The Effects of Nurse‐Led Coaching on Discordant Home Hemodialysis Patients
Notice bibliographique
Résumé
INTRODUCTION: Home hemodialysis (home HD) has demonstrated superior clinical outcomes, improved quality of life, and enhanced treatment flexibility in comparison to 3 days/week in-center HDs. Nonetheless, some patients are discordant with their dialysis prescription and require a coaching program in order to maintain their normal lifestyle and ameliorate their illness behavior. OBJECTIVE: To describe the feasibility of conducting a nurse-led coaching program for discordant home HD patients and its effect on hospitalization and technique complications. METHODS: This is a retrospective single center observational cohort study of all prevalent home HD patients at University Health Network (UHN) from the period of January 2018 to December 2022. Demographic and clinical data were extracted from chart review. Nurses conducted weekly motivational interviewing with patients by phone, email, or in-clinic visits in the home HD unit to discuss the importance of being concordant to treatment and adapting the length and schedule of dialysis to avoid clinical complications. Health coaching was defined as patient-centered, incorporating patient-determined goals, self-discovery processes, accountability, and content information in the context of an ongoing helping relationship. Patients were categorized as concordant, concordant with agreement doing at least 75% of dialysis prescription, or discordant for those skipping/shortening home HD sessions without prior agreement with the clinical team. Comparisons were carried out using chi-squared or ANOVA testing as appropriate. p < 0.05 was defined as statistical significance. RESULTS: From 94 patients, 61 were concordant and 33 (35%) required coaching: 15 (16%) were concordant patients with agreement and 18 (19%) were discordant patients. Patients' demographics were summarized respectively for concordant patients, concordant with agreement, and for discordant patients. Age was 51 (37-61), 53 (47-61), 46 (35-54) [p = 0.102]; male gender was 62%, 53%, 72% [p = 0.519]; diabetes status was 21%, 7%, 6% [p = 0.219] and proportions of patients living alone were 13%, 7%, 17% [p = 0.739]. Patients requiring coaching tended to have a higher median time on home HD, 7.6 versus 4.3 years [p = 0.145] and tended to be less likely to be listed for kidney transplant [p = 0.174]. There were no differences in hospitalization and technique complications among patients who required coaching versus standard care. CONCLUSION: We demonstrated that it is feasible to provide coaching to home HD patients. Ongoing clinical testing of nurse-led coaching in home HD is warranted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».