Evaluating palliative care’s role in symptom management for CKD patients in Egypt: A quasi-experimental approach
Bibliographic record
Abstract
Abstract Objectives Chronic kidney disease (CKD) is a global health challenge that affects patients’ symptom burden and quality of life. Palliative care interventions show promise in addressing the multiple needs of CKD patients, focusing on symptom management, psychosocial support, and advance care planning. This study aimed to evaluate the effectiveness of palliative care interventions in improving symptom management in patients with CKD. Methods The study used a quasi-experimental research design with a sample size of 128 participants diagnosed with CKD. Participants were selected based on strict criteria to ensure consistency of palliative care interventions. Non-probability purposive sampling was used to select participants. Data were collected using validated instruments such as the Edmonton Symptom Assessment System, Kidney Disease Quality of Life-Short Form, Palliative Performance Scale, Dialysis Symptom Index and Functional Assessment of Chronic Illness Therapy-Fatigue. These instruments provided robust measures of symptom severity, quality of life, performance status, symptom burden, and fatigue. The intervention consisted of 4 sessions designed to address symptom management, psychosocial support, and advance care planning strategies. Results Post-intervention, CKD patients showed significant improvements across multiple measures. Pain decreased from 6.2 to 4.8 ( p = 0.002, 23% improvement), and fatigue decreased from 7.5 to 6.1 ( p = 0.001, 19% reduction). Depression improved from 5.6 to 4.2 ( p = 0.001, 25% reduction) and anxiety decreased from 4.9 to 3.8 ( p = 0.004, 22% reduction). Physical functioning increased from 65.3 to 72.1 ( p = 0.002, 10% improvement), cognitive function from 72.8 to 78.5 ( p = 0.003, 8% increase), and emotional well-being from 60.2 to 65.7 ( p = 0.004, 9% improvement). Ambulation improved from 75.2 to 81.5 ( p = 0.001, 8% increase), activity from 68.7 to 74.3 ( p = 0.004, 8% increase), and self-care from 82.4 to 88.1 ( p = 0.003, 7% improvement). Nutritional status improved from 79.6 to 85.2 ( p = 0.002, 7% increase) and level of consciousness from 70.3 to 75.8 ( p = 0.005, 8% increase). Fatigue scores decreased significantly from 53.2 to 48.6 ( p = 0.001, 9% decrease), activities of daily living from 50.1 to 45.8 ( p = 0.001, 9% decrease), and well-being from 55.6 to 50.2 ( p = 0.001, 10% improvement). Significance of the results The results highlight the potential of palliative care interventions to improve outcomes and well-being for people with CKD. By addressing their complex needs, these interventions offer valuable lessons for nephrology and palliative care practice, emphasizing holistic approaches to patient care. The findings add to the evidence supporting the integration of palliative care into CKD management, highlighting its value in improving patient outcomes and quality of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".