Daniela Comelis Bertolin

Caracterização e etiologia da insuficiência renal crônica em unidade de nefrologia do interior do Estado de São Paulo

OBJETIVOS: Caracterizar a los pacientes con insuficiencia renal cronica (IRC) que participan en un programa dialitico; verificar las causas de la IRC; identificar las enfermedades asociadas a la IRC; levantar el tipo de tratamiento y el acceso actual de esos pacientes. METODOS: Se trata de un estudio descriptivo epidemiologico, realizado en una Unidad de Nefrologia en el que fueron incluidos todos los pacientes registrados en el Programa Nefro Data. RESULTADOS: De los 217 pacientes registrados en la Unidad en estudio, observamos que el 68,2% tenian edad superior a 40 anos y el 59,4% eran del sexo masculino. En cuanto a la enfermedad de base, el 31,3% de los pacientes presentan Nefroesclerosis Hipertensiva y el 25,3% Diabetes Mellitus (DM), seguido de la Glomerulonefritis con el 24,5%. Respecto a las enfermedades asociadas, el 42,4% de los pacientes poseen Hipertension Arterial Sistemica (HAS), el 24,9% no poseen comorbidades, el 19,8% HAS y DM. En relacion al tipo de acceso vascular el 70,5% poseen fistula arteriovenosa, siendo la utilizacion del cateter de Tenckhoff exclusivo de la dialisis peritoneal en el 13,3%. CONCLUSION: los resultados permiten una mejor planificacion frente a las necesidades reales de los pacientes.Objectives: Characterize the pacients with chronic renal failure (CRF) in dialythical program; verify the causes of the CRF; identify the associated diseases to CRF; measure the type of treatment and the actual access of the pacients to them. Methods: This is a epidemiological descriptive research performed in a nephrology unit, and all pacients registered in the Nefro Data program were included. Results: Of the group of 217 patients registered in the studied unit, 68,2% have age of 40 or greater and 59,4% are male. Regarding the base disease, 31,3% of the pacients have Hipertensive Nephrosclerosis, 25,3% have Diabetes Mellitus (DM) and 24,5% have Glomerulonephritis. Regarding the associated diseases, 42,4% of the pacients have Systemic Arterial Hipertension (SAH) 24,9% don’t have comorbities, 19,8% have both SAH and DM. Regarding the type of vascular acess, 70,5% have arteriovenous fistula, being the utilization of the Tenckhoff catheter exclusive of peritoneal dialysis in 13,3% of the studied cases. Conclusion: The results allow a better planning with regard to the patients real needs.

Modos de enfrentamento dos estressores de pessoas em tratamento hemodiálitico: revisão integrativa da literatura

An integrative literature review was performed with the purpose to synthesize the contribution brought by research on the ways that people on hemodialysis deal with the treatment. Through a bibliographic review, 12 articles were identified, which composed the study sample. The results point out that problem-focused coping are the most used and that depression was positively correlated with the forms of emotionfocused coping for people on hemodialysis. The identification of the forms of dealing with the treatment is valuable information to plan treatments individually so as to control the stressors inherent to the disease and to hemodialysis, thus supporting the patient toward a betterAn integrative literature review was performed with the purpose to synthesize the contribution brought by research on the ways that people on hemodialysis deal with the treatment. Through a bibliographic review, 12 articles were identified, which composed the study sample. The results point out that problem-focused coping are the most used and that depression was positively correlated with the forms of emotionfocused coping for people on hemodialysis. The identification of the forms of dealing with the treatment is valuable information to plan treatments individually so as to control the stressors inherent to the disease and to hemodialysis, thus supporting the patient toward a better adaptation to the therapeutic regimen.

Depressão em idosos portadores de insuficiência renal crônica em tratamento hemodialítico

Objectives: This study aimed to characterize the elderly on hemodialysis for chronic renal failure in a teaching hospital and to describe their levels of depression. Methods: This is a descriptive exploratory study with 61 patients. A socio-demographic questionnaire and the geriatric depression scale (GDS) were used to collect the data. Data analysis consisted of descriptive statistics and Spearman rho correlations. Results: The mean age of patients was 69.97±7.51. The majority was white (79%), married (72%), and male (57%). Approximate a quarter of the patients (26%) were illiterate. The mean depression score was 10.43±4.37, suggesting the presence of normal to slightly depressive symptoms. Conclusions: There were statistically significant correlation coefficients between family monthly income and education (p value=0.004) and between depressive symptoms and illiteracy (p=0.028). This last finding indicates that the illiterate patients had more depressive symptoms, suggesting they have less adaptation capacity or resilience to cope with the disease and its implications.Objectives: This study aimed to characterize the elderly on hemodialysis for chronic renal failure in a teaching hospital and to describe their levels of depression. Methods: This is a descriptive exploratory study with 61 patients. A socio-demographic questionnaire and the geriatric depression scale (GDS) were used to collect the data. Data analysis consisted of descriptive statistics and Spearman rho correlations. Results: The mean age of patients was 69.97±7.51. The majority was white (79%), married (72%), and male (57%). Approximate a quarter of the patients (26%) were illiterate. The mean depression score was 10.43±4.37, suggesting the presence of normal to slightly depressive symptoms. Conclusions: There were statistically significant correlation coefficients between family monthly income and education (p value=0.004) and between depressive symptoms and illiteracy (p=0.028). This last finding indicates that the illiterate patients had more depressive symptoms, suggesting they have less adaptation capacity or resilience to cope with the disease and its implications.

