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Session 3: Concurrent 1.3
Concurrent Session
Concurrent Session
1:45 pm
13 June 2024
P7
Session Description
Session Chair: Prof Paul Bennett
Session Program
1:45 pm
234R - Research Paper
Abstract:
Aim:
We examined factors associated with the QoL of caregivers across different stages of CKD and investigated the relationship between the QoL of caregivers and severity of kidney disease.
Method:
A cross sectional study was performed among adult patients with CKD (eGFR <60 mL/min/1.73m2) and their caregivers recruited from the renal clinic of a large tertiary referral hospital. Demographic and clinical characteristics of patients were collected from medical records. Caregivers completed the Adult Carer Quality of Life Questionnaire, which measures QoL in eight separate domains with possible scores ranging from 0 to 15 with higher values indicating better QoL. Logistic regression analyses were performed to determine factors associated with low QoL among caregivers.
Results:
A total of 278 dyads of caregivers and patients with CKD were studied. The mean age (SD) of caregivers and patients was 56.6 (15.2) and 63.7 (15.3) years respectively. Mean QoL scores for caregivers across the 8 domains ranged from 8.1 to11.7 and the overall QoL score was 80.7 (19.2). Female gender of caregivers and patients, longer caregiving time, diagnosis of diabetes and lower socioeconomic status of patients were all associated with lower scores in one or more domains.
Conclusion:
In caregivers of patients with CKD, female gender of both caregivers and patients, longer caregiving time, lower socioeconomic status and a diagnosis of diabetes among patients were independently associated with low QoL. An understanding of these factors provides insight into the development of targeted interventions to improve QoL of caregivers.
Abstract:
Aim:
We examined factors associated with the QoL of caregivers across different stages of CKD and investigated the relationship between the QoL of caregivers and severity of kidney disease.
Method:
A cross sectional study was performed among adult patients with CKD (eGFR <60 mL/min/1.73m2) and their caregivers recruited from the renal clinic of a large tertiary referral hospital. Demographic and clinical characteristics of patients were collected from medical records. Caregivers completed the Adult Carer Quality of Life Questionnaire, which measures QoL in eight separate domains with possible scores ranging from 0 to 15 with higher values indicating better QoL. Logistic regression analyses were performed to determine factors associated with low QoL among caregivers.
Results:
A total of 278 dyads of caregivers and patients with CKD were studied. The mean age (SD) of caregivers and patients was 56.6 (15.2) and 63.7 (15.3) years respectively. Mean QoL scores for caregivers across the 8 domains ranged from 8.1 to11.7 and the overall QoL score was 80.7 (19.2). Female gender of caregivers and patients, longer caregiving time, diagnosis of diabetes and lower socioeconomic status of patients were all associated with lower scores in one or more domains.
Conclusion:
In caregivers of patients with CKD, female gender of both caregivers and patients, longer caregiving time, lower socioeconomic status and a diagnosis of diabetes among patients were independently associated with low QoL. An understanding of these factors provides insight into the development of targeted interventions to improve QoL of caregivers.
2:00 pm
409R - Research Paper
Abstract
Aim:
This was a feasibility pilot study to assess patient interest and engagement. The initiative provided insight into what does and does not work when implementing an online peer support group for haemodialysis patients.
Method:
A single site study was conducted at a 23-chair dialysis unit dialysing 99 adult patients. All haemodialysis patients were invited to participate. Data was also collected to measure social psychosocial outcomes using validated tools pre and post intervention.
Results:
Out of 99 patients approached 26 agreed to enrol and 9 withdrew. Pre and post QoL and HADS surveys were collected for analysis. Results are pending.
Conclusion:
This pilot study provided insights into an online peer-support group for haemodialysis patients, indicating potential benefits for social support and psychosocial wellbeing despite participation challenges. Individual needs must be considered in intervention design. Further analysis of the pre- and post-intervention data will shed light on the potential impact of the online support group.
Abstract
Aim:
This was a feasibility pilot study to assess patient interest and engagement. The initiative provided insight into what does and does not work when implementing an online peer support group for haemodialysis patients.
Method:
A single site study was conducted at a 23-chair dialysis unit dialysing 99 adult patients. All haemodialysis patients were invited to participate. Data was also collected to measure social psychosocial outcomes using validated tools pre and post intervention.
Results:
Out of 99 patients approached 26 agreed to enrol and 9 withdrew. Pre and post QoL and HADS surveys were collected for analysis. Results are pending.
Conclusion:
This pilot study provided insights into an online peer-support group for haemodialysis patients, indicating potential benefits for social support and psychosocial wellbeing despite participation challenges. Individual needs must be considered in intervention design. Further analysis of the pre- and post-intervention data will shed light on the potential impact of the online support group.
417R - Research Paper
Abstract
Aim:
To better understand the facilitators, supports and barriers to maintaining or obtaining employment for people with kidney disease who are treated with dialysis in a regional health district in Australia.
