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S 16 Parallel Session
Title: End of life care
Sunday, September 7, 16:00 – 17:30
Omega 2
Programme of the session:
GS: Aine Burns
End of life care
O 30
A multidisciplinary approach to improving conservative management
Geraldine Hyslop, Frank Sciuto, Susan Kennedy (UK)
O 31
Risk of depression among pre dialysis patients and those on dialysis treatment (comparison
study)
Suzana Vidrih (Croatia)
O 32
Relationship between conflict behaviour and conflict resolution
Ana Cunha (Portugal)
O 33
Support groups for Haemodialysis patients and family members during Dialysis treatment
Iris Romach (Israel)
Abstracts:
GUEST SPEAKER
Abstract is not available
BIOGRAPHY OF THE GUEST SPEAKER
O 30
A multidisciplinary approach to improving conservative management
A. Hyslop1, F. Sciuto1, S. Kennedy1
1The Renal Unit, The Royal Cornwall Hospitals Trust, truro, United Kingdom
Our CM programme was set up in 2004 with 11 patients (10% of annual referrals) and has increased to 23%.
A recent service review highlighted transport to and from the hospital a major cause for concern with patients. Appointments (OPA-Outpatient appontiment) are far from home, parking at the hospital is not only difficult but expensive. Public transport in Cornwall is poor
Objectives:Improve the service by reducing the number of OPA in secondary care but continue to provide support and supervision by setting up a Telephone Consultation Clinic between opatients with members of the MDT-CKD Nurse. Renal Dietician and Specialist Practitioner
Methods: Patients and GPS wrre sent letters introducing the service
Collaborative working with community nurses was developed to ensure that routine bloods tests, weight and blood pressure are taken and a list of the patients’ medications maintained.
Patients are contacted by phone and their results are discussed with them .A follow up letter is sent to the GP.
Conclusion/Application to practice:The Telephone Consultation Clinic provides good quality care with a high dregree of patient satisfaction
Reducing the number of OPA has cut transport costs and inconvenience for patients, whilst developing excellent relationships with primary care.
Disclosure: No conflict of interest declared
O 31
Risk of depression among pre dialysis patients and those on dialysis treatment (comparison study)
S. Vidrih1, B. Poje1, V. Babić1, M. Baničević1, B. Vujičić1, S. Rački1
1Nephrology and Dialysis , KBC Rijeka, Rijeka, Croatia
Methods:The group comprised 78 patients (65% male) with chronic kidney failure undergoing three diferent stages of treatment (predialysis, beginning treatment and 6 months later). Data was collected using the SF36v2 questionnaire for assessing quality of life. We used a method called First Stage Positive Depression Screening. We compared data between our three groups and between these groups and the general population. The percentage of those at risk of depression in general population is 18%, in our predialysis sample it was 50% and among the HD group at beginning of treatment 80%, After 6 months among the HD group this figure dropped to 55%. In the PD group, 37% were depressed when treatment commenced and afterr 6 months it was 40%.
Conclusion/Application to practice: From this study we see that our patients are at a much higher risk of depression than those in the general population. That is to be expected. What we learned is that HD patients at the beginning of treatment and 6 months later had a higher rate of depression than PD patients at the same point.
Disclosure: No conflict of interest declared
O 32Relationship between conflict behaviour and conflict resolution
A. Cunha1, C. Seixo1, C. Amorim1, F. Ambrosio1, J. Fazendeiro Matos2, R. Peralta2
1NephroCare Dialysis Centre Barreiro, Fresenius Medical Care, Barreiro, Portugal; 2NephroCare Nursing Care Management, Fresenius Medical Care, Porto, Portugal
Background: Conflicts between healthcare professionals and haemodialysis patients can arise. They can be resolved with a careful analysis of the conflict situations.
Objectives:To observe and analyse conflict situations.
Methods: We evaluated indicators of conflicts, conflict resolutions, personal feelings, and behaviours over 6 months.
Results:We analysed conflict situations of 228 patients (59.65% male) and 59 professionals (49.15% nurses, 22.03% medical assistants, 25.42% physicians).
• 100-130 dialysis treatments/day were performed. In the first 90 days of the study, 33% of conflict situations and in the last 90 days 67% were observed.
• Most conflicts were experienced on Wednesdays (42%), Thursdays (38%), during late (44.5%) and night shift (38.9%), and at the start (42.2%) and end (50%) Total study period check by conflicts 4.9 /1000 treatments, day.
• Conflicts arose more frequently between nurses and patients. The most prevalent indicators of conflicts were the time of entry into the dialysis room 1.27/1000 treatments, day, and the time during haemostasis 1.72/1000 treatments, day.
• In both actors we evaluated:
Raising the voice was an immediate conflict resolution in 94.5% of cases. The main feelings in conflict situations were anger (77.7%) and frustration (36.7%).
Disclosure: No conflict of interest declared
O 33
Support groups for Haemodialysis patients and family members during Dialysis treatment
D. Niazov1, I. Romach1, Z. Rapaport1
1Dialysis, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
Objectives:
a. Ease the entrance of new patients to hemodialysis treatment.
b. empower the old patients.
Methods: We initiated 4 sessions of meetings with 5 patients and their family members (newcomers and older ones) in the dialysis room, during hemodialysis treatment. Each of these meetings lasted 1.5 hours, and included each time two facilitators, a nurse and a social worker. The themes of the meetings were: 1) open conversation with the physician in charge of the dialysis unit regarding ESRD and its medical implications; 2) Diet, with a nephrologic dietitian; 3) Nursing issues and 4) social rights.
Results:
1) The older patients' experiences had a significant postive influence on the new patients' acceptance of their new status as hemodialysis patients.
2) The rating of their satisfaction questionnaire was higher following the sessions.
Conclusion/Application to practice: Active theme-oriented meetings with patients and their family members increases patients' satisfaction and ability to cope with the CKD illness.
Disclosure: No conflict of interest declared
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