Hemodialysis and Its Impact to end Stage Renal Disease Patients
Student’s Name
University

Contents
1.0 Background to the Study.........................................................................................3
2.0 Introduction.............................................................................................................3
3.0 Problem Statement..................................................................................................4
4.0 Data Collection........................................................................................................4
5.0 Data Management and Analysis..............................................................................5
6.0 The Protection of Human Rights.............................................................................6
7.0 Interpretation of Findings........................................................................................7
8.0 Conclusion...............................................................................................................7
References.....................................................................................................................8

Hemodialysis and Its Impact to end Stage Renal Disease Patients 1.0 Background to the Study The final stage of chronic kidney diseases is when the kidneys can longer support their functions; this is the end stage where organs are pronounced to have failed completely (Esra, 2013). The role of kidneys is to remove toxic excess water and toxic metabolic waste from the body. This stage is (ESRD), end-stage renal disease (Ronco, 2002). Hypertension and diabetes commonly cause ESRD; the end scene follows chronic kidney disease (Esra, 2013). Kidneys may continue to function for over ten to twenty years even when they have been affected by the chronic kidney disease. But they stop working when ESRD is reached (Ronco, 2002). Hemodialysis in lay man’s language means kidney therapy (Esra, 2013). Hemodialysis is supposed to cleanse the body by artificially removing toxins and excess water from the body; Hemodialysis steps into primarily playing the function of kidneys and prevent end-stage renal disease (Ronco, 2002). The effectiveness of this process (hemodialysis), is influenced by four factors, these are; remedies or solutions, liquid limitation, participation at dialysis sessions and adherence to dietary rules (Esra, 2013). Dietary rules prescribed to patients with kidney disease involve restrictions on proteins consumption, sodium and potassium intake (Ronco, 2002). 2.0 Introduction When critiquing research, the principal objective is to examine the strengths and shortcomings of the study (Yin,2003).The credibility of the research in terms of data collected, methods of analysis and findings are reviewed with an aim of gauging the accuracy and reliability of the study (Yin,2003). In this paper, therefore, I have analyzed this article. “The Emotional Impact of End-Stage Renal Disease: Importance of Patients’ Perceptions of Intrusiveness and Control” by (Devins et al., 1983). The analysis focuses on data, findings, analysis and interpretation (Yin, 2003). 3.0 Statement of the Problem
The context of this research was an end-stage renal disease. (Devins et al., 1983) Was to study the relationship between renal diseases with cardiovascular risk (Devins et al., 1983). The mortality rate is high in patients who have developed kidney disease due to heart conditions and do not undergo hemodialysis is high. As compared to the mortality rate in patients with chronic kidney disease and who undergo hemodialysis to cleanse their kidneys (Devins et al., 1983). This study also investigated the value of prognosis of AMC arterial media calcification and its influence on mortality on patients. It examined a patient who have developed kidney disease from cardiovascular disease but undergo hemodialysis sense to remove toxins from their bodies (Devins et al., 1983). Solution to the problem is the study (Yin,2003). 4.0 Data Collection This study involved 35 patients who were suffering from chronic kidney disease but were undergoing hemodialysis to cleanse their kidneys. These patients were identified from the data available from medical coding systems at Royal Victoria Hospital. The sampling methodology used to determine these 35 patients was stratified sampling. According to, (Yin, 2003), with stratified sampling, the population is categorized in different layers known as strata. Each level consists of individuals with homogeneous characteristics. Once the layers are created, either simple random sampling or systematic random sampling is used to make a sample from each stratum (Yin, 2003). Quantitative studies involve generation of data in numerical form or data that can be expressed in figures or quantity (Yin, 2003). To come up with a sample of 35 patients, the patients who were suffering from classified kidney disease were classified into layers or strata. The criterion used to create these levels was the cause of kidney disease in these patients. The level with patients who had patients’ kidney disease caused by cardiovascular disease and were undergoing hemodialysis was selected for this study. The 35 patients were interviewed, as the study used standardized interviews to generate and classify data (Yin, 2003). Use of small sample in this study minimized the standard error and bias while analyzing the data, as the sample size was 35 patients. This size of the sample increased the validity and reliability of the data collection instrument and the results as well (Yin, 2003). 5.0 Data Management and Analysis The parameters used to measure the data collected from these patients were self-esteem, happy and sad mood, depression, happiness and symptoms (Devins et al., 1983). These parameters are qualitative, but the study was quantitative, so the researchers created artificial scales that attached numerical figures to the qualitative. The researchers, therefore, observed the rules of quantitative research. These were used to formulate the questions that the patients answered in the interview. Principal components were used to analyze the data. As the data collected was expressed quantitatively, descriptive statistics and regression analysis were employed to analyze the data (Yin, 2003). According to (Yin, 2003), descriptive involves the use of measures of dispersion and measures of central tendency to analyze data. Measures of dispersion require computation of kurtosis, skewness and measures of association (r2) (Yin, 2003), the results are then expressed graphically; the slopes in the graphs show the extent to which research variables are related. Measures of central tendency, on the other hand, involve computation of mean, mode and median (Yin, 2003), these are used to indicate the relationship between research variables from a central point. Regression analysis gives a clear dimension of understanding the research variables in a particular study (Yin, 2003). It was used, therefore, to indicate the effects of hemodialysis on end-stage renal disease patients. The study topic was openly and critically reviewed. Again, nominal scales were used to classify the data in layers that were used for identification. According to (Yin,2003), nominal scales are used for identification purposes only.Numerical data is obtained from qualitative responses, and nominal scales are then employed to make it easier for qualitative analysis as the data is coded into statistical figures. 6.0 The Protection of Human Rights Protection of rights involves employing measures and concepts meant to guarantee the rights of study participants (Yin, 2003). The first concept that this study used to assure the protection of the 35 respondents was that they will be treated as anonymous respondents. In the standardized interviews, patients were not asked to give out their personal information, such as names, age, places of residence, sex, etc. This enhanced confidentiality of the participants as they handled the interviews. The researchers again informed the patients, the purpose and the nature of the study before interviewing them; the respondents were made aware of the conversations they were participating. Again the patients filled and signed written consents before the commencement of the study; this is an important ethical consideration as the approval indicates that there was mutual understanding between the researchers and the 35 patients. The signed consents suggest that the 35 participants were not forced to participate in the study; rather it was under their will and cognizance. The data collection instruments had been reviewed and approved by the university review board; this indicates that the researcher had obtained the requisite approval prior to the commencement of their study. Protection of human participants was observed fully in this study.

