialysis catheters were more frequent than in Turkish patients (p=0.012). Though there were more persons working in Syrian families (1.86±1.09 vs 1.04±0.92;p=0.003), per capita income was lower (1±0.9$ vs 4.5±2.8$;p=0.001). The only income for Syrian patients was “daily wage” and “salary”. They were not taking any social charity (p=0.001). People living together were 4.5±2 in Turkish families and 7.4±3 in Syrian families (p=0.001). Most of the Syrian patients were tenants (p=0.018) and they didn’t have any hot water installation (p=0.043). Owning of washing machine, dishwasher and refrigerator was more common in Turkish patients (p=0.013;p=0.001;p=0.001). Syrian patients couldn’t afford having their goods repaired and to pay their bills (p=0.014;p=0.001).
Table 1: Findings of questionnaire of the Syrian and socially underprivileged Turkish haemodialysis patients
Conclusion/Application to practice
Syrian haemodialysis patients are younger and more educated than underprivileged Turkish patients. They are dealing with difficulties in starting a new life in a foreign country. Although they’re trying to improve their socio-economic situations, they haven’t reached sufficient living conditions.
O 49
Evaluating how technology is used by people with chronic kidney disease
A. Bonner1, 2, 3, K. Corones1, K. Campbell4, B. Hayes5, B. Harvie6, J. Kelly 4, K. Gillespie1, K. Havas1, 2
1School of Nursing, Queensland University of Technology, Brisbane, Australia; 2NHMRC Chronic Kidney Disease Centre for Research Excellence, University of Queensland, Brisbane, Australia; 3Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Australia; 4Bond Univesity, Gold Coast, Australia; 5Renal Unit, Cairns Hospital, Cairns, Australia; 6Renal Unit, Bundaberg Hospital, Bundaberg, Australia
Background
Globally, technology is used by people with chronic diseases to find out about their health problems and treatment. It is also being increasingly used by renal teams at various stages along the chronic kidney disease (CKD) trajectory to support, educate and communicate with patients. However, the level and type of technology use in Australia is unknown.
Objectives
To investigate the use of internet and mobile phones in people with CKD.
Methods
A cross-sectional design undertaken at five locations recruited 619 participants. Inclusion criteria included: >18 years of age (no upper age limit); with known CKD (any stage); and attending a renal clinic or dialysis unit. A 38-item self-report survey captured demographic characteristics and internet and mobile phone use.
Results
Most participants were male (54.3%), <60 years of age (51.9%), had >10 years of schooling (52.4%) and were not on dialysis (59.1%). Internet was accessed at home (77.4%) via a laptop (30.8%) for checking emails (81.5%). Only 24.9% were aware of websites to get information about renal healthcare and even fewer used chat rooms (5.9%). Mobile phones were primarily used for making calls (86.1%) or SMS (80.8%). Those with smartphones mostly used apps for social networking, communication (e.g. email, Skype), banking or playing games. About half (50.6%) indicated a willingness to use technology for their renal healthcare including taking photos of meals for later advice.
Conclusion/Application to practice
The wide-spread introduction of technology to support CKD self-management may be justifiable; although it assumes that patients have good general and health literacy skills.
BIOGRAPHY OF THE SPEAKER
O 50
Active aging on haemodialysis: an adapted low intensity exercise programme in elderly patients
A. Junqué1
1Nefrologia, Consorci Sanitari de Terrassa, Terrassa, Spain
Background
Elderly haemodialysis (HD) patients are an increasing group with high dependency and comorbidity.Benefits of exercise have not been specifically evaluated in elderly HD population
Objectives
Analyze an adapted low intensity intradialytic exercise on muscle strength, functional capacity and quality of life in our elderly HD patients (> 75 years) as well as body composition and nutritional parameters
Methods
12 weeks single-center study.HD patients were assigned into exercise (ET) or control group (C).Analized:1.-Nutritional and lipid profile biochemical data.2.-Maximum length quadriceps strength (MLQS) and hand-grip (HG).3.-“Sit to stand to sit" (STS10) and “six-minutes walking test”(6MWT).4.-Health questionnaire: EQ-5D.5.-Body composition (EBI).
Results
22 patients.50% male. Mean age 83.2 years.44.1 months in HD.11 group E, 11group C. No related adverse effects.Finally, ET group globally improved (* p <0.05): MLQS 10.5±7.6 vs 12.9±10.1 kg, HG *16.6±8.7 vs 18.2±8.9 kg, STS10 *29.9±10.6 vs 25±7.87 sec, 6MWT *14.6%, 234.4 vs 274.7 m and EQ-5D 49±19.1 vs 59.5±20.3.Non significant lower body fat (FAT) (33.2±13.1 vs 32.8±12.8) and higher musculoskeletal tissue percentage (27.2±6.5 vs 28.2±6.2) were observed in ET.No biochemical, dialysis adequacy or EBI changes were found.
Conclusion/Application to practice
1.-An adapted low intensity exercise programme improved muscle strength, functional capacity and quality of life in our elderly patients on HD and stand out the benefits of exercise in HD patients, even in this elderly population.2.-We did not found relevant changes on nutrtional data and body composition in our elderly HD patients.3.-We should consider an adapted low intensity intradialytic exercise as a part of comprehensive care in despite of elderly HD patient.