Pengalaman Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisis dalam Mengikuti Asupan Diet dan Cairan: Studi Fenomenologi
Abstract
This study aims to gather information about the life experiences of patients with chronic kidney disease undergoing hemodialysis in adhering to their diet and fluid intake. The method used is a phenomenological approach involving 15 patients undergoing hemodialysis at the H. Adam Malik General Hospital Medan selected by purposive sampling technique. Data collection was carried out using a qualitative approach in the form of in-depth interviews. Data were analyzed using the Colaizzi method. The results showed that there were seven themes regarding patient experience, namely; 1) changes in the patient's physiological condition; 2) expression of the patient's feelings regarding changes in health conditions; 3) the need to obtain support; 4) changes in meeting the nutritional needs of patients; 5) changes in fulfilling the patient's fluid needs; 6) the need to obtain information about treatment; and 7) patient's obstacles in following diet and fluid rules. In conclusion, each patient's experience in following diet and fluid intake is different.
Keywords: Fluid Intake, Diet Intake, Hemodialysis
References
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Charles, C., & Ferris, A. H. (2020). Chronic Kidney Disease. Primary Care: Clinics in Office Practice, 47(4), 585–595. https://doi.org/10.1016/j.pop.2020.08.001
Dalvi, V., & Mekoth, N. (2017). Patient Non-Dherence: An Interpretative Phenomenological Analysis. International Journal of Health Care Quality Assurance, 30(3), 274–284. https://doi.org/10.1108/IJHCQA-03-2016-0033
Daniels, G. B., Robinson, J. R., & Walker, C. A. (2018). Adherence to Treatment by African Americans Undergoing Hemodialysis. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 45(6), 561–568. https://www.proquest.com/openview/de7428dbd76391e83e69a0efce737a35/1?pq-origsite=gscholar&cbl=45638
Decaux, G., Musch, W., Kengne, F. G., Couturier, B., Soupart, A., & Vandergheynst, F. (2020). Low-Solute Intake in Chronic Asymptomatic Hyponatraemia Related to Syndrome of Inappropriate Secretion of ADH (SIADH): Think about Food Beyond Water Intake! Nephrology Dialysis Transplantation, 35(11), 2013–2014. https://doi.org/10.1093/ndt/gfaa147
Di-Iorio, B. R., Bellasi, A., Raphael, K. L., Santoro, D., Aucella, F., Garofano, L., Ceccarelli, M., Di Lullo, L., Capolongo, G., Di Iorio, M., Guastaferro, P., & Capasso, G. (2019). Treatment of Metabolic Acidosis with Sodium Bicarbonate Delays Progression of Chronic Kidney Disease: The UBI Study. Journal of Nephrology, 32(6), 989–1001. https://doi.org/10.1007/s40620-019-00656-5
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Hecking, M., McCullough, K. P., Port, F. K., Bieber, B., Morgenstern, H., Yamamoto, H., Suri, R. S., Jadoul, M., Gesualdo, L., Perl, J., & Robinson, B. M. (2019). Self-Reported Urine Volume in Hemodialysis Patients: Predictors and Mortality Outcomes in the International Dialysis Outcomes and Practice Patterns Study (DOPPS). American Journal of Kidney Diseases, 74(3), 425–428. https://doi.org/10.1053/j.ajkd.2019.02.012
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Kim, S., & Yang, J. (2021). An Alternative View of a Hemodialysis–Life Balance: Life Reorganization of Korean Patients Undergoing Hemodialysis. Journal of Transcultural Nursing, 32(6), 664–671. https://doi.org/10.1177/1043659620988339
Ladesvita, F., & Sukmarini, L. (2019). Berat Badan Interdialisis terhadap Adekuasi Hemodialisa pada Pasien Hemodialisa Kronik. Jurnal Keperawatan Widya Gantari Indonesia, 3(1), 1–6. https://doi.org/10.52020/jkwgi.v3i1.1080
Lazarus, E. R. (2019). Effectiveness of Education and Exercise on Quality of Life among Patients Undergoing Hemodialysis. Clinical Epidemiology and Global Health, 7(3), 402–408. https://doi.org/10.1016/j.cegh.2018.07.003
Lee, E. J., Chang, A. K., & Chung, Y. C. (2021). Socioecological Factors Affecting Fluid Restriction Adherence Among Korean Patients Receiving Hemodialysis: A Qualitative Study. Journal of Transcultural Nursing, 32(3), 239–247. https://doi.org/10.1177/1043659620919162
Mahjubian, A., Bahraminejad, N., & Kamali, K. (2018). The Effects of Group Discussion Based Education on the Promotion of Self-Management Behaviors in Hemodialysis Patients. Journal of Caring Sciences, 7(4), 225–232. https://doi.org/10.15171/jcs.2018.034
Mailani, F., Muthia, R., Herien, Y., Huriani, E., Chan, C. M., & Abdullah, K. L. (2021 Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study. Nurse Media Journal of Nursing, 11(3), 389–403. https://doi.org/10.14710/nmjn.v11i3.38838
Maimani, Y. Al, Elias, F., Salmi, I. Al, Aboshakra, A., Alla, M. A., & Hannawi, S. (2021). Interdialytic Weight Gain in Hemodialysis Patients: Worse Hospital Admissions and Intradialytic Hypotension. Open Journal of Nephrology, 11(02), 156–170. https://doi.org/10.4236/ojneph.2021.112013
Mansouri, S., Jalali, A., Rahmati, M., & Salari, N. (2020). Educational Supportive Group Therapy and the Quality of Life of Hemodialysis Patients. BioPsychoSocial Medicine, 14(27), 1–10. https://doi.org/10.1186/s13030-020-00200-z
Maqhfirah, D., & Ginting, D. A. B. (2021). The Relationship between Social Support and the Meaning of Life in Patients Undergoing Hemodialysis at the Special Kidney Hospital Medan. International Research Journal of Advanced Engineering and Science, 6(1), 301–305. http://irjaes.com/wp-content/uploads/2021/03/IRJAES-V6N1P240Y21.pdf
Matarese, M., Lommi, M., De Marinis, M. G., & Riegel, B. (2018). A Systematic Review and Integration of Concept Analyses of Self-Care and Related Concepts. Journal of Nursing Scholarship, 50(3), 296–305. https://doi.org/10.1111/jnu.12385
Matsuzawa, R., & Roshanravan, B. (2018). Management of Physical Frailty in Patients Requiring Hemodialysis Therapy. Contributions to Nephrology, 196, 101–109. https://doi.org/10.1159/000485707
Mochizuki, Y., Harada, H., Yokokawa, M., Kinoshita, N., Kubota, K., Okado, T., & Fukayama, H. (2018). Oral and Maxillofacial Surgery in Patients Undergoing Dialysis for Advanced Renal Disease: Report of Five Cases. BMC Oral Health, 18(166), 1–10. https://doi.org/10.1186/s12903-018-0634-z
Mousa, D., Alharbi, A., Helal, I., Al-homrany, M., Alhujaili, F., Alhweish, A., Marie, M. A., & Al Sayyari, A. (2021). Prevalence and Associated Factors of Chronic Kidney Disease among Relatives of Hemodialysis Patients in Saudi