Method:
Qualitative study design using semi-structured interviews, demographics and field notes. A convenience sampling of 20 participants recruited from community based and home-based dialysis therapies.
Results:
Grounded theory approach was used to perform the data analysis, coding and theming was attended by three research team members. Grounded in data themes were revealed such as type of employment, employer support and dialysis therapy choice. Family support. Financial implications and access to financial support. Psychosocial burden and physical kidney failure/dialysis symptoms.
Conclusion:
The study results explore the barriers and enablers of maintaining employment with people on dialysis treatments allowing clinicians to better understand the immense challenges faced by those working and attending dialysis treatments.
Abstract
Aim:
To better understand the facilitators, supports and barriers to maintaining or obtaining employment for people with kidney disease who are treated with dialysis in a regional health district in Australia.
Method:
Qualitative study design using semi-structured interviews, demographics and field notes. A convenience sampling of 20 participants recruited from community based and home-based dialysis therapies.
Results:
Grounded theory approach was used to perform the data analysis, coding and theming was attended by three research team members. Grounded in data themes were revealed such as type of employment, employer support and dialysis therapy choice. Family support. Financial implications and access to financial support. Psychosocial burden and physical kidney failure/dialysis symptoms.
Conclusion:
The study results explore the barriers and enablers of maintaining employment with people on dialysis treatments allowing clinicians to better understand the immense challenges faced by those working and attending dialysis treatments.
2:30 pm
299R - Research Paper
Abstract
Aim:
This study aimed to identify renal nurse’s attitudes towards providing sexual healthcare and determine levels of confidence in discussing sexual dysfunction with people who are receiving haemodialysis
Method:
Using a cross-sectional design, renal nurse members of the Renal Society of Australasia completed an anonymous, online survey. The survey included demographic items and instruments designed to measure nurses’ attitudes and confidence towards discussing sexual dysfunction. Data were analysed using descriptive statistics and non-parametric techniques.
Results:
Overall, most renal nurses were confident (n = 30, 42.9%) and had positive attitudes (n = 54, 77.2%) towards discussing sexual health concerns with patients although they rarely did so (n = 45, 64.4%). Male nurses reported having significantly higher levels of confidence in communication (p <.05) and confidence in practical knowledge (p <.05) compared to female nurses. However, many nurses indicated that they were less likely to discuss sexual concerns with older people (n = 55, 78.6%) compared to younger people (n = 30, 42.9%). A lack of practical training, lack of time, and patients’ culture, religion, language, and ethnicity were identified as barriers to discussing sexual concerns.
Conclusion:
Renal nurses have a key role in providing care to people receiving haemodialysis where discussions about sexual concerns should be occurring, however many nurses still struggle to do so. This may lead to sexual health matters being overlooked or not addressed at all.
Abstract
Aim:
This study aimed to identify renal nurse’s attitudes towards providing sexual healthcare and determine levels of confidence in discussing sexual dysfunction with people who are receiving haemodialysis
Method:
Using a cross-sectional design, renal nurse members of the Renal Society of Australasia completed an anonymous, online survey. The survey included demographic items and instruments designed to measure nurses’ attitudes and confidence towards discussing sexual dysfunction. Data were analysed using descriptive statistics and non-parametric techniques.
Results:
Overall, most renal nurses were confident (n = 30, 42.9%) and had positive attitudes (n = 54, 77.2%) towards discussing sexual health concerns with patients although they rarely did so (n = 45, 64.4%). Male nurses reported having significantly higher levels of confidence in communication (p <.05) and confidence in practical knowledge (p <.05) compared to female nurses. However, many nurses indicated that they were less likely to discuss sexual concerns with older people (n = 55, 78.6%) compared to younger people (n = 30, 42.9%). A lack of practical training, lack of time, and patients’ culture, religion, language, and ethnicity were identified as barriers to discussing sexual concerns.
Conclusion:
Renal nurses have a key role in providing care to people receiving haemodialysis where discussions about sexual concerns should be occurring, however many nurses still struggle to do so. This may lead to sexual health matters being overlooked or not addressed at all.
2:45 pm
514Q - Research Paper
Abstract
Aim:
To describe significant challenges, we faced to strike a delicate balance between cultural sensitivity and clinical safety while we sought to provide dialysis treatment to a patient exhibiting challenging and aggressive behavior.
Method:
Description about the repercussions of managing a challenging patient, its ramifications on the renal staff, and our strategies for restoring a positive atmosphere within the service.
Results:
Despite the numerous hurdles encountered, we successfully administered dialysis treatment to a verbally aggressive and physically intimidating patient for a span of seven months
Conclusion:
Recognition of the necessity for the organization to establish stringent guidelines to prioritize the safety and well-being of staff in situations where cultural considerations supersede clinical concerns and staff safety.
