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Evaluation of Health for Chronic Renal Patients

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D’Youville College

Evaluation of Health for Chronic Renal Patients

NUR 601 Fall 2016

Dr. Abigail Mitchell

Rayne K. Thoman

Healthy kidneys have several functions in our bodies such as filtering blood and producing urine.  When kidneys can no longer function normally, toxins can build up in the body along with excess fluid.  When kidney function goes below 10% to 15 % hemodialysis is one treatment option that can filter waste and remove excess fluid, as well as, balance electrolytes such as sodium, potassium, bicarbonate, chloride, calcium, magnesium, and phosphate. (Kruger A.P., Ubessi L.D., Kirchner R.M., Guido L.A., Barbosa, A., & Stumm, E.M.F., 2013).  Hemodialysis removes blood from the body and filters it through a man-made membrane called a dialyzer, an artificial kidney.  The blood is then returned to the body.  Blood needs to flow through the dialyzer for several hours to adequately clean the blood and rid the body of excess fluid.  This is generally done three times a week for about 4 hours each treatment.

Hemodialysis has been proven to be an effective treatment option for those patients with Chronic Kidney Disease.  However, hemodialysis alone does not provide a complete treatment for those in kidney failure.  Diet and fluid restriction also need to be followed carefully and medications need to be taken in order to replace other kidney function such as regulating blood pressure and stimulating the production of red blood cells in order to prevent anemia.  Anemia is common in individuals suffering with CKD.  These individuals, whose blood is low in red blood cells, suffer with anemia, causing symptoms such as fatigue, depression, loss of energy, paleness, and heart problems.  Fatigue can be a debilitating symptom by many patients on long term hemodialysis and can affect their quality of life.  According to the research performed by Kruger A.P., Ubessi L.D., Kirchner R.M., Guido L.A., Barbosa, A., & Stumm, E.M.F., titled,  Evaluation of Health in Relation to Time of Diagnosis and Hemodialysis for Chronic Renal Patients, chronic kidney disease is recognized as a public growing health problem worldwide. (Kruger et al., 2013).  

As described in the assigned text, Foundations of Nursing Research, critiquing Quantitative Research Reports is particularly helpful to the beginning researcher because the process aids in the development of research skills.  (Nieswaidomy, 2012).  A research critique involves a thorough examination of all parts of a study including the abstract, the literature review, the introduction, method, results, discussion, the conclusion, and references.  When critiquing a quantitative research report you generally begin with the abstract.  Reviewing the abstract of the research, Evaluation of Health in Relation to Time of Diagnosis and Hemodialysis for Chronic Renal Patients, the researcher discusses the objective of his/her research.  The objective of the researcher is to analyze patients undergoing hemodialysis and their perceived health status at the time of diagnosis and undergoing hemodialysis.  The abstract also states that a quantitative research method was performed using 77 patients and the results indicate that overall, patients rate their health as good although, 16.9 % did rate their overall health as worse that compared to a year ago.  (Kruger et al., 2013).  The qualifications of the authors, all having received their PhD in nursing, provide the reader with the qualifications of the researchers.  The title of the research article, Evaluation of Health in Relation to Time of Diagnosis and Hemodialysis for Chronic Renal Patients, clearly defines the focus of the research and its population.  

The introduction of a research report sets the stage for the presentation with a brief exploration of the study area, background information and significance of the problem.  Kruger et al. clearly states in the introduction the statistics of those diagnosed with Chronic Kidney Disease and those who are on hemodialysis.  The authors then discuss the causes of CRF, treatment modalities, complications of CKD and of hemodialysis treatment.  At the end of the introduction, the authors clearly state the purpose of the study, the problem statement, the purpose statement and the research question.  While critiquing this report I have noticed that the authors do identify the sources of literature review with in-text citations.  The Theoretical framework is clearly identified within the introduction as the authors believe that early diagnosis and immediate follow up care can improve quality of life although further research needs to be done to address these topics.  A study on the perception of CKD is influenced by a lack of knowledge, insecurity about the future, complications of the disease, and death.  The authors also state that more research needs to be done on these topics.  The assumptions made by the researcher may include assuming that patients have the mental capacity or knowledge to answer questions, that they will answer honestly, or that they are not influenced by other patients who may have negative/positive experiences with CKD and hemodialysis.  The limitations are not straightforward and clearly stated but it may be, simply stated, a small patient population that can also be considered a limitation.  The hypothesis is stated that the authors intend to analyze from the patients perspective going through hemodialysis, their perspective on their health at the time of diagnosis and going through hemodialysis.  No definition of terms is included within the research although definition of key terms is an important aspect for the reader to have for a greater understanding of the theoretical framework for the study.  

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