Search

Background: Dialysis recovery time (DRT) refers to the period during which fatigue and weakness subside following hemodialysis treatment, allowing patients to resume their daily routines. This study aimed to identify the factors influencing DRT in hemodialysis patients in Turkey and Portugal, where the prevalence of chronic kidney disease is notably high. Methods: A cross-sectional observational study was conducted in a private dialysis center in Turkey and three dialysis centers in Portugal. The study included hemodialysis patients aged 18 years or older who had been undergoing four-hour hemodialysis sessions three times a week for at least six months. Participants had no communication barriers and voluntarily agreed to take part in the study. Data were collected using a semi-structured questionnaire to gather descriptive characteristics and the Hospital Anxiety and Depression Scale. Logistic regression analysis was employed to identify independent variables influencing DRT. Results: A total of 294 patients participated in the study, including 187 from Turkey and 107 from Portugal. In Turkey, increased interdialytic weight gain (P = 0.043) was associated with prolonged recovery time, while the use of high-flux dialyzers (P = 0.026) was linked to shorter recovery times. In Portugal, older age (P = 0.020) was found to extend recovery time. Conclusion: Recovery time after dialysis is influenced by varying factors across different countries. Further research with larger sample sizes is needed to deepen understanding of these factors and their implications. Clinical trial number: NCT04667741. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to test the validity and reliability of the shortened version of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE‐Nursing Practice). Methods: This methodological, cross‐sectional study was conducted between September and December 2022. The original version of the SEE‐Nursing Practice was administered in questionnaire format across 17 hospitals. Exploratory and confirmatory factor analyses were conducted to identify relevant items for the new shortened version of the scale and evaluate its construct validity. Results: The study involved 1713 registered nurses from various regions of Portugal. From the exploratory factor analysis, the SEE‐Nursing Practice was condensed to 59 items and 3 subscales. In the structure subscale, 14 items were removed, and the remaining 29 items distributed over four factors; in the process subscale, 18 items were removed, and the remaining 19 items organized into three factors; in the outcome subscale, 2 items were removed, and the remaining 11 items distributed over two factors. The Cronbach's alpha for the three subscales exceeded 0.90, indicating high reliability. Confirmatory factor analyses provided support for the validity of the 59‐item model. Conclusion: The shortened version of the SEE‐Nursing Practice shows adequate validity and reliability, reducing the burden associated with its longer version. Summary statement: What is already known about this topic? Given the impact of nursing practice environments on clients, nurses, and institutions, it is essential to have tools that allow for understanding the reality of practice contexts.The use of tools to evaluate nursing practice environments enables the measurement of the impact of interventions implemented with a view to their continuous improvement.Lengthy assessment tools can result in a greater response burden for the participant and, consequently, a lower response rate and poor quality of those responses.What this paper adds? The shortened version of the Scale for the Environments Evaluation of Professional Nursing Practice was considered valid and reliable for assessing practice environments from the standpoint of structure, process, and outcome.The implications of this paper: This study makes the shortened version of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE‐Nursing Practice) available to the scientific community.It enables the assessment and proposal of improvement strategies in nursing practice environments with the shortened version of the SEE‐Nursing Practice, saving time associated with its completion, which will have a positive impact on participant adherence. [ABSTRACT FROM AUTHOR]

Management of vascular access is a challenge for the dialysis team, particularly to keep the arteriovenous access working. The vascular access coordinator can positively contribute to increase the number of arteriovenous fistulas and reduce central venous catheters. In this article, we introduce a new approach to vascular access management centered on (the results of setting up) the role of vascular access coordinator. We described the three‐level model (3Level_M) for vascular access management organized in three levels: vascular access nurse manager, vascular access coordinator, and vascular access consultant. We defined the instrumental skills and training required to be developed by each element and clarify the articulation between the model and all members of the dialysis team related to vascular access. [ABSTRACT FROM AUTHOR]

Background/Aims: Intradialytic hypotension (IDH) is a serious and frequent complication of hemodialysis (HD). Thus far, data are scarcely available to assess the impact of first versus subsequent HD sessions of the week in IDH. Therefore, the purpose of this work was to evaluate IDH risk in patients on thrice-weekly HD. Methods: We conducted an analysis of all blood pressure (BP) measurements obtained during 492 HD treatments given to 41 prevalent adult patients over a one month period. A logistic regression model for repeated binary observations was used to determine the association between hypotension and patient and dialysis factors. Results: The incidence of IDH was 32.5%. First dialysis session of the week was associated with a 9% higher risk of hypotension relatively to the second one. The risk was even higher from the first to the third session of the week (60%) and from the second to the third (50%). A higher hypotension odds ratio was also associated with age (1.03, 90%CI: 1.01-1.06), higher predialysis BP (1.04, 90%CI: 1.03-1.05) and higher phosphorus level (1.38, 90%CI: 1.07-1.76). The risk decreased 24.4% for each additional antihypertensive drug taken by the patient. Conclusions: The odds of hypotension occurrence decrease throughout dialysis sessions of the week. Minimizing modifiable risk factors may decrease IDH episodes. [ABSTRACT FROM AUTHOR]

It is well known that conditional heteroscedasticity is exhibited by many economic and financial time series such as stock prices or returns. Empirical analysis is often based on a subseries obtained through systematically sampling from an underlying time series and we analyze how that can affect testing for heteroscedasticity. The results show the distribution of the test statistics is changed by systematic sampling, causing a serious power loss that increases with the sampling interval. Consequently, the tests often fail to reject the hypothesis of no conditional heteroscedasticity, leading to the wrong decision and missing the true nature of the data-generating process. [ABSTRACT FROM AUTHOR]