Authors: Edward Appiah Boateng RGN, BSc, MSc; Linda East  RN, BSc, MPhil, PhD

Summary: 
Background
This systematic review aims to generate evidence on which dialysis modality (in-centre haemodialysis, HD, or peritoneal dialysis, PD) improves quality of life (QOL) of end stage renal disease (ESRD) patients.
Methods
MEDLINE, CINAHL and EMBASE were searched from their inception to July, 2010, for studies that compared QOL in both HD and PD patients.
Results
Only 26 of the 574 studies identified were included in this review. These were cross-sectional, longitudinal or retrospective in design. QOL tools used include SF-36, Kidney Disease Quality of Life (KDQOL) and CHOICE Health Experience Questionnaire (CHEQ). PD patients mostly rate their QOL higher than HD patients. Yet, HD patients may enjoy a relatively better QOL in the physical dimensions over time. Mental health components are, however, comparable between both dialysis populations.
Conclusion
There is no simple ‘yes’ or ‘no’ answer to the question of which dialysis modality improves QOL. However, a good understanding of the evidence base will facilitate individual decision-making.

Keywords: End stage renal disease, haemodialysis, peritoneal dialysis, quality of life

Authors: Maren Böhmert MA Ed.; Saskia Kuhnert, MBA; Albert Nienhaus, MD, MPH, PhD

Summary:
Background
As the number of dialysis patients increases, the psychological stress and strain suffered by dialysis personnel is of growing importance. For this reason a systematic review of the international literature was performed.
Methods
A search of relevant databases for original studies or reviews published after 1990 resulted in 20 articles. The quality of these studies was assessed and they were grouped according to their focused central issues.
Results
Stress and burnout were examined in ten studies and a review. Working conditions and working situation in general were examined in eight studies. The findings were heterogeneous and difficult to compare. The results indicate that employees in the dialysis sector are subject to moderate levels of stress and burnout. Job satisfaction seems to be good. The few studies that allowed for comparison with other professions did not reveal excess stress and strain in dialysis personnel.
Conclusion
The results do not indicate that dialysis workers are exposed to above-average levels of stress or strain. Nevertheless, there is room for optimisation and need for action in some facilities.

Key words:  review, psychological stress and strain, dialysis personnel

Authors: Dympna Calvey. MSc(Ad. Practice) RN.Renal Cert. Lorraine Mee, MSc. BSc, RN. RM CNT PGCEd.  

Summary: The phenomenon of experiencing life dependent on haemodialysis is infinitely multi-faceted.  It effects all aspects of people’s lives, and not only their lives, but those of the people around them.  Busy dialysis units often do not have time to explore these effects on the lives of their patients outside the clinical setting.
Aims
The aim of this qualitative study was to step into the lives of seven patients once they were outside the dialysis unit. 
Method
Seven chronic haemodialysis patients were selected and interviewed using an in-depth semi-structured approach, following the philosophy of Heidegger.  Data was analysed using Colaizzi’s (1979) seven stage process. 
Results
The strongest common theme emerged through descriptions of the patient’s ‘Sense of Self’, within which emerged sub-themes; The Future Self, The Living Self, The Mortal/Fragile Self and The Growing/Learning Self.  These were further explored and related back to importance of awareness of such findings within the renal haemodialysis practice setting.

Key words:  Haemodialysis, Sense of Self, Qualitative.

Authors: Fiona Murphy RGN, RNT, BSc(Hons), BSc(Hons) Health Stud,  PGDip Adv Nurs Scie,PGDip CHScieEdu, MA,MSc. RayTrevitt MSc, BSc, RGN, Dip Health Service Management. Melissa Chamney RGN, MN (Nephrology), Grad.Dip.Ac.Practice, Renal Cert.   Margaret McCann RGN, RNT, BNS(Hons), MSc, FFNMRCSI.

Summary: This is the first article in a series of three articles concerning renal transplantation. This first article will address the patient’s health and wellbeing while waiting for renal transplantation and the role of the multidisciplinary team in the promoting of this. The subsequent articles will address pre and post renal transplant care and the long term complications of renal transplantation.

Key words: Renal transplantation, health, wellbeing, education

Authors: Kaylene Wadd RN. MSc. Research (c). Post Grad Dip. Family & Child Health, Lindy King RN PhD, Paul Bennett. RN PhD, 4Julian Grant RN PhD.

Summary: 
Aim 
This literature review explored the extant literature to further our understanding of the experience of being a parent on dialysis.
Methods 
Keywords used to search the literature were haemodialysis, hemodialysis, chronic kidney disease, end stage renal disease, parent and experience. Databases searched included CINAHL, Medline, Wiley/Blackwell, EBSCOHost, Web of Science, Pubmed, and ProQuest.  Years included were 1999 to 2009. Seventeen primary research articles (sixteen qualitative, one mixed methods) met the search criteria with only one on parents undergoing dialysis.
Findings
The experience of the parent on dialysis has rarely been explored in the literature. Related research has indicated important themes including: restricted lives; relationships; adjustment; consequences and future outlook.
Conclusions 
More should be known about challenges that face parents who receive dialysis.  This review established an urgent need for further research to determine the experiences and needs of this population to provide empirical, person-centred nursing care.

Key Words: Dialysis, Parent, Chronic Kidney Disease

Authors: Kantaporn Yodchai RN, MSN, PhD (c);Trisha Dunning AM, RN, MEd PhD; Alison M.  Hutchinson RN, BAppSci, MBioeth PhD; Areewan Oumtanee RN, PhD; Sally Savage BA (Hons), PhD

Summary:
Background
Researchers have explored the experiences of patients on haemodialysis (HD); however, most studies have not included Thai patients.  Thus, the way Thai patients experience and adapt to HD is unknown. 
Aim
To conduct a pilot study to explore how HD affects Thai patients with end stage renal disease (ESRD) and understand HD patients’ perspectives about adapting to being dependant on HD.
Methods
Data were collected using semi-structured interviews that focused on problems, feelings, thoughts, attitudes, and ways of adapting to HD.  Grounded theory method (GT) was selected to guide data collection and analysis.
Findings
Five patients (age range 24 to 66 years; mean 44.60 years; mode = 24) participated in the study. Four main coping processes emerged during data analysis: planning, adjustment and avoidance, belief in religion and superstition, and living with hope.  In addition, the patients reported a range of adverse effects of HD including fluid restriction, fatigue, effects on sexual activity, altered body image, fear of dying, stress and depression, and suicide.
Conclusion
Thai patients with ESRD felt treatment, including HD, adversely affected their lives and required physical, psychological, and social changes to enable them to cope.  They reported use of a range of strategies to deal with the adverse effects.

Key words: End stage renal disease, adaptation, haemodialysis, dependence