Decision-making process in the selection of home hemodialysis treatment by adult patients with end-stage renal disease in the United Kingdom: a systematic literature review

Introduction: In the UK, the number of people diagnosed with renal disease is on the increase. As a result, there will be more people in need of renal replacement therapy (RRT). Despite the mounting evidence showing that home hemodialysis (HHD) treatment is clinical and cost-effective as well as amendable to suit patients' lifestyle, the number of patients choosing this dialysis modality is low. The aim of this study is to explore factors influencing decision-making process in the selection of HHD treatment for adult patients with end-stage renal disease in the UK. Methods: A systematic literature review methodology was utilized to review, critique, and synthesize the literature on the low uptake of HHD among adult patients. Systematic searches involving the databases Google Scholar, EMBASE, MEDLINE, PsycINFO, and CINAHL were carried out for articles published from 2008 to 2021. A search was conducted from June 1 through December 23, 2020. Eight articles met the study inclusion criteria. We followed preferred Reporting Items for Systematic Reviews and Meta-analyses in designing the research and reporting. Results: This systematic review revealed that patient information needs, dialysis education, training and support, and patient decision-making preference were the major factors influencing decision-making of adult patients. Conclusion: Deciding over which dialysis modality to choose can be challenging for many adult patients. Dialysis education, training, and support should not stop at the predialysis stage but should continue during treatment

Effectiveness of non-surgical interventions to improve health and well-being in women living with Mayer–Rokitansky–Kuster–Hauser syndrome: a systematic review

Aim: The aim of this paper is to present the evidence on the effectiveness of non-surgical interventions to improve health and well-being in women living with Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome. Design: Systematic review guided by Preferred Reporting Items for Systematic Reviews checklist. Data Sources: The search was conducted between June and September 2022 across the following databases: CINAHL, EMBASE, Medline, PsycINFO and Cochrane. Trial registries (clinicaltrials. gov, World Health Organization International Clinical Trials Registry Platform (ICTRP), Cochrane Controlled Trials Register-CCTR), Google scholar, dissertations, conference proceedings and reference lists of included studies were also searched. Corresponding authors, formal and informal MRKH groups were contacted to obtain any significant studies or reviews. Review Methods: Eligible were only English-language empirical studies of any time period. The review followed narrative synthesis. Results: Twenty-three studies were identified that fit the inclusion criteria which included 1540 MRKH syndrome affected women. Four studies were on psychological interventions (n = 85) and 19 studies (vaginal dilation therapy n = 897, coital dilation n = 57) focused on non-surgical vaginal dilation as a measure to vaginal agenesis in MRKH syndrome. Conclusions: Clearly, vaginal dilation is a viable initial treatment option for women with MRKH syndrome. There is limited evidence that ‘coital dilation’ is an effective method of dilation for vaginal agenesis. The literature, however, supports the need for psychological intervention to improve health and well-being. Impact: Women with MRKH syndrome who require dilation can receive guidance and support from their healthcare providers, particularly sexual and reproductive health nurses, clinical nurse specialists and gynaecologists. From the point of diagnosis, clinical psychologists should be involved. As much as feasible, family and partner support can be encouraged. Patient or Public Contribution: No patient or public contribution