Experiencias de pacientes en hemodiálisis con restricción de dieta y de líquidos: metasíntesis
Palabras clave:
pacientes en hemodiálisis, experiencia, metasíntesis cualitativa, dieta renal, restricción de líquidos
Resumen
Introducción: El incumplimiento de la dieta y la restricción de líquidos es un problema de comportamiento común e importante en la población en hemodiálisis, con impacto en el estado de salud, y que se asocia con aumento de la morbimortalidad. Por lo tanto, investigar las percepciones y experiencias de los pacientes en hemodiálisis con respecto a la dieta y a la restricción de líquidos es muy importante para alcanzar el manejo de los mismos. Material y métodos: Este es un estudio de metasíntesis. Para la revisión de la literatura se utilizaron las bases de datos electrónicas CINAHL, MEDLINE, PubMed, Web of Science, OVID y Scopus. Los estudios se evaluaron críticamente utilizando la herramienta de evaluación crítica de Joanna Briggs. Fueron extraídos los datos cualitativos, meta-resumidos y luego meta-sintetizados. En el análisis de los datos se utilizó el método de análisis temático. Resultados: Esta revisión consistió en 23 estudios cualitativos. Las experiencias de los pacientes sometidos a hemodiálisis en relación con la dieta y la restricción de líquidos se clasificaron en tres temas principales, a saber, "el significado de la dieta y la restricción de líquidos para el paciente", "barreras percibidas" y "estrategias de manejo propias del paciente para la dieta y la restricción de líquidos". Conclusión: Los resultados de la síntesis en nuestro estudio indicaron que los pacientes en hemodiálisis percibían la dieta y la restricción de líquidos como un proceso complejo y desafiante que implicaba una lucha constante. Algunas barreras personales, sociales y sistémicas percibidas por los pacientes dificultaron aún más el cumplimiento de las indicaciones. Más importante aún, se determinó que la mayoría de los pacientes no recibieron suficiente apoyo en el manejo de la dieta y la restricción de líquidos y que habían desarrollado estrategias por sí mismos. De acuerdo con estos resultados, recomendamos aumentar los servicios de asesoramiento individual para la restricción dietética-líquida de los pacientes en hemodiálisis, considerar los obstáculos percibidos por ellos al planificar la restricción dietética-líquida y realizar una planificación que sea realista y factible.
Citas
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2) Oliveira AP, Schmidt DB, Amatneeks TM, Santos JC, Cavallet LH, Michel RB. Quality of life in hemodialysis patients and the relationship with mortality, hospitalizations and poor treatment adherence. J Bras Nefrol. 2016;38(4):411-20. doi: 10.5935/0101-2800.20160066.
3) Lambert K, Mullan J, Mansfield K. An integrative review of the methodology and findings regarding dietary adherence in end stage kidney disease. BMC Nephrol. 2017;18(1):318. doi: 10.1186/s12882-017-0734-z.
4) Murali KM, Mullan J, Roodenrys S, Hassan HC, Lambert K, Lonergan M. Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials. PLoS One. 2019;14(1):e0211479. doi: 10.1371/journal.pone.0211479.
5) Opiyo RO, Nyasulu PS, Olenja J, Zunza M, Nguyen KA, Bukania Z, et al. Factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis in national referral hospitals in Kenya: a mixed-methods survey. Renal Replace Ther. 2019;5(1):41. doi: 10.1186/s41100-019-0237-4.
6) Gebrie MH, Ford J. Depressive symptoms and dietary non-adherence among end stage renal disease patients undergoing hemodialysis therapy: systematic review. BMC Nephrol. 2019;20(1):429. doi: 10.1186/s12882-019-1622-5.
7) Geldine CG, Bhengu B, Manwere A. Adherence of adult chronic kidney disease patients with regard to their dialysis, medication, dietary and fluid restriction. Res J Health Sci. 2017;5(1):3-17. doi: 10.4314/rejhs.v5i1.2.
