Aims and objectives: To examine the impact of fatigue on the daily activity levels of people with chronic kidney disease, compare whether being predialysis or receiving different renal replacement therapies had any effect on fatigue and activity and identify whether any items in the fatigue severity scale were more predictive of daily activity levels. Background: Chronic kidney disease is a complex and long-term disease where people commonly experience fatigue and reduced levels of fitness; both of which impact on an individual's ability to carry out routine activities of daily life. Design: A descriptive cross-sectional design. Methods: A convenience sample of 112 people completed the fatigue severity scale and Human Activity Profile. Participants differed in their renal history and were either predialysis or receiving renal replacement therapy. Results: Women or older participants were significantly more fatigued and less active than men or younger participants. A significant difference between mean fatigue and activity scores was found for type of renal replacement therapy, with participants receiving peritoneal dialysis being the most fatigued and the least active. Additionally, lower levels of albumin were significantly correlated with greater levels of fatigue and the ability to engage in fewer activities. Conclusion: People with chronic kidney disease regardless of whether they are predialysis or receiving either peritoneal or haemodialysis experience high levels of fatigue and are able to engage in fewer daily activities. The fatigue severity scale and the Human Activity Profile are useful indicators of fatigue and physical activities which can be used in routine assessment practices. Relevance to clinical practice: Renal nurses are ideally positioned to engage in early identification and regular monitoring of both fatigue and activity levels in people with chronic kidney disease. Individual care plans can be developed to incorporate supportive rehabilitative strategies which aim to reduce fatigue and maximise activity levels.
Aim. This Norwegian-based study investigates how and to what extent the idea of the nursing home as a home has been realized. Background. For the last two decades, Norway, as other Western Country has had an explicit national policy that nursing homes should become more like homes. The research literature indicates that residents in nursing home seem to lack the opportunities to maintain a private sphere. Design. A field study design was conducted. Methods. Data were collected in 1999 in two long-term units in a traditional nursing home by using participant observation and interviewing the residents. A phenomenological hermeneutic analysis strategy was used to get an impression of the residents' everyday life. Results. The residents spend most of their time in the common living room. The common living room has an ambiguous boundary between the public and private spheres, unlike the clear boundaries characterizing a home. The relationship among the residents is fragile, and the residents who can, withdraw from the common living room. Conclusions. Despite having single rooms and more home-like interior decoration, the residents in nursing home still have reduced opportunity to develop a private everyday lifestyle. The long-term unit examined in this research had a forced relationship between the residents, and the residents with best health resources systematically withdraw from the common area to control both where and with whom they wish to spend their time. Relevance to clinical practice. This study lays the foundation for rethinking daily routines in long-term units in nursing homes. One way to realize the idea of the nursing home as a home could be to define the living room as a clear public area and to give the residents a chance to develop a more private lifestyle by alternating between their private rooms and a public common living room.