Determination of Complication of Hemodialysis for children at AL-Hussein Teaching Hospital in Al-Nasiriya City

Determination of Complication of Hemodialysis for children at AL-Hussein Teaching Hospital in Al-Nasiriya City

Munther Kamil Oudah 1* 

1. Community Health Department, Al-Nasiriyah Technical Institute, Southern Technical University, Iraq;

Corresponding author:    Munther Kamil Oudah

Email: munther2016@stu.edu.iq Mobile: +9647801062470

ORCID

ABSTRACT

Abstract :-

Objectives : The research aimed to: evaluate the hemodialysis complications in the dialysis unit at Al-Hussein Teaching Hospital, Nasiriyah city..

 Methodology:- A descriptive study approach was used throughout the current investigation, which lasted from 20 October 2018 to February 2019: 80 patients (non-probability) were carefully examined. AL-Hussein Hospital educates at the AL-Nasiriyah Hemodialysis Unit in the city of AL-Nasiriyah. Data were acquired utilizing a self-reported questionnaire for the administrative reporting procedure. The questionnaire has three components: socio-demographic characteristics of the parents (age, gender, educational level, jobs, monthly income and residence). The questionnaire's second portion includes questions concerning chronic hemodialysis complications. The material validity of the instrument was determined by panel experts, and the instrument's internal correctness was determined by pilot study and the Alpha correlation coefficient (r = 0.870). Descriptive and inferential statistical approaches were used to examine the data., using the Social Science Statistical System (IBM SPSS)20.0.

Results :- The results showed that the bulk of the sample was in the 7-11 year old age group. The majority of the study sample is male, Level of education, the greater number of students not reading and writing (32.0 %) were accounted for by surveys, job status and the findings showed that the largest proportion of the survey were (unemployed and research subjects are inadequate and accountable (49.0 % ).Much of the study population is rural living. Study findings indicate the highest rate of infection with hemodialysis.

Recommendations :- The research advised that family members of hemodialysis patients get instructional health education to raise their understanding of chronic hemodialysis complications..

Keywords: Patients, Patient Knowledge, Hemodialysis complication .

Received: 13 November 2022, Accepted: 17 January 2023, Available online: 28 July 2023

INTRODUCTION

Chronic hemodialysis (HD) is known to be a preventive measure to save the lives of terminally ill patients with kidney disease (ESRD) and is largely dependent on the availability of vascular access (VA) and does not allow access to blood vessels, arteries and arteriovenous fistula veins (AVF) to be created and used successfully (Beathard & Posen 2000; Moist et al ,2013).

         For patients between 200 and 800 ml / min vascular access to the patient's blood vessel system should be established. There are several different kinds of access (Smeltzer et al , 2010 ).

Conversely, establishing well-quality delivery, t remains difficult to do so, but this is a critical aspect of dialysis patient treatment. Preparation in atherovenous fistula and high failure rate is included in the original entry. Arteriovenous greases prevent the use in combination with mother ships of organic or biological substances that require a new strategy and surgery (Naser & Mohammed, 2016).

       The safest vascular access would be to provide safe and successful care by allowing the blood to be drained and retrieved from the body by mistake. Vascular access is easy to use, reliable and has a minimal risk to the client when dialysis is performed. On the contrary, it is still difficult to develop high quality access, despite being an integral part of treating dialysis patients. The original arrival involves advance preparation in an arteriovenous fistula, And the defect rate is high. The use of synthetic or organic matter with mother ships, which require a further planning and operational experience, is replaced by venous grafts (Mick Kumwenda et al ., 2015).

       Hooland  et al ., (2010 ), he belief that successful dialysis, which is a good job of reaching and maintaining blood vessels requires a multidisciplinary connection, in which the kidneys, surgeons, nurses, In the next partnership, the dialysis and patients work together as one team.

Proper monitoring and treatment of blood vessel control is of great importance for dialysis patients. Connection is the foundation in treating dialysis. Maintaining vascular access requires a strong relationship between doctor and patient care staff. It is the duty of nurses to bring their clinical experience and strategies into action and to advise and inspire patients to look out for themselves. Patients are responsible for applying good knowledge of the self-care learned to their daily lives (Bai et al.,2014).

Aims of the study :

To determine complication of hemodialysis for children in hemodialysis unit at AL-Hussein teaching hospital in AL-Nasiriya city.

METHOD

In this chapter present the following :

   1- Study design: Descriptive research was carried out as this analysis was carried out from 20 October 2018 until 1 February 2019.

 2- Study settings: - The study took place in the Al-Hussein Dialysis Center in Nasiriyah.

 3- Sample of the study:- Randomization: Sampling of (80) patients on the choice of chronic dialysis in the dialysis unit at Al-Hussein Teaching Hospital.

Criteria :

A-Age less  than 18 years .

B- Patients accepted to cooperate in study.

C- Patients male and female

4-A Study Tools: 

The study was carried out in the dialysis unit of Al-Hussein Teaching Hospital in Nasiriyah, and the researchers developed a questionnaire that included:

Part 1 : Among the socio-demographic characteristics are ( age, gender, education level, occupation, marital status and monthly income ).