8) Clark S, Farrington K, Chilcot J. Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants. Semin Dial. 2014;27(1):42-9. doi: 10.1111/sdi.12159.
9) Ibrahim S, Hossam M, Belal D. Study of non-compliance among chronic hemodialysis patients and its impact on patients' outcomes. Saudi J Kidney Dis Transpl. 2015;26(2):243-9. doi: 10.4103/1319-2442.152405.
10) Chazot C, Wabel P, Chamney P, Moissl U, Wieskotten S, Wizemann V. Importance of normohydration for the long-term survival of haemodialysis patients. Nephrol Dial Transplant. 2012;27(6):2404-10. doi: 10.1093/ndt/gfr678.
11) Covic A, Rastogi A. Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence. BMC Nephrol. 2013;14:153. doi: 10.1186/1471-2369-14-153.
12) McDonald TJ, Oram RA, Vaidya B. Investigating hyperkalaemia in adults. BMJ. 2015;351:h4762. doi: 10.1136/bmj.h4762.
13) Malterud K. Qualitative metasynthesis: a research method for medicine and health sciences. 1th ed. New York: Routledge, 2019.
14) Paterson BL. The shifting perspectives model of chronic illness. J Nurs Scholarsh. 2001;33(1):21-6. doi: 10.1111/j.1547-5069.2001.00021.x.
15) Sandelowski M, Barroso J. Handbook for synthesizing qualitative research. New York: Springer, 2006.
16) Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al.; PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi: 10.1186/2046-4053-4-1.
17) Aromataris E, Munn Z (editors). JBI Manual for Evidence Synthesis [Internet]. JBI: 2020. Disponible en:
18) Hannes K, Lockwood C, Pearson A. A comparative analysis of three online appraisal instruments' ability to assess validity in qualitative research. Qual Health Res. 2010;20(12):1736-43. doi: 10.1177/1049732310378656.
19) Cervantes L, Jones J, Linas S, Fischer S. Qualitative interviews exploring palliative care perspectives of latinos on dialysis. Clin J Am Soc Nephrol. 2017;12(5):788-798. doi: 10.2215/CJN.10260916.
20) Griva K, Ng HJ, Loei J, Mooppil N, McBain H, Newman SP. Managing treatment for end-stage renal disease--a qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence. Psychol Health. 2013;28(1):13-29. doi: 10.1080/08870446.2012.703670.
21) Hong LI, Wang W, Chan EY, Mohamed F, Chen HC. Dietary and fluid restriction perceptions of patients undergoing haemodialysis: an exploratory study. J Clin Nurs. 2017;26(21-22):3664-76. doi: 10.1111/jocn.13739.
22) Lee EJ, Chang AK, Chung YC. Socioecological factors affecting fluid restriction adherence among korean patients receiving hemodialysis: a qualitative study. J Transcult Nurs. 2021;32(3):239-47. doi: 10.1177/1043659620919162.
23) Smith K, Coston M, Glock K, Elasy TA, Wallston KA, Ikizler TA, et al. Patient perspectives on fluid management in chronic hemodialysis. J Ren Nutr. 2010;20(5):334-41. doi: 10.1053/j.jrn.2009.09.001.
24) Stevenson J, Tong A, Gutman T, Campbell KL, Craig JC, Brown MA, Lee VW. Experiences and perspectives of dietary management among patients on hemodialysis: an interview study. J Ren Nutr. 2018;28(6):411-21. doi: 10.1053/j.jrn.2018.02.005.
25) Tovazzi ME, Mazzoni V. Personal paths of fluid restriction in patients on hemodialysis. Nephrol Nurs J. 2012;39(3):207-15.
26) Clark-Cutaia MN, Sevick MA, Thurheimer-Cacciotti J, Hoffman LA, Snetselaar L, Burke LE, et al. Perceived Barriers to Adherence to Hemodialysis Dietary Recommendations. Clin Nurs Res. 2019;28(8):1009-29. doi: 10.1177/1054773818773364.
27) Flythe JE, Dorough A, Narendra JH, Forfang D, Hartwell L, Abdel-Rahman E. Perspectives on symptom experiences and symptom reporting among individuals on hemodialysis. Nephrol Dial Transplant. 2018;33(10):1842-52. doi: 10.1093/ndt/gfy069.
28) Lambert K, Mansfield K, Mullan J. How do patients and carers make sense of renal dietary advice? A qualitative exploration. J Ren Care. 2018;44(4):238-50. doi: 10.1111/jorc.12260.
29) Morris A, Lycett D. Experiences of the dietary management of serum potassium in chronic kidney disease: interviews with UK adults on maintenance hemodialysis. J Ren Nutr. 2020;30(6):556-60. doi: 10.1053/j.jrn.2020.01.025.
30) Oka M, Yoneda K, Moriyama M, Takahashi S, Bull C, Chaboyer W. The dietary patterns of japanese hemodialysis patients: a focused ethnography. Glob Qual Nurs Res. 2019;6:2333393619878150. doi: 10.1177/2333393619878150.
31) Tarakji AR, Surette M, Frotten R, Wilson K, Morley C. Experiences of people of Acadian descent receiving hemodialysis in southwest Nova Scotia. Can J Diet Pract Res. 2014;75(2):e342-45. doi: 10.3148/75.2.2014.e342.
32) Urquhart-Secord R, Craig JC, Hemmelgarn B, Tam-Tham H, Manns B, Howell M, et al. Patient and Caregiver Priorities for Outcomes in Hemodialysis: An International Nominal Group Technique Study. Am J Kidney Dis. 2016;68(3):444-54. doi: 10.1053/j.ajkd.2016.02.037.
33) Cubillo B, McCartan J, West C, Brimblecombe J. A Qualitative analysis of the accessibility and connection to traditional food for aboriginal chronic maintenance hemodialysis patients. Curr Dev Nutr. 2020;4(4):nzaa036. doi: 10.1093/cdn/nzaa036.
34) de las Heras Mayoral MT, Martínez Rincón C. Conocimiento y percepción nutricional en diálisis: su influencia en la transgresión y adherencia; estudio inicial. Nutr Hosp. 2014;31(3):1366-75. doi: 10.3305/nh.2015.31.3.7942.
35) Aker S, Yüksel S. Determining the factors that determine treatment compliance among hypertensive patients undergoing hemodialysis: A qualitative study. J Hum Sci. 2016;13(3):4389-404. doi:10.14687/jhs.v13i3.3940.
36) de Brito-Ashurst I, Perry L, Sanders TA, Thomas JE, Yaqoob MM, Dobbie H. Barriers and facilitators of dietary sodium restriction amongst Bangladeshi chronic kidney disease patients. J Hum Nutr Diet. 2011;24(1):86-95. doi: 10.1111/j.1365-277X.2010.01129.x.
37) Fakih El Khoury C, Karavetian M, Halfens RJG, Crutzen R, El Chaar D, Schols JMGA. Dietary application for the management of patients with hemodialysis: a formative development study. Healthc Inform Res. 2019;25(4):262-73. doi: 10.4258/hir.2019.25.4.262.
38) Glyde M, Keane D, Dye L, Sutherland E. Patients' perceptions of their experience, control and knowledge of fluid management when receiving haemodialysis. J Ren Care. 2019;45(2):83-92. doi: 10.1111/jorc.12275.
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Publicado
2022-03-15
Cómo citar
1.
Özkan İlknur, Taylan S. Experiencias de pacientes en hemodiálisis con restricción de dieta y de líquidos: metasíntesis. Rev Nefrol Dial Traspl. [Internet]. 15 de marzo de 2022 [citado 18 de abril de 2024];42(1):22-0. Disponible en: http://www.revistarenal.org.ar/index.php/rndt/article/view/754
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Artículo Original
Derechos de autor 2022 Revista de Nefrología, Diálisis y Trasplante
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0.
