Application review of diet management evidence during dialysis in maintenance hemodialysis patients and its facilitators and barriers
10.3760/cma.j.cn115682-20220831-04273
- VernacularTitle:维持性血液透析患者透析期间饮食管理证据应用审查及促进和障碍因素分析
- Author:
Taofeng WU
1
;
Qin GU
;
Jingfang CHEN
Author Information
1. 南京医科大学附属苏州医院（苏州市立医院）血液透析中心，苏州 215000
- Keywords:
Dialysis;
Maintenance hemodialysis;
Diet therapy;
Review;
Facilitators/barriers
- From:
Chinese Journal of Modern Nursing
2023;29(26):3507-3511
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the clinical application of diet management evidence during dialysis in maintenance hemodialysis (MHD) patients, analyze facilitators/barriers and develop intervention strategies, so as to provide reference for the conversion of evidence-based evidence into clinical practice.Methods:From January to February 2022, 131 persons related to diet management of MHD patients during dialysis were selected from Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital) by convenience sampling, including 3 hemodialysis doctors, 7 hemodialysis nurses, and 121 MHD patients. We introduced 7 pieces of evidence of diet management for MHD patients during dialysis, developed 17 review indicators based on the evidence, and conducted a clinical status review. Based on the review results, we conducted an analysis of facilitators and barriers.Results:The clinical compliance rate of 17 review indicators ranged from 0 to 71.29%. The standardized scores of patients' diet management knowledge, beliefs, and behaviors were 26.00%, 61.88%, and 67.82%, respectively, while the standardized scores of medical and nursing diet management knowledge, beliefs, and behaviors were 42.20%, 68.00%, and 64.00%, respectively. The facilitators included the high validation importance and feasibility of each item in the evidence, the willingness of medical and nursing staff and patients to learn about diet management knowledge, the availability of ordering services in the cafeteria, the availability of a hemodialysis information system, and the pre dialysis evaluation and post dialysis evaluation stages. Barriers mainly included unclear explanation of evidence items, lack of practical details, lack of ways to learn diet management knowledge, single form of education channels, conflicts with patients' traditional dietary habits, difficulty in obtaining food that met the requirements of the conditions, lack of a comprehensive diet management process, lack of diet management teams, and lack of evaluation standards for diet management and lack of practical guidance.Conclusions:The evidence of diet management during dialysis in MHD patients has not yet been effectively translated into clinical practice. An evidence-based practice plan should be constructed based on the analysis of facilitators/barriers and intervention strategies to shorten the gap between clinical practice and evidence.