Abstract
Aim:
To describe significant challenges, we faced to strike a delicate balance between cultural sensitivity and clinical safety while we sought to provide dialysis treatment to a patient exhibiting challenging and aggressive behavior.
Method:
Description about the repercussions of managing a challenging patient, its ramifications on the renal staff, and our strategies for restoring a positive atmosphere within the service.
Results:
Despite the numerous hurdles encountered, we successfully administered dialysis treatment to a verbally aggressive and physically intimidating patient for a span of seven months
Conclusion:
Recognition of the necessity for the organization to establish stringent guidelines to prioritize the safety and well-being of staff in situations where cultural considerations supersede clinical concerns and staff safety.
3:00 pm
499Q - Quality Improvement Paper
Abstract
Aim:
To assess whether there is an association between live harp music and anxiety, stress, depression symptoms amongst clients having in-centre haemodialysis.
Method:
Proxy measurements for stress/anxiety, such as BP and pulse and symptom scores from the Integrated Palliative care Outcome Scale – Renal (IPOS) and the Psycho-existential Wellbeing Symptom Assessment Scale (PESAS) are used to determine whether there is a correlation between harp music and wellbeing for participants.
Results:
Of the eleven participants, at pre-intervention, 81% were taking antihypertensives. 54% reported depression with 18.8% prescribed antidepressants. 72.7% reported anxiety, with 9.9% prescribed anxiolytics. Post-intervention results are being collected and analysed for presentation at the RSA conference.
Conclusion:
Although final results are pending, this project holds promise that haemodialysis nurses can promote innovative approaches to enhance care and wellbeing in a technological environment. Future projects could compare differences with recorded harp music and improve control of confounding variables.
Abstract
Aim:
To assess whether there is an association between live harp music and anxiety, stress, depression symptoms amongst clients having in-centre haemodialysis.
Method:
Proxy measurements for stress/anxiety, such as BP and pulse and symptom scores from the Integrated Palliative care Outcome Scale – Renal (IPOS) and the Psycho-existential Wellbeing Symptom Assessment Scale (PESAS) are used to determine whether there is a correlation between harp music and wellbeing for participants.
Results:
Of the eleven participants, at pre-intervention, 81% were taking antihypertensives. 54% reported depression with 18.8% prescribed antidepressants. 72.7% reported anxiety, with 9.9% prescribed anxiolytics. Post-intervention results are being collected and analysed for presentation at the RSA conference.
Conclusion:
Although final results are pending, this project holds promise that haemodialysis nurses can promote innovative approaches to enhance care and wellbeing in a technological environment. Future projects could compare differences with recorded harp music and improve control of confounding variables.
474Q - Research Paper
Abstracts
Aim:
Improve mental health outcomes of those receiving Haemodialysis rurally through improved screening, early identification of deterioration in mental state and appropriate escalation of care.
Method:
Implementation of a validated tool used to screen 100% of consumers that allows for a report of change by the consumer and for clinician assessment. Healthcare practitioners were trained in appropriate use of the risk screening tools, screening frequency and symptoms of mental state deterioration. A pathway for escalation of care was implemented and the role of healthcare practitioners identified. Multiple audits to review the screening results were conducted comparing pre and post implementation outcomes.
Results:
22 patients were screened utilising the newly sourced tool, 3 consumers who were previously not at risk through historic methods, were flagged as being at risk of deteriorating mental health. One consumer who had previously been treated for a mental health condition and was previously deemed as 'doing well' was rescreened and further deterioration was identified. Risk identification enabled early referral to appropriate services and interventional care to commence.
Conclusion:
Deterioration in mental health has been noted as a common occurrence in the chronic health setting. Improved screening processes enhanced our ability to promptly identify changes in mental state and improve the mental health outcomes of consumers otherwise experiencing barriers in accessing care.
Abstracts
Aim:
Improve mental health outcomes of those receiving Haemodialysis rurally through improved screening, early identification of deterioration in mental state and appropriate escalation of care.
Method:
Implementation of a validated tool used to screen 100% of consumers that allows for a report of change by the consumer and for clinician assessment. Healthcare practitioners were trained in appropriate use of the risk screening tools, screening frequency and symptoms of mental state deterioration. A pathway for escalation of care was implemented and the role of healthcare practitioners identified. Multiple audits to review the screening results were conducted comparing pre and post implementation outcomes.
Results:
22 patients were screened utilising the newly sourced tool, 3 consumers who were previously not at risk through historic methods, were flagged as being at risk of deteriorating mental health. One consumer who had previously been treated for a mental health condition and was previously deemed as 'doing well' was rescreened and further deterioration was identified. Risk identification enabled early referral to appropriate services and interventional care to commence.
Conclusion:
Deterioration in mental health has been noted as a common occurrence in the chronic health setting. Improved screening processes enhanced our ability to promptly identify changes in mental state and improve the mental health outcomes of consumers otherwise experiencing barriers in accessing care.