Avaliação do grau de satisfação de pacientes renais crônicos em hemodiálise

Objective: To identify the level of satisfaction in patients with chronic renal disease on hemodialysis regarding their care and the physical structure of the hemodialysis unit of the Hospital “de Base” of Sao Jose do Rio Preto, SP. Methods: This descriptive study used a Likettype scale to collect data from 81 patients from the nephrology department. Results: Almost all patients were very satisfied (53 %) or satisfied (47%) regarding their care and the physical structure of the hemodialysis unit. A few limitations of the service were also reported. Conclusion: Patients’ satisfaction with the service led to reflection among health care providers regarding their practice and served as an indicator for continuous improvement of the hemodialysis service.

Necessidades de aprendizagem de profissionais de enfermagem na assistência aos pacientes com fístula arteriovenosa

Objectives: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. Methods: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. Results: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patient’s instructions and education (19.4%). Conclusions: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.OBJECTIVES: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. METHODS: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. RESULTS: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patients instructions and education (19.4%). CONCLUSIONS: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.

Pacientes vítimas de politrauma com insuficiência renal aguda na unidade de terapia intensiva

Objective: To identify the characteristics of patients with acute renal failure (ARF), polytrauma victims hospitalized in an Intensive Care Unit (ICU). Methods: A retrospective analysis was performed on 357 records of patients with ARF in the period of 2002 to 2003. These patients presented a creatinine index of 1.8 to 4 mg/dl. Of these patients, 10.6% in the ICU were polytrauma victims. Results: Of the 38 (10.6%) patients with ARF and polytrauma victims, 78.9% of were males; 47.3% were aged between 16 and 45 years; 84.3% presented oliguria; 92.1% received no treatment for ARF during hospitalization; 50% remained from one to five days in the ICU; 47.3% had not presented any underlying disease and mortality occurred in 50%. Conclusion: Daily control of the renal function in polytrauma victims is important to prevent ARF complications and consequent mortality.Objective: To identify the characteristics of patients with acute renal failure (ARF), polytrauma victims hospitalized in an Intensive Care Unit (ICU). Methods: A retrospective analysis was performed on 357 records of patients with ARF in the period of 2002 to 2003. These patients presented a creatinine index of 1.8 to 4 mg/dl. Of these patients, 10.6% in the ICU were polytrauma victims. Results: Of the 38 (10.6%) patients with ARF and polytrauma victims, 78.9% of were males; 47.3% were aged between 16 and 45 years; 84.3% presented oliguria; 92.1% received no treatment for ARF during hospitalization; 50% remained from one to five days in the ICU; 47.3% had not presented any underlying disease and mortality occurred in 50%. Conclusion: Daily control of the renal function in polytrauma victims is important to prevent ARF complications and consequent mortality.

Characterization and etiology of the chronic renal failure in a countryside nephrology unit of São Paulo State

