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S 16 Parallel session

S 16 The patien experinence – Patient Involvement
Saal 2, 27th September 2015, 16:00 – 17:30

Programme of the Session:

GS: Ian K Walsh (UK)
Patient Safety: Hierarchy and Cognition

O 36
How do patients experience a kidney biopsy?

Jeanette Finderup (Denmark)

O 37
Together ""- A support group for hemodialysis patients

Ilana Rafaelov Atias (Israel)

O 38
A qualitative study of patients' experiences of involvement in dialysis choice

Jeanette Finderup (Denmark)

O 39
Quality of life in dialysis patients and some affecting factors

Mukadder Mollaoglu (Turkey)


Patient Safety: Hierarchy and Cognition
I.K. Walsh1
1Centre for Medical Education, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast

Patient safety is now rightly part of the fabric of clinical practice, with an increasing recognition of the importance of human factors and nontechnical skills. Beyond this level, however, it can be argued that cognition, operated by metacognition, both play central roles; in turn influencing performance in both technical and nontechnical skill domains. Recent data suggest that safe clinical decision making can be enhanced by metacognitive training.  A hierarchy of metacognitive safety provides a practical structure upon which to base teaching, learning and practice within any patient-safe clinical arena.


O 36
How do patients experience a kidney biopsy?
J. Finderup1, M. Nielsen1, L. Perchardt1, M. Sander1
1Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark

Background: Guidelines for care before, during and after a kidney biopsy vary nationally. A literature seach has shown few studies about the care before, during and after a kidney biopsy and we found no study from the patients' perspective.
Objectives: The aim of the study is to gain knowledge about patients' experieces before, during and after a kidney biopsy.
Methods: A qualitative study with a phenomenological and hermeneutic approach using observational-views of 7 patients before, during and after a kidney biopsy. Data was analyzed using Malterud's principles of systematic text condensation.
Results: Three themes were found: The patients' basic needs; The patients needs for information; The patients use of humor as a coping strategy.
Conclusion/Application to practice: The patients' experience is characterized by the need to fulfill self-care requirements. Patients had difficulty in performing activities due to bed rest and had more or less need for care. The patients' need for information varied for different reasons and   information should be individualized in its dissemination. There is particular need for more information to the patient after discharge.  Good relationship between carer and patient  supported individualized information and the possibilities for using humor.

Disclosure: No conflict of interest declared

O 37
"Together "- A support group for hemodialysis patients

I. Rafaelov Atias1
1Nephrology, Rambam Health Care Campus , Haifa Bat Galim, Israel

Background: ESRD and continuing dialysis treatment can conceal difficulties in all areas of life.
The progressive deterioration of the patient's health, causes him and his family to live under pressure.
Our dialysis department believe that a support group can provide support and tools for patients who are dealing with quality of life changes, fear and uncertain expectations in the future. The group Allows the patient to take personal responsibility over the treatment.
Objectives: Improve the patient's ability to deal with a chronic illness and the accompanying difficulties,while involving the patient in the course of treatment.
Literature review
Identifying needs through questionnaires to patients
Selecting patients who have expressed commitment to group
Write a program adapted to the patients' individual needs
Planning meetings during dialysis treatment with a social worker and a nurse

Working with techniques and various accessories.
70% of patients reported improvement or change in their lives due to participation in the group
100% of patients reported that the group contributed in providing information
100% of patients reported to feel comfortable in the group
100% of patients asked to participate in other groups in the future.
Conclusion/Application to practice:
Support group helps in providing information and coping with the disease
The group is a tool that allows patients to share experiences and feelings
The group is a platform that allows to reach all patients in the dialysis unit
We recommend to proceed with plans of a support group in hemodialysis
We recommend checking the Group's influence on the patient's quality of life

Disclosure: No conflict of interest declared

O 38
A qualitative study of patients' experiences of involvement in dialysis choice

J. Finderup1, A. Erlang1, I. Hamborg1, H. Bjoernholdt1
1The Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark

Background: International guidelines recommend patients should choose a dialysis modality based on their own values and preferences- why is involvement  needed in the choice of dialysis modality? A literature search indicates a lack in knowledge according to the patients involvement in the decision-making process. There is a specific lack of knowledge concerning how patients experience this  process just after making their decision and before starting dialysis.
Objectives: To gather information about how patients experience involvement  by health care professionals in the decision-making process of  choosing a dialysis  modality, just after they have made the decision and before starting dialysis.
Methods: A qualitative method with a human scientific approach, including phenomenology and hermeneutics. The study is based on individual semi-structured interviews with 9 adult patients with  chronic kidney disease. A data-driven analysis based on systematic text condensation was used.
Results: Patients have  a great part in the decision. Health care professionals contribute to the perception of being involved. Patients keep putting off the final choice.
Conclusion/Application to practice: The patients find themselves involved in their choice of dialysis modality and have different views of what is needed for the experience of involvement. Information, interaction, and advice from health care professionals are factors affecting this process. However, the experience of not feeling sick means that, patients keep putting off the final choice of dialysis modality suitable for them. To improve practice, decisons-aids could contribute to a more structural involvement of the patients in the decision-making.

Disclosure: No conflict of interest declared

O 39
Quality of life in dialysis patients and some affecting factors

M. Mollaoglu1, G. Deveci2, M. Kayatas3
1Health Sciences Faculty, Cumhuriyet University, Sivas, Turkey; 2Nephrology, Cumhuriyet University, Sivas, Turkey; 3Nephrology (MD), Cumhuriyet University, Sivas, Turkey

Background: Because QoL evaluations may give important clues for the development of the services offered, it is quite significant to evaluate the QoL of dialysis patients (DP) multidimensionally.
Objectives: This study was conducted to determine the quality of life (QoL) in dialysis patients and the factors affecting the QoL.
Methods: 104 DP receiving treatment at a university hospital were included in this research, which was also a cross-sectional study. Data were collected with the Patient Information Form (PIF) and Kidney Disease Quality of Life Form (KDQOL-36). Collected data were evaluated on SPSS. Results: The most affected QoL dimensions in the sampling were disease burden based on kidney disease, physical health-12 and mental health-12, respectively. The QoL was found low in higher ages, women, people with low education level, people living with family and patients undergoing dialysis for a long time (p< 0.05), and mental health was low in single people. Moreover, mental health component scores were especially obtained low in people who didn’t adhere to their diet. In our study, the effect on quality of life was not found statistically important in terms of having a comorbid disease and taking erythropoietin (p> 0.05).
Conclusion/Application to practice: HD affect patients' quality of life negatively. The increase in the awareness and sensitivity of the health personnel working with these patients about the affected dimensions of QoL and the affecting factors will be a significant determiner guiding the care process for these patients.

Disclosure: No conflict of interest declared