Effects of a Goal-Oriented Care Interventions
Condition: Chronic Kidney Diseases; Acute on Chronic Renal Failure; Acute Kidney Injury
MeSH terms: Kidney Diseases; Renal Insufficiency, Chronic; Acute Kidney Injury; Kidney Failure, Chronic
Study type: Interventional

Summary: 
      This study was a clinical trial. This study aimed to evaluate the effects of Goal-Oriented
      Care intervention on blood pressure, percentage of interdialytic weight gain, self-management
      behaviors, and quality of life in hospitalized patients with unplanned dialysis at three and
      six-months post-discharge. This study was an experimental design in a medical center in
      Southern Taiwan. A cluster sample method was selected for each two wards from four nephrology
      wards and was randomly assigned to the experimental and control groups. The enrolled patients
      were assigned to the experimental and control groups according to different wards' admission.
      The inclusion criteria were: (1) patients who received unplanned dialysis during
      hospitalization; (2) aged between 20 and 80 years; (3) not undergoing renal replacement
      therapy before recruitment; (4) alert consciousness status and ability to communicate; (5)
      ability to perform self-management behaviors. The exclusion criteria were a history of
      psychiatric illness, any active infection and inability to communicate or understand the
      educational process. Each group consisted of 46 participants. Both groups received routine
      health education. However, the experimental group during hospitalization additionally
      received 40 minutes of one-on-one education three times a week for three weeks, as the
      Goal-Oriented Care program for 6 hours in total, followed by telephone sessions of 20 minutes
      every month for six months post-discharge. On receiving the third dialysis, baseline data
      including self-report questionnaires assessed participants' demographic and disease
      characteristics and medical record reports for blood pressure and percentage of interdialytic
      weight gain were collected. A week after discharge, self-management behaviors and quality of
      life baseline data were assessed using self-reported questionnaires and these were followed
      up at three and six-months post-discharge, which then also included blood pressure and
      percentage of interdialytic weight gain.Generalized estimating equations were used to assess
      changes amounts in each outcome variable from the baseline to three months and six-months
      post-discharge between two groups.
    

Detailed description: 
      On receiving the third dialysis, baseline data including self-report questionnaires assessed
      participants' demographic and disease characteristics and medical record reports for blood
      pressure and percentage of interdialytic weight gain were collected. A week after discharge,
      self-management behaviors and quality of life baseline data were assessed using self-reported
      questionnaires and these were followed up at three and six-months post-discharge, which then
      also included blood pressure and percentage of interdialytic weight gain. All data were
      analyzed using the computer-based statistical software package SPSS, version 20.0.
      Descriptive statistics were calculated to examine the distribution of the study variables as
      mean, standard deviation and percentage among participants. Inferential statistics included
      the chi-square test, independent two-sample t-test, and paired sample t-test. Generalized
      estimating equations were used to assess changes amounts in each outcome variable from the
      baseline to three months and six-months post-discharge between two groups.
    

Intervention name(s): The Goal-Oriented Care program; The routine health education
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The Goal-Oriented Care Interventions The GOC intervention included the following steps: respecting the participant's values in setting goals, considering direct and indirect factors influencing the goals, communicating and setting goals, implementing goal-oriented strategies, and evaluating goals while adjusting the content of the strategies.; The control group received routine education, which consisted of oral education and provision of educational pamphlets by nurses during hospitalization.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care