7.0 Interpretation of Findings While considering the strengths and the shortcomings of a particular study, it is important to mention the findings of the study (Yin, 2003). The major finding of this study among the 35 patients was that hemodialysis significantly reduces end-stage renal disease. Hemodialysis does so by increasing the life of kidney affected by chronic kidney disease by over 10 -20 years, it is, therefore, not the absolute remedy for end-stage renal disease or kidney failure. These findings, therefore, fulfilled the purpose of this study. The sample size, data collection instrument, and data analysis procedures employed in this study were appropriate. These validated this research and increased the reliability of its findings too. It is correct to say that the survey solved the research problem, and its objectives were met. The study was perfect.
8.0 Conclusion In conclusion, it is important to note that the article by (Devins et al., 1983) is a perfect model. For the appropriate linkage between the research problem, the purpose of the study, its objectives, the research methodology, and findings. The relevance of the topic, its information and technique qualifies it as a credible and reliable source of information in the nursing field. It is a contributor to nursing knowledge.

References
Esra, F. (2013). Medical Nutrition Therapy for Hemodialysis Patients. Hemodialysis.
Devins, G., Binik, Y., Hutchinson, T., Hollomby, D., Barré, P., & Guttmann, R. (1983). The Emotional Impact of End-Stage Renal Disease: Importance of Patients' Perceptions of Intrusiveness and Control. The International Journal of Psychiatry in Medicine, 327-343.
Ronco, C. (2002). Hemodialysis technology. Basel: Karger.
Yin, R. (2003). Case study research: Design and methods (3rd ed.). Thousand Oaks, Calif.: Sage Publications.