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      Terapias de sustitución de la función renal: metaestudio y síntesis de evidencias cualitativas Translated title: Renal Replacement Therapy: A Meta-study and Synthesis of Qualitative Evidence Translated title: Terapias de substituição da função renal: metaestudo e síntese de evidência qualitativa

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          Abstract

          RESUMEN El objetivo del presente estudio fue sintetizar en términos de evidencias cualitativas o evidencias Q hallazgos derivados de estudios cualitativos frente al tema de las terapias de sustitución de la función renal (TSFR). Método: metaestudio cualitativo desarrollado en cuatro momentos. Resultados: se integraron 75 estudios. De los cuales, 52 exploraban experiencias relacionadas con hemodiálisis (HD), 10 de diálisis peritoneal (DP), 6 trasplante, 6 DP y HD al mismo tiempo y 1 estudio exploró las 3 TSFR. Los estudios incluidos describen y representan el fenómeno de vivir en una condición de cronicidad y estar sometido a una TSFR de manera muy semejante, que se agruparon en patrones comunes del fenómeno, estos son descritos en tres grandes temáticas: la metamorfosis de la vida; dolores diversos y la terapia invade la vida. Conclusión: los resultados dan cuenta de la estrecha interrelación de las dimensiones humanas, por esto el fenómeno de vivir en una TSFR genera una transfiguración el “Ser”, como totalidad, pues no es posible desligar una dimensión de otra, de allí la importancia de pensar la atención de las necesidades en perspectiva relacional y no jerarquizada.

          Translated abstract

          ABSTRACT The objective of this study was to synthesize, in terms of qualitative or Q evidence, the findings derived from qualitative studies on the subject of renal function substitution therapies (RFST). Method: A qualitative meta-study was carried out in four instances. Results: Seventy-five (75) studies were included. Of these, 52 explored experiences related to hemodialysis (HD), 10 concerned peritoneal dialysis (PD), six were on transplants, six concerned PD and HD at the same time, and one looked at the three RFSTs. The studies that were included describe and represent the phenomenon of living with a chronic condition and being subjected to a RFST in a very similar way. The common patterns of the phenomenon were grouped and described in three main subject areas: metamorphosis of life; various aches and pains; and therapy invades life. Conclusion: The results show the human dimensions are closely interrelated. Accordingly, the phenomenon of living with a RFST generates a change in one’s “being" as a whole, since it is not possible to separate one dimension from another. This underscores the importance of thinking about attending to needs from a relational and non-hierarchical perspective.

          Translated abstract

          RESUMO Objetivo: sintetizar em termos de evidências qualitativas ou evidências Q achados derivados de estudos qualitativos sobre o tema das Terapias de Substituição da Função Renal (TSFR). Método: metaestudo qualitativo desenvolvido em quatro momentos. Resultados: foram integrados 75 estudos, dos quais 52 exploraram experiências relacionadas com hemodiálise (HD), 10 com diálise peritoneal (DP), 6 com transplante, 6 com DP e HD ao mesmo tempo e 1 estudo explorou as três TSFR. Os estudos incluídos descrevem e representam o fenômeno de viver numa condição de cronicidade e estar submetido a uma TSFR de maneira muito semelhante, que foram agrupados em padrões comuns do fenômeno, estes são descritos em três grandes temáticas: a metamorfose da vida, dores diversas e a terapia invade a vida. Conclusões: os resultados evidenciam a estreita inter-relação das dimensões humanas, por isso o fenômeno de viver numa TSFR gera uma transfiguração do Ser, como totalidade, pois não é possível desligar uma dimensão da outra; em consequência, destaca-se a importância de pensar o atendimento das necessidades em perspectiva relacional, e não hierarquizada.

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          Metatheory, Metamethod, Meta-Data-Analysis: What, Why, and How?

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            Perceptions of patient participation amongst elderly patients with end-stage renal disease in a dialysis unit.

