Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis Patients

Introduction: The aim of this study is to understand nephrology medical staff’s awareness of, basic knowledge of, practical ability of, and the barriers to palliative kidney care to patients on maintenance hemodialysis (HD) in mainland China. Methods: This cross-sectional descriptive study employed...

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Main Authors: Shuo Zhang, Wenbo Zhu, Jinghua Xia, Ying Zheng, Xuemei Li, Limeng Chen, Xiaohong Ning, Yan Qin
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Kidney International Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468024923014833
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author Shuo Zhang
Wenbo Zhu
Jinghua Xia
Ying Zheng
Xuemei Li
Limeng Chen
Xiaohong Ning
Yan Qin
author_facet Shuo Zhang
Wenbo Zhu
Jinghua Xia
Ying Zheng
Xuemei Li
Limeng Chen
Xiaohong Ning
Yan Qin
author_sort Shuo Zhang
collection DOAJ
description Introduction: The aim of this study is to understand nephrology medical staff’s awareness of, basic knowledge of, practical ability of, and the barriers to palliative kidney care to patients on maintenance hemodialysis (HD) in mainland China. Methods: This cross-sectional descriptive study employed convenience sampling of medical staff (physicians and nurses) working in nephrology departments in mainland China. Independent predictors of self-assessment ability for palliative care (PC) were determined using multivariate binary logistic regression. Results: Responses were received from medical staff in 28 provinces and 657 questionnaires were analyzed. Among the participants, 53.1% (349/657) were doctors, and only 4.3% claimed to be confident in providing PC to patients on HD. The average score of self-assessing ability for PC was 2.65 ± 1.15 (range 1–5). Among the 580 participants who experienced patient withdrawal from dialysis, only 16.0% reported that their patients had well-planned withdrawal from dialysis. Male (odds ratio [OR] [95% confidence interval [CI], 0.585 [0.34–0.99], P = 0.048), nurse (OR [95% CI], 1.81 [1.01–3.27], P = 0.047), more experience in dealing with deceased cases (OR [95% CI], 1.28 [1.02–1.61], P = 0.034), less experience of medical disputes before/after withdrawal from dialysis (OR [95% CI], 0.62 [0.40–0.98], P = 0.041), and PC training experiences (OR [95% CI], 2.33 [1.86–2.91], P < 0.001) were independently correlated with significant better self-assessing ability for PC. Conclusion: This study demonstrates that the nephrology medical staff had a positive attitude but lacked relative knowledge and training in PC. Institutionalized education, training models, practice guidelines for kidney PC, and guidelines for well-planned withdrawal from dialysis according to cultural background are urgently needed in mainland China.
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spelling doaj.art-94d516638ecc4503ab9e5f0302e9d7452023-12-05T04:15:28ZengElsevierKidney International Reports2468-02492023-12-0181227942801Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis PatientsShuo Zhang0Wenbo Zhu1Jinghua Xia2Ying Zheng3Xuemei Li4Limeng Chen5Xiaohong Ning6Yan Qin7Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaPalliative Care Medicine Center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaPalliative Care Medicine Center, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Xiaohong Ning, Palliative Care Medicine Center, Geriatric Department Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, China, 100730.Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; Correspondence: Yan Qin, Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing 100730, China.Introduction: The aim of this study is to understand nephrology medical staff’s awareness of, basic knowledge of, practical ability of, and the barriers to palliative kidney care to patients on maintenance hemodialysis (HD) in mainland China. Methods: This cross-sectional descriptive study employed convenience sampling of medical staff (physicians and nurses) working in nephrology departments in mainland China. Independent predictors of self-assessment ability for palliative care (PC) were determined using multivariate binary logistic regression. Results: Responses were received from medical staff in 28 provinces and 657 questionnaires were analyzed. Among the participants, 53.1% (349/657) were doctors, and only 4.3% claimed to be confident in providing PC to patients on HD. The average score of self-assessing ability for PC was 2.65 ± 1.15 (range 1–5). Among the 580 participants who experienced patient withdrawal from dialysis, only 16.0% reported that their patients had well-planned withdrawal from dialysis. Male (odds ratio [OR] [95% confidence interval [CI], 0.585 [0.34–0.99], P = 0.048), nurse (OR [95% CI], 1.81 [1.01–3.27], P = 0.047), more experience in dealing with deceased cases (OR [95% CI], 1.28 [1.02–1.61], P = 0.034), less experience of medical disputes before/after withdrawal from dialysis (OR [95% CI], 0.62 [0.40–0.98], P = 0.041), and PC training experiences (OR [95% CI], 2.33 [1.86–2.91], P < 0.001) were independently correlated with significant better self-assessing ability for PC. Conclusion: This study demonstrates that the nephrology medical staff had a positive attitude but lacked relative knowledge and training in PC. Institutionalized education, training models, practice guidelines for kidney PC, and guidelines for well-planned withdrawal from dialysis according to cultural background are urgently needed in mainland China.http://www.sciencedirect.com/science/article/pii/S2468024923014833dialysisend-stage renal diseasekidney palliative caresurveywithdrawal from dialysis
spellingShingle Shuo Zhang
Wenbo Zhu
Jinghua Xia
Ying Zheng
Xuemei Li
Limeng Chen
Xiaohong Ning
Yan Qin
Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis Patients
Kidney International Reports
dialysis
end-stage renal disease
kidney palliative care
survey
withdrawal from dialysis
title Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis Patients
title_full Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis Patients
title_fullStr Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis Patients
title_full_unstemmed Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis Patients
title_short Urgency for Kidney Palliative Care in Chinese Maintenance Hemodialysis Patients
title_sort urgency for kidney palliative care in chinese maintenance hemodialysis patients
topic dialysis
end-stage renal disease
kidney palliative care
survey
withdrawal from dialysis
url http://www.sciencedirect.com/science/article/pii/S2468024923014833
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AT yingzheng urgencyforkidneypalliativecareinchinesemaintenancehemodialysispatients
AT xuemeili urgencyforkidneypalliativecareinchinesemaintenancehemodialysispatients
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