Impact of CKD on Life Participation in Latin America
Bibliographic record
Abstract
Introduction: Patients with chronic kidney disease (CKD) carry symptom and treatment burden, which together with comorbidities, can impair their ability to engage in life activities. Different values and priorities regarding life participation may vary depending on the population and setting. We aimed to describe the perspectives of life participation in patients with CKD not requiring kidney replacement therapy (KRT) in Latin America. Methods: In April 2024, we conducted a workshop with facilitated breakout groups (small group discussions) involving patients, caregivers, and health care professionals in Spanish language to discuss the impact of CKD on life participation in patients with CKD. Transcripts were analyzed thematically. Results: Sixty-six participants, including 51 patients and caregivers, and 15 health care professionals from 5 countries (Argentina, Chile, Uruguay, Bolivia, and Peru) attended. Five themes were identified as follows: despair and sense of doom (coming to a sudden halt, diminished involvement in social activities with family and friends, paralyzing fear, fragility and vulnerability, and losing mental fortitude); stigmatized and judged (alone in the diagnosis, reprimanded for dietary choices, and discriminated by employers and colleagues); debilitating symptoms (incapacitated by pain and fatigue impairing functioning); threatening life goals (obscuring decision-making around family planning and relinquishing career aspirations); and garnering hope and strengthening resilience (overcoming challenges with family support, finding strength in spirituality, encouraged by clinicians, and physical activity to promote well-being). Conclusion: Patients with CKD experienced despair, hopelessness, loneliness and isolation, debilitating symptoms, and uncertainty about their family and vocational goals, which contributed to impaired life participation. Strategies are needed to address these challenges to enhance the capacity of patients to live well with CKD.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".