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改善夸祖鲁 - 纳塔尔省初级医疗保健中慢性肾病管理指南的建议。

Recommendation to improve chronic kidney disease management guideline in primary healthcare, KwaZulu-Natal.

作者信息

Ramkelawan Verosha, Mbeje Pretty N, Mtshali Ntombifikile G

机构信息

School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban.

出版信息

Curationis. 2025 Feb 25;48(1):e1-e8. doi: 10.4102/curationis.v48i1.2623.

Abstract

BACKGROUND

The prevalence of chronic kidney disease (CKD) is high in KwaZulu-Natal (KZN), especially in individuals with risk factors such as HIV, diabetes mellitus and hypertension. Despite existing guidelines, the study identified multifactorial gaps in implementing CKD management measures at the primary healthcare (PHC) level. This leads to late-stage diagnoses and increased burdens on tertiary institutions, as identified in institutional statistics. The study was therefore conducted in four different settings: a tertiary hospital in Durban and three PHC centres across KZN (two urban centres and one in a township).

OBJECTIVES

The study's objective is to describe the perceptions of healthcare professionals on the management of CKD, in the PHC setting in KZN, South Africa.

METHOD

A qualitative, exploratory design involving healthcare professionals was adopted. Purposeful sampling was used. Open coding and conventional content analysis were adopted to analyse data.

RESULTS

Findings revealed three overarching themes: (1) knowledge and awareness about existing guidelines, (2) fragmented system and a lack of clear guidelines and (3) implications of clear guidelines on patient care. Participants demonstrated diverse awareness of guidelines, revealing a need for continuous education. Participants expressed needs for continuous education and clear guidelines.

CONCLUSION

The study highlights an urgent need to bridge the knowledge gap and establish a cohesive healthcare system to address the growing CKD burden in KZN effectively.Contribution: The study emphasises the potential benefits of implementing clear guidelines to improve patient outcomes, early detection and appropriate interventions, thereby reducing the burden on tertiary facilities.

摘要

背景

夸祖鲁 - 纳塔尔省(KZN)慢性肾脏病(CKD)的患病率很高,尤其是在有人类免疫缺陷病毒(HIV)、糖尿病和高血压等风险因素的人群中。尽管有现有指南,但该研究发现,在初级卫生保健(PHC)层面实施CKD管理措施存在多方面差距。正如机构统计数据所示,这导致了晚期诊断以及三级医疗机构负担加重。因此,该研究在四个不同地点开展:德班的一家三级医院以及夸祖鲁 - 纳塔尔省的三个初级卫生保健中心(两个城市中心和一个乡镇中心)。

目的

本研究的目的是描述南非夸祖鲁 - 纳塔尔省初级卫生保健环境中医疗保健专业人员对CKD管理的看法。

方法

采用了一项涉及医疗保健专业人员的定性、探索性设计。使用了目的抽样法。采用开放式编码和传统内容分析法对数据进行分析。

结果

研究结果揭示了三个总体主题:(1)对现有指南的知识和认识,(2)系统碎片化以及缺乏明确指南,(3)明确指南对患者护理的影响。参与者对指南的认识各不相同,表明需要持续教育。参与者表达了对持续教育和明确指南的需求。

结论

该研究强调迫切需要弥合知识差距,并建立一个有凝聚力的医疗保健系统,以有效应对夸祖鲁 - 纳塔尔省日益加重的CKD负担。贡献:该研究强调了实施明确指南以改善患者预后、早期检测和适当干预的潜在益处,从而减轻三级医疗机构的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4c3/11886468/d5cff4eaaa21/CUR-48-2623-g001.jpg

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