Oquendo Lissete González, Asencio José Miguel Morales, de Las Nieves Candela Bonill
Department of Nursing, Faculty of Health Sciences, based Fuerteventura, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
Head of the Department of Nursing, Faculty of Health Sciences, University of Malaga, Malaga, Spain.
J Clin Nurs. 2017 Dec;26(23-24):3893-3905. doi: 10.1111/jocn.13804. Epub 2017 Jun 5.
The objective of this integrative review is to identify the factors that contribute to diet adherence in people suffering from kidney disease who are receiving haemodialysis treatment.
Adherence to the therapeutic regimen determines therapeutic success, quality of life and survival in patients on haemodialysis. Lack of diet adherence ranges from 25%-86% in patients receiving haemodialysis treatment and affects patient morbidity and mortality.
An integrative literature review was conducted based on the criteria of Whittemore & Knafl.
A literature review was performed by two members of the team using twelve databases including PubMed, CUIDEN, CINAHL, The Cochrane Library and ScienceDirect.
The main issues identified after analysing the results were as follows: the intrinsic barriers (age, dialysis time, motivation, perceived benefit, distorted perception of adherence) and facilitators (self-efficacy, perception of disease, perception of control), extrinsic barriers (family dysfunction, lack of social support, cultural patterns of consumption of food) and facilitators (social support, relationship with healthcare providers), and interventions to encourage diet adherence, such as the use of motivational interviewing in educational interventions, and the training and education of relevant professionals in communication skills.
Diet nonadherence remains a serious health problem and suffers from a lack of solid criteria to identify this condition. The onset of depression signs and the level of social support available to the patient should be assessed, because these are important factors that determine adherence to treatment.
Professionals should be trained in health education and communication techniques to contribute to the patient's self-management and motivation for diet adherence. Controlled and randomised clinical studies involving predialysis stages should be performed to investigate the impact of the assessment and control of barriers to diet adherence.
本整合性综述的目的是确定在接受血液透析治疗的肾病患者中，有助于饮食依从性的因素。
坚持治疗方案决定了血液透析患者的治疗成功、生活质量和生存率。接受血液透析治疗的患者中，饮食依从性差的比例在25%至86%之间，这会影响患者的发病率和死亡率。
根据惠特莫尔和克纳夫的标准进行了一项整合性文献综述。
该团队的两名成员使用包括PubMed、CUIDEN、CINAHL、考克兰图书馆和科学Direct在内的12个数据库进行了文献综述。
分析结果后确定的主要问题如下：内在障碍（年龄、透析时间、动机、感知益处、对依从性的认知偏差）和促进因素（自我效能感、对疾病的认知、控制感）、外在障碍（家庭功能障碍、缺乏社会支持、食物消费文化模式）和促进因素（社会支持、与医疗服务提供者的关系），以及鼓励饮食依从性的干预措施，如在教育干预中使用动机性访谈，以及对相关专业人员进行沟通技巧培训和教育。
饮食不依从仍然是一个严重的健康问题，且缺乏确定这种情况的可靠标准。应评估抑郁症状的出现和患者可获得的社会支持水平，因为这些是决定治疗依从性的重要因素。
专业人员应接受健康教育和沟通技巧方面的培训，以促进患者的自我管理和饮食依从性动机。应进行涉及透析前阶段的对照和随机临床研究，以调查评估和控制饮食依从性障碍的影响。
