Strategies to improve long-term outcomes for patients with chronic kidney disease in China

Background: Chronic kidney disease (CKD) is an incurable disease requiring lifelong management. China has a high prevalence of CKD, which disproportionately affects older adults and those with chronic risk factors for CKD development. The rising prevalence of CKD in China places a substantial burden on the general population and the healthcare system. Summary: In China, there are currently many unmet needs for patients with CKD and high-risk individuals, resulting from a lack of education and support to reduce risk factors, delayed diagnoses, limited knowledge of CKD among primary care physicians and poor access to treatments among some patient populations. An integrated, nationwide approach is required to improve the current situation of CKD management in China. There are currently several national healthcare frameworks in place that focus on new major health policies to prevent disease and encourage people to adopt healthier lifestyles, and while they do not directly target CKD, they may have a positive indirect impact. We explore the unmet needs for patients with CKD in China and discuss the potential strategies that may be required to overcome them. Such strategies include improving physician and patient education, establishing a targeted screening programme, supporting patients to improve self-management behaviours, accelerating the creation of medical consortia and medical satellite centres, and migrating from hospital- to community-based management. In additional to policy-driven strategies, development of novel therapies will be key to providing new solutions for the long-term management of CKD

Validity and reliability of the Chinese version of the care transition measure.

The 15-item care transition measure (CTM-15) is a reliable and valid instrument assessing the quality of care transition from patients' perspectives. The aim of this study was to evaluate the psychometric properties of the CTM-15 and the CTM-3 (a 3-item short version of the CTM-15) in Mainland China.This was a cross-sectional study with a convenience sample of 646 patients in a general tertiary-level hospital in Chengdu, China. The results indicated that the Cronbach's α values of the Chinese version of the two measures were 0.90 and 0.56, and the test-retest reliability values were 0.91 and 0.87, respectively. Three factors were extracted for the CTM-15 in Chinese populations. The CTM-15 and the CTM-3 scores discriminated well between patients with and without re-hospitalization for their index condition. The CTM-15 and the CTM-3 had significant positive relationships with self-rated health status. The CTM-3 score was significantly related to the CTM-15 score, and the CTM-3 score accounted for 64.23% of the variance of the CTM-15 score.This study has demonstrated the psychometric properties of the CTM-15 and the CTM-3 in Mainland China. Although the Cronbach's α value of the CTM-3 is suboptimal, it has exhibited high test-retest reliability, convergent validity and criterion validity. Therefore, the CTM-3 can substitute the CTM-15 as a performance measurement tool when the sample size is large enough to compensate its suboptimal reliability or the reduced response burden is a concern

Scores on the CTM-15 and CTM-3 among different subgroups (n = 646).

<p>Scores on the CTM-15 and CTM-3 among different subgroups (n = 646).</p

Results of confirmatory factor analysis of the CTM-15 (n = 646).

<p>AVE: average variance extracted, GFI: goodness of fit index, AGFI: adjusted goodness of fit index, CFI: comparative fit index, TLI: Tacker-Lewis index, RMSEA: root mean square error of approximation, SRMR: standardized root mean square residual.</p><p>Results of confirmatory factor analysis of the CTM-15 (n = 646).</p

Results of exploratory factor analysis of the CTM-15 (n = 646).

<p>Results of exploratory factor analysis of the CTM-15 (n = 646).</p

Reproductive concerns and associated factors among female chronic kidney diseases patients: a Multi‐Center Cross‐Sectional Study

AimThe study aimed to investigate the current status of reproductive concerns and explore the associated factors among young female chronic kidney disease (CKD) patients.DesignA multi‐center cross‐sectional study was designed.MethodsThe study was conducted in six representative tertiary hospitals across southwest China. A total of 295 female Chronic kidney disease patients between 18–45 years of age completed a 20 min, web‐based survey, which included demographics and disease‐related information questionnaire, Reproductive Concerns Scale, Generalized Anxiety Disorder 7 (GAD‐7) instrument and Patient Health Questionnaire 9 (PHQ‐9) instrument.ResultThe survey total collected 270 valid questionnaires. The mean reproductive concern score was 54.39 ± 10.90 (out of a maximum of 90), with the mean scores for sub‐scales ranging from 7.80 ± 1.69 to 10.44 ± 1.85. Multiple regression analysis showed that those with higher reproductive concerns were more likely to have pregnancy intentions, to be in Chronic kidney disease stages 1–3, and to have a higher GAD‐7 score. This study offered further evidence of the need for improved education and emotional support surrounding reproductive concerns among young Chinese women with Chronic kidney disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/169312/1/nop2850.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/169312/2/nop2850_am.pd

Characteristics of samples (n = 646).

<p>Characteristics of samples (n = 646).</p

Status and factors related to post‐traumatic growth in continuous ambulatory peritoneal dialysis: A multi‐centre study

AimTo investigate the extent of post‐traumatic growth, and the correlation between post‐traumatic growth and self‐perceived stress, post‐traumatic growth and self‐perceived burden among CAPD patients.DesignA cross‐sectional study.MethodsThis was a multi‐centre study including 752 patients from 44 hospitals. Self‐perceived stress, self‐perceived burden and post‐traumatic growth were measured using the post‐traumatic growth inventory (PTGI), the Chinese version of the perceived stress questionnaire (CPSQ) and the self‐perceived burden scale (SPBS). A multiple stepwise regression analysis was fit with the total PTGI score as the outcome of interest.ResultsPatients concurrently experienced post‐traumatic growth and stress following peritoneal dialysis. The initiation of patients’ education level, employment status and self‐perceived stress were all found to relate to growth among Chinese CAPD patients. There was not sufficient evidence to suggest that self‐perceived burden was related to experiencing growth.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/171193/1/nop21096.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/171193/2/nop21096_am.pd