OBJETIVOS: Caracterizar a los pacientes con insuficiencia renal cronica (IRC) que participan en un programa dialitico; verificar las causas de la IRC; identificar las enfermedades asociadas a la IRC; levantar el tipo de tratamiento y el acceso actual de esos pacientes. METODOS: Se trata de un estudio descriptivo epidemiologico, realizado en una Unidad de Nefrologia en el que fueron incluidos todos los pacientes registrados en el Programa Nefro Data. RESULTADOS: De los 217 pacientes registrados en la Unidad en estudio, observamos que el 68,2% tenian edad superior a 40 anos y el 59,4% eran del sexo masculino. En cuanto a la enfermedad de base, el 31,3% de los pacientes presentan Nefroesclerosis Hipertensiva y el 25,3% Diabetes Mellitus (DM), seguido de la Glomerulonefritis con el 24,5%. Respecto a las enfermedades asociadas, el 42,4% de los pacientes poseen Hipertension Arterial Sistemica (HAS), el 24,9% no poseen comorbidades, el 19,8% HAS y DM. En relacion al tipo de acceso vascular el 70,5% poseen fistula arteriovenosa, siendo la utilizacion del cateter de Tenckhoff exclusivo de la dialisis peritoneal en el 13,3%. CONCLUSION: los resultados permiten una mejor planificacion frente a las necesidades reales de los pacientes.Objectives: Characterize the pacients with chronic renal failure (CRF) in dialythical program; verify the causes of the CRF; identify the associated diseases to CRF; measure the type of treatment and the actual access of the pacients to them. Methods: This is a epidemiological descriptive research performed in a nephrology unit, and all pacients registered in the Nefro Data program were included. Results: Of the group of 217 patients registered in the studied unit, 68,2% have age of 40 or greater and 59,4% are male. Regarding the base disease, 31,3% of the pacients have Hipertensive Nephrosclerosis, 25,3% have Diabetes Mellitus (DM) and 24,5% have Glomerulonephritis. Regarding the associated diseases, 42,4% of the pacients have Systemic Arterial Hipertension (SAH) 24,9% don’t have comorbities, 19,8% have both SAH and DM. Regarding the type of vascular acess, 70,5% have arteriovenous fistula, being the utilization of the Tenckhoff catheter exclusive of peritoneal dialysis in 13,3% of the studied cases. Conclusion: The results allow a better planning with regard to the patients real needs.

Ways for people on hemodialysis to deal with stressors: a literature review

An integrative literature review was performed with the purpose to synthesize the contribution brought by research on the ways that people on hemodialysis deal with the treatment. Through a bibliographic review, 12 articles were identified, which composed the study sample. The results point out that problem-focused coping are the most used and that depression was positively correlated with the forms of emotionfocused coping for people on hemodialysis. The identification of the forms of dealing with the treatment is valuable information to plan treatments individually so as to control the stressors inherent to the disease and to hemodialysis, thus supporting the patient toward a betterAn integrative literature review was performed with the purpose to synthesize the contribution brought by research on the ways that people on hemodialysis deal with the treatment. Through a bibliographic review, 12 articles were identified, which composed the study sample. The results point out that problem-focused coping are the most used and that depression was positively correlated with the forms of emotionfocused coping for people on hemodialysis. The identification of the forms of dealing with the treatment is valuable information to plan treatments individually so as to control the stressors inherent to the disease and to hemodialysis, thus supporting the patient toward a better adaptation to the therapeutic regimen.

Psychological adaptation to and acceptance of type 2 diabetes mellitus

Objective To evaluate individuals’ psychological adaptation to type 2 diabetes mellitus throughout acceptance of the disease and its relation with perceived stress and values of glycated hemoglobin (A1c) before and after group educational intervention. Methods Quasi-experimental study developed at outpatient unit that included 77 participants who fulfilled inclusion criteria. The study instruments were a questionnaire that obtained sociodemographic variables and the Acceptance of Disease Scale and Perceived Stress Scale, both applied during interviews before and after group education intervention using Diabetes Conversations Maps. Results Interviewed patients showed improvements in the acceptance of the disease after educational intervention. We observed an inverse relation between acceptance of the disease, perceived stress, and the mean glycated hemoglobin (A1c) value before and after the intervention. Conclusion Acceptance of type 2 diabetes can improve after a group educational intervention. A high score for acceptance of the disease was related to a low score for perceived stress and lower mean glycated hemoglobin (A1c) value.

Learning needs of professional nurses to care for patients with arteriovenous fistula

Objectives: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. Methods: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. Results: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patient’s instructions and education (19.4%). Conclusions: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.OBJECTIVES: To identify the learning needs of professional nurses to provide quality care for patients with arteriovenous fistula (AV Fistula) for hemodialysis. METHODS: This cross-sectional descriptive study was conducted with 36 professional nurses from the hemodialysis unit of a hospital in the State of Sao Paulo. A semi-structured questionnaire was used to collect the data. Initially, questionnaires were distributed to 43 nurses, but only 36 (83.7%) responded and returned the questionnaires. RESULTS: A great number of nurses (44.9 %) reported to have difficulties in providing quality care for patients with AV Fistula. Difficulties were related to the access of AV Fistula for hemodialysis (47.2%), hemostasis of the site when withdrawing the needle after hemodialysis (19.4%) and lack of competency for the management of hematoma (13.9%), and patients instructions and education (19.4%). CONCLUSIONS: Nurses had many learning needs to prepare them to care for patients with arteriovenous AV Fistula. This finding led to the development of a protocol to facilitated quality care nursing care.