Functional dependency evaluation of hemodialysis patients. A multicentric study
Valoración del grado de dependencia funcional de los pacientes en hemodiálisis (HD): estudio multicéntrico
M.D. Arenas, F. Alvarez-Ude, M. Angoso, I. Berdud , A. Antolín, J. Lacueva , S. García Marcos , A. Fernández, M.T. Gil, A. Soriano
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Soriano" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:8 [ "pii" => "X2013251406020359" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020359?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699506020351?idApp=UINPBA000064" "url" => "/02116995/0000002600000005/v0_201502091328/X0211699506020351/v0_201502091328/es/main.assets" ] ] "itemSiguiente" => array:16 [ "pii" => "X2013251406020391" "issn" => "20132514" "estado" => "S300" "fechaPublicacion" => "2006-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2006;26:609-14" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2088 "formatos" => array:3 [ "EPUB" => 217 "HTML" => 1628 "PDF" => 243 ] ] "en" => array:8 [ "idiomaDefecto" => true "titulo" => "Acute renal rejection is associated with induction of replicative senescence in CD8+ T lymphocytes" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "609" "paginaFinal" => "614" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Senescencia Replicativa en Células T CD8+ de Pacientes con Rechazo Agudo en Trasplante Renal." ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Jiménez, J. Carracedo, R. Ramírez, A. Rodríguez, D. Del Castillo, R. Pérez, P. Aljama" "autores" => array:1 [ 0 => array:1 [ "nombre" => "R. Jiménez, J. Carracedo, R. Ramírez, A. Rodríguez, D. Del Castillo, R. Pérez, P. Aljama" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:8 [ "pii" => "X0211699506020394" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699506020394?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020391?idApp=UINPBA000064" "url" => "/20132514/0000002600000005/v0_201502091552/X2013251406020391/v0_201502091552/en/main.assets" ] "itemAnterior" => array:16 [ "pii" => "X2013251406020324" "issn" => "20132514" "estado" => "S300" "fechaPublicacion" => "2006-10-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2006;26:594-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2333 "formatos" => array:3 [ "EPUB" => 242 "HTML" => 1821 "PDF" => 270 ] ] "en" => array:8 [ "idiomaDefecto" => true "titulo" => "Comparative study of PTFE grafts in forearm vs cuffed permanent catheters" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "594" "paginaFinal" => "599" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "ESTUDIO COMPARATIVO DEL USO DE PRÓTESIS VASCULARES DE PTFE A NIVEL DE ANTEBRAZO vs CATÉTER PERMANENTE" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.J. Moyano , M. Salgueira , N. Aresté , B. Escalera , N. del Toro , E. Jiménez-Víbora , A.I. Martínez-Puerto , J.R. Molas , A. Palma" "autores" => array:1 [ 0 => array:1 [ "nombre" => "M.J. Moyano , M. Salgueira , N. Aresté , B. Escalera , N. del Toro , E. Jiménez-Víbora , A.I. Martínez-Puerto , J.R. Molas , A. Palma" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:8 [ "pii" => "X0211699506020327" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699506020327?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020324?idApp=UINPBA000064" "url" => "/20132514/0000002600000005/v0_201502091552/X2013251406020324/v0_201502091552/en/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Functional dependency evaluation of hemodialysis patients. A multicentric study" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "600" "paginaFinal" => "608" ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.D. Arenas, F. Alvarez-Ude, M. Angoso, I. Berdud , A. Antolín, J. Lacueva , S. García Marcos , A. Fernández, M.T. Gil, A. Soriano" "autores" => array:1 [ 0 => array:1 [ "nombre" => "M.D. Arenas, F. Alvarez-Ude, M. Angoso, I. Berdud , A. Antolín, J. Lacueva , S. García Marcos , A. Fernández, M.T. Gil, A. Soriano" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Valoración del grado de dependencia funcional de los pacientes en hemodiálisis (HD): estudio multicéntrico" ] ] "tienePdf" => false "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436463" "palabras" => array:1 [ 0 => "hemodiálisis, dependencia funcional,indice de comorbilidad de charlson, test delta" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "Las características de los pacientes que se incluyen en hemodiálisis (HD) han cambiado en los últimos años, habiendo aumentado la edad y la comorbilidad, lo que tiene implicaciones, no solo en lo referente a morbimortalidad, sino también a otros sobre aspectos funcionales, dada la necesidad de ayuda que requieren estos pacientes. El objetivo de este estudio ha sido analizar el grado de dependencia funcional del paciente en HD y la necesidad de cuidados por parte del personal sanitario. Métodos: Estudio transversal y descriptivo en 586 pacientes dializados en abril /05 en 10 unidades de HD ubicados en la Comunidad Valenciana, Andalucia y Castilla-León. Se incluyen todos los pacientes dializados durante abril/05. No existían criterios de