Part  2 :Questionnaire consist of questions related to patients knowledge toward hemodialysis complication :

Complications of dialysis consist of questions related to the following (with the start of dialysis, fat metabolism disorder (triglycerides), with the start of dialysis contributing to cardiovascular complications, do you suffer from anemia after dialysis or a stomach problem after the start of Dialysis, and after the start of dialysis, a metallic taste is reported when they need dialysis, bone pain and fractures, Interferes with mobility, these symptoms occur during and after dialysis, do you suffer from high blood pressure, during and after dialysis, do you suffer from low blood pressure, and during and after dialysis, was a skin or itching problem reported, and a problem with Sleep and difficulty falling asleep. You are the one who started dialysis until now, muscle pain occurs Do you suffer from this so far, the systemic disorders that occur with you from the start of dialysis until now, do these signs and symptoms include headache, nausea, vomiting, insomnia, and decreased awareness of you).

Methods:-

       The official permission was obtained from the Health Management Authority's administrative office and from the patient in the dialysis unit obtained from the participants before their inclusion in the study was explained to each participant member.

Scoring and ranking:

 The following designs were used to grade and score the items:

1-The respondents' evaluations for each question were rated with (2) years (1) No. 2: A higher questionnaire ranking (MS) increased progression of hemodialysis complications.

     The study data was determined according to the level of (success and failure) the cut point was (1.5) and the acceptance pass as calculated by the formula:

Cut off point = 3/2=1.5 It is classified as scores of response according to the following

Pass =(1.1-2.0 )

Fail= (0.0-1.0 )

Data collection :-

 RESULTS This chapter presents the findings of the systematic analysis of data in the tables and related to the study's objectives as follows.

Table (1) Patient distribution (80) of demographic hemodialysis:

Table (1) shows that the highest sample ratio (65 percent) for the study was between 7 to 11 years of age and 10 percent within 10 years (1 to 6 years) of age group.

Table ( 2 ) : Distribution of patients (80) with hemodialysis by education level:

 Table (2) Refer to intermediate school as the highest percentage (37 percent) of the study sample, reading note and writing the lowest percentage (7.5).

Table ( 3) : Distribution (80) of patients with hemodialysis by gender:

Table (3) shows that men and women were the highest percentage in the sample (65%) and males (35%).

Table (  4) Distribution by income of the (80) hemodialysis patients

           Table ( 4) This indicates that the highest percentage of the research sample (53 percent) was inadequate, while the lowest percentage (17.5) was adequate.

Table (5 ) : Distribution according to residency of the (80) hemodialysis patients:

Table (5) It indicates that the highest (53%) of the sample was rural, while the lowest (46%) was urban.

Table ( 6 ) Summary statistical of sample regarding complication of hemodialysis for children .

F= Frequency, % = percent

DISCUSSION

The diagrams systematically explain the findings and direct the discussion to a reasonable extent of the results, while providing the literature and related studies accessible.

In order to meet the study objectives, the data were analyzed using descriptive and inferential statistics.

Part-1 : Discussion of socio-demographic features of children's complication of hemodialysis

         Findings of this study revealed that over half of the research sample in Table (3), the bulk of the middle-aged research sample ranged from (7-11) years to (5) patients with a percentage (65 percent) average age (22.2) years. Supports Alashek et al. Muhammad et al. (2011) is close to this analysis. They said that there were (115) patients in the sample population , who had extracts that had access to blood vessels, and more than half (67%) were male and (33%) males. 33% males. This high prevalence of ESRD in men and confirms Mahdi (2013) results, which suggests that the prevalence of chronic kidney disease was well over half that for men.

As for the quality of education, more people had a limited level of education, such as not reading, writing, reading and writing, and graduation, which is an ordinary outcome for our society as the largest number of families with weak monthly earnings.

       The findings show a high percentage of the sample (disabled, unemployed, retired and domestic women) in relation to employment status.

The most of the study sample is focused on the insufficient monthly income as well as the cost of health care data for the individual, particularly the development person who lives in our nation during the global financial crisis.

We feel that the authorities in our country's health ministry must be more devoted, based on these data, to the critical function of their experts in scientifically creating health policy.

         As far as residence is concerned, the largest percentage of the study sample is agricultural.

Part 2 : Discussion of the distribution of the (80) patients with chronic hemodialysis complication for children .

Complications of chronic hemodialysis in teaching hospital in Al-Nasiriyah City.

CONCLUSIONS

1-The highest percentage of research samples is more male than female, illiterate, read and write, and married and primary school.

2- Determining patient information about the risk of hemodialysis reveals that the majority of the research population has limited knowledge about chronic hemodialysis complications.

Recommendation :-

        Based on the study conclusions, the study can recommend that :

1- An extensive, systematic population-based (national) analysis could be carried out to evaluate Patients awareness about risk of chronic hemodialysis.

2- Provides instructional health education to hemodialysis patient family members to increase their knowledge of complications of chronic hemodialysis.

3- The application of health education had a favorable impact on the investigated patients' management and self-care behaviors regarding vascular access devices, as well as total understanding of chronic renal failure.

4- Educational programs for patients with end-stage renal disease should be continued with their caretakers following maintenance hemodialysis to improve their understanding of treatment problems and to build their expertise.

ETHICAL CONSIDERATIONS COMPLIANCE WITH ETHICAL GUIDELINES

This study completed the approved from Thi-Qar health office directorate and the hemodialysis center then also an agremnet from patinets. 

FUNDING
This research received no support from government, commercial, or non-profit organizations.

AUTHOR’S CONTRIBUTIONS

Author studies the concept, writes, and reviews the final edition.

DISCLOSURE STATEMENT:

There are no conflicts of interest reported by the author.

ACKNOWLEDGEMENTS

We appreciate the anonymous referees' helpful suggestions.

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