Hospital Practices and Research

Abstract Background: Patients undergoing hemodialysis often experience significant suffering, encompassing various psychological and existential components that negatively impact their quality of life.
Objectives: This study aimed to compare the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Spiritual Self-Care Training (SSCT) in reducing the components of suffering—physical, psychological, and existential—among patients undergoing hemodialysis.
Methods: This study utilized a three-group quasi-experimental design, employing a pre-test, post-test, and follow-up protocol with MBCT, SSCT, and control groups. The target population comprised hemodialysis patients residing in Isfahan, Iran, during the autumn of 2024. A convenience sample of 60 participants was drawn from this population and subsequently randomly allocated to three distinct groups (n = 20 per group). The Life Suffering Questionnaire served as the instrument for measuring the dependent variable across all three assessment time points. The experimental groups received 10 weekly therapeutic sessions each lasting for 90 minutes, with MBCT and SSCT administered, while the control group was a waitlist control receiving no intervention during the study period. Data were analyzed using repeated-measures analysis of variance (ANOVA), supplemented by Bonferroni post-hoc tests, via SPSS version 26.
Results: The findings revealed statistically significant differences across three domains of suffering—physical, psychological, and existential—when comparing MBCT, SSCT, and the control group (P<0.01). Notably, SSCT exhibited superior efficacy relative to MBCT in alleviating both physical and psychological suffering (P<0.05). Conversely, no significant difference in effectiveness was observed between the two intervention groups with respect to existential suffering.
Conclusion: SSCT outperformed MBCT in reducing physical and psychological suffering in hemodialysis patients, while both interventions equally mitigated existential suffering. These findings highlight the need for tailored interventions, specifically by integrating spiritual components into cognitive therapies, to address the multifaceted suffering of chronically ill patients. Clinically, incorporating such integrated interventions into hemodialysis care could enhance patient well-being and quality of life.

Abstract Background: In sub-Saharan Africa (SSA), the trend in the number of patients admitted for maintenance hemodialysis is on the rise. The identification of risk factors for chronic kidney disease (CKD) ensures adequate primary and secondary preventive measures geared at reducing the burden of CKD in low-resource settings. A family history of CKD is an established risk factor for CKD in high-income countries. However, data on family predisposition to CKD is scarce in the literature on SSA.
Objective: The current study aimed to determine the prevalence and risk factors of CKD in family relatives of a Cameroonian population of hemodialysis patients (HDP) followed-up in a major hemodialysis referral center in Cameroon.
Methods: The current cross-sectional study was conducted over four months on a consecutive sample of first-degree family relatives of end-stage renal disease patients undergoing maintenance hemodialysis at the hemodialysis unit of the General Hospital of Yaoundé. For each participating family relative, socio-demographic characteristics, clinical data, and biological data including fasting blood glucose, proteinuria, and serum creatinine were collected.
Results: A total of 82 first-degree family relatives of HDP were recruited. The prevalence of CKD among the participants was 15.8%. The main identified risk factors for CKD were age (P=0.0015), female gender (P=0.0357), hypertension (P=0.0004), regular intake of herbal remedies (P=0.0214), and diabetes mellitus (P=0.0019).
Conclusion: Overall, the current findings suggest an urgent need for population education, routine screening of CKD, and the identification of risk factors in first-degree family relatives of HDP in Cameroon.

Abstract Background: Chronic kidney disease is a health problem in today’s world and hemodialysis is an alternative method for patients with chronic renal failure. Preparing provincial and national information on the situation of patients can play a significant role in improving the quality of services provided to patients undergoing hemodialysis.
Objective: This study aimed to investigate the characteristics of patients on dialysis in hemodialysis centers in Isfahan and some other centers (up to 30 km distant).
Methods: This cross-sectional study was conducted on 1,024 patients on dialysis in 13 dialysis centers in the early part of 2013. Studied variables were collected using a researcher-made questionnaire with Cronbach's alpha coefficient of 0.86. Data was analyzed using descriptive statistics and Chi-square test by SPSS version 22 software.
Results: The results of 1024 patients undergoing hemodialysis includes the following: 60% (610 people) were male with a mean age of 54±17.67 years, and 92% (867 patients) had a private house. The family history of hemodialysis was positive in 24% (229 patients). In this study, 38% of patients (365 patients) were illiterate and the most common cause of kidney disease was diabetes in 42% (436) of the patients. Vascular access was venous-arterial fistula in 52% (519 people) with a mean hemodialysis of 52 months. Chronic renal failure was estimated at 300 per one million inhabitants in Isfahan Province (based on the last census in 2011 with the population estimated at 4,815,863 persons).
Conclusion: Majority of the studied population variables was somewhat similar to the studies conducted in other provinces; the only major difference was the most common cause of chronic renal failure leading to dialysis.