One-Year Linear Trajectories of Symptoms, Physical Functioning, Cognitive Functioning, Emotional Well-being, and Spiritual Well-being Among Patients Receiving Dialysis.

Background: This study evaluated 1-year linear trajectories of patient-reported dimensions of quality of life among patients receiving dialysis.

Study Design: Longitudinal observational study.

Setting & Participants: 227 patients recruited from 12 dialysis centers.

Psychosocial Factors and 30-Day Hospital Readmission among Individuals Receiving Maintenance Dialysis: A Prospective Study.

Background: Thirty-day hospital readmissions are common among maintenance dialysis patients. Prior studies have evaluated easily measurable readmission risk factors such as comorbid conditions, laboratory results, and hospital discharge day. We undertook this prospective study to investigate the associations between hospital-assessed depression, health literacy, social support, and self-rated health (separately) and 30-day hospital readmission among dialysis patients.

A systematic evaluation of websites offering information on chronic kidney disease.

In this study, we described the content and characteristics of 40 non-proprietary websites offering information about chronic kidney disease (CKD) and evaluated their information quality using the DISCERN scale and readability using Flesch Reading Ease and Flesch-Kincaid grade level. The areas in which the websites scored the lowest on the DISCERN scale were whether the website discussed knowledge gaps, presented balanced information, and was clear about the information source. Websites that rated higher quality on the DISCERN scale were more difficult to read.

Patient-reported cognitive functioning and daily functioning in chronic dialysis patients.

Subjective cognitive impairment negatively affects daily functioning, health-related quality of life, and health care consumption, and is predictive of future cognitive decline in many patient populations. However, no subjective measures of multidimensional cognitive functioning have been evaluated for dialysis patients. Our purposes were to examine (1) the association between patient-reported (subjective) cognitive functioning and objective cognitive functioning and (2) the relationships between subjective and objective cognitive functioning and everyday functioning of dialysis patients.

Management of ethical issues related to care of seriously ill dialysis patients in free-standing facilities.

Context: There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities.

Objectives: To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed.

Methods: A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year.

Patient perspectives on informed decision-making surrounding dialysis initiation.

Background: Careful patient-clinician shared decision-making about dialysis initiation has been promoted, but few studies have addressed patient perspectives on the extent of information provided and how decisions to start dialysis are made.

Methods: Ninety-nine maintenance dialysis patients recruited from 15 outpatient dialysis centers in North Carolina completed semistructured interviews on information provision and communication about the initiation of dialysis. These data were examined with content analysis.

Characterizing daily life experience of patients on maintenance dialysis.

Background: Despite growing literature of the dialysis patients' high burden of illness and a compromised quality of life, little is known about their daily life experiences.

Methods: A cross-sectional study using the day reconstruction method, an experience sampling method, was used. Seventy-one dialysis patients recruited from three dialysis centers systematically reconstructed their activities and experiences of the preceding day.

A new nursing model for the care of patients with chronic kidney disease: the UNC Kidney Center Nephrology Nursing Initiative.

Nurses at the University of North Carolina Kidney Center at Chapel Hill have developed a systematic approach to the care of patients with chronic kidney disease (CKD). This is an organized nephrology nursing structure that manages efficiency of patient flow and provides patient education throughout the continuum of CKD to improve patient outcomes. Patients are guided through a nurse-directed system at all points of care.