            A patient's right to influence treatment and health care has been guaranteed by Norwegian law since 1999. The aim of this study was to explore how elderly patients with end-stage renal disease who are undergoing treatment with haemodialysis for the rest of their lives perceive patient participation in a dialysis unit. This study, which was inspired by critical discourse analysis, drew on data derived from transcribed interviews with 11 patients. Two discourses related to patient participation were identified. The first and dominant discourse was called the health-care team's power and dominance. Both environmental conditions and the team's practice exercised power and control over the patients. The patients trusted the health-care team, but some felt powerless and were afraid of what might happen if they refused to follow the instructions. The health-care team owned the knowledge and decided what the patients needed to know. Most of all the patients wanted dialogue about the future. After years of treatment, patient identity seemed to be threatened by this situation. The second discourse is called the patients struggling for shared decision-making. Some patients struggled to be involved in decision-making about 'dry weight', diet, blood access and time of treatment when these factors threatened their well-being and the quality of their daily lives. The elderly patients' right to participate in their haemodialysis treatment did not seem to be well incorporated into the social practices of haemodialysis units. Changing the social practices in the dialysis units from a paternalistic ideology to an ideology of participation will require consideration of the context, the dialogue and the process of shared decision-making with the patient. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
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              Escalas y listas de evaluación de la calidad de estudios científicos

              El objetivo de este estudio fue identificar las escalas de evaluación de la calidad metodológica de artículos científicos y de las listas de verificación de la calidad de información en investigaciones en el área de la salud. Fueron desarrollados dos procedimientos básicos: a) revisión sistemática de la literatura científica en las bases de datos Web of Science, Journals@ovid, Science Direct, Scopus, SportDiscus, Mary Ann Liebert y Oxford Journals Online, con selección de artículos publicados en los últimos cinco años e indexados en la lengua inglesa; b) revisión bibliométrica en las referencias de los artículos seleccionados en la revisión sistemática, sin definición del tiempo ou de la lengua. Fueron seleccionados diferentes estudios que representaron 14 escalas y sus modificaciones, y también 11 listas utilizadas. Se puede concluir que las escalas y las listas difieren entre sí en relación con el número de items, validad, fiabilidad y márgenes de puntuación. La mayoría de las escalas e items presentan propiedades psicométricas de validez y fiabilidad, y son aplicables a los estudios revisionales, principalmente metanaliticos, tanto en la búsqueda de la calidad metodológica como en la calidad de información.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                aqui
                Aquichán
                Aquichán
                Universidad de La Sabana (Bogotá, Distrito Capital, Colombia )
                1657-5997
                July 2017
                : 17
                : 3
                : 328-352
                Affiliations
                [1] orgnameFundación Universitaria de Ciencias de la Salud Colombia lpmesa1@ 123456fucsalud.edu.co
                [5] orgnameFundación Universitaria de Ciencias de la Salud Colombia tmavila@ 123456fucsalud.edu.co
                [4] orgnameFundación Universitaria de Ciencias de la Salud Colombia lmreina1@ 123456fucsalud.edu.co
                [2] orgnameFundación Universitaria de Ciencias de la Salud Colombia ajcarrillo@ 123456fucsalud.edu.co
                [3] orgnameFundación Universitaria de Ciencias de la Salud Colombia racastiblanco@ 123456fucsalud.edu.co
                Article
                S1657-59972017000300328
                10.5294/aqui.2017.17.3.9
                97d66df3-9c34-4932-b790-89a684fea9a5

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 03 November 2016
                : 26 November 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 98, Pages: 25
                Product

                SciELO Colombia


                Atendimento ao paciente,pesquisa qualitativa,health services,Investigación cualitativa,prestação de atenção de saúde,patient care,Qualitative research,renal dialysis,servicios de salud,diálisis renal,serviços de saúde,diálise renal,atención al paciente,health care delivery,prestación de atención de salud

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