exclusión. Para valorar el grado de dependencia se utilizó el "Test Delta", que consta de tres subescalas que miden: Dependencia: (puntuación máxima 30), Deficiencia física: (puntuación máxima 15) y Deficiencia psíquica: (puntuación máxima 15). Los ítems se puntúan de 0 a 3, de menor a mayor severidad. Se analizaron los resultados obtenidos en el Test Delta, de acuerdo con las siguientes variables: Edad, tiempo medio en hemodiálisis, Indice de Comorbilidad de Charlson (ICC), Provincias y Unidades. Resultados: El 45,6% de los pacientes presentaba algún tipo de dependencia ( de ellos, en un 12,8% era de en grado moderado y en un 8,1% en grado severo).El análisis por subescalas mostró una Deficiencia física moderada-severa en el 19,6% presentaba una Deficiencia física en grado moderado-severo, y en el 6,7% una Deficiencia psíquica moderada-severa. Este grado de dependencia variaba significativamente de unas unidades a otras oscilando el porcentaje de pacientes que precisan asistencia en grado moderado-severo entre (0% - 59,8%), y según áreas geográficas. La edad y el ICC mostraron asociación estadísticamente significativa con el grado de dependencia, de modo que a mayor edad (r: 0,26; p <0 001 y mayor puntuación en el icc r: 0 21 p <0 001 mayor grado de dependencia sin embargo el tiempo permanencia en hemodiálisis no mostró asociación con los aspectos evaluados test delta que mostraron puntuación fueron relacionados la movilidad del paciente requerimientos ayuda se deben fundamentalmente a falta autonomía por alteraciones aparato locomotor y menor medida trastornos conducta un 16 casos además vigilancia estricta sesión hd personal sanitario debe realizar otras actuaciones como prevención escaras curas pies diabéticos adicionales al cuidado habitual fav etc conclusión centros están atendiendo pacientes importante lo supone una carga trabajo para muy especialmente enfermería ocasiones es imposible atender este tipo ratio asignado actualmente conciertos vigentes requiere dotación existencia parámetros manera objetiva permitan valorar tales circunstancias hacen aconsejable aprobar instrumento valoración común sea sencillo universal rápido pueda adaptarse las necesidades cambiantes población va destinado</0> </0>" ] "en" => array:1 [ "resumen" => "SUMMARY Background: There has been a change in the hemodialysis population characteristics over the last years with a progressive increase in patient,s age and associated comorbility and mortality. This older hemodialysis population are more functionally and medically dependent increasing the time taken to perform nursing work. The objective of this study was to evaluate the degree of functional dependency on hemodialysis patients and the need of care by nursing workload. Methods: A transversal descriptive study was done during 1 month (april 2005) on 586 patients from 10 HD Units in Spain. No exclusion criteria were used. The Delta Test, who was used to evaluate the patients dependency needs, is a workload measure instrument base on three subscales: dependency, Physical Deficiency and mental deficiency. The indicators are measure on a scale of one to three with each level representing an increasing demand on nursing time. The results obtained from the Delta Test were analyzed taking into account the following variables: age, average time in dialysis, Charlson comorbidity Index, geographic location and HD unit. Results: 46% of the patients show some degree of dependency, of these 12.8% were moderated and 8.1% severe; the subscale analysis showed that 19.6% and 6.7% had, respectively, a moderate to severe physical and mental health deficiency. The dependency degree varied significantly between HD Units and geographic location with a range of 0% to 59.8%. The degree of dependency were statistically associated with age and CCI. The higher CCI (r: 0,21; p < 0.001) and age (r: 0,26; p < 0.001) the higher was the Delta Test Score for dependency level. Patients times of initiation on dialysis were not associated with an increase in the degree of dependency. The aspects evaluated by the Delta Test that showed a higher score were those related to patients mobility. The patients assistance requirements during the HD session are basically related to a lack of mobility due to musculoskeletal disease and to a lesser extent to behavior alterations. Conclusions: HD units are attending patients with an important degree of dependency which impose and added workload to the healthcare personnel. In occasions, it is very difficult to attend and give proper care with the current legally established nurse to patient ratio which. This suggests the need to implement a better staffing policy. The Delta Test provides an objective, adaptable and standardized instrument for measuring degree of dependency of HD patients." ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002600000005/v0_201502091552/X2013251406020359/v0_201502091552/en/main.assets" "Apartado" => null "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251406020359?idApp=UINPBA000064" ]
Article information
ISSN: 20132514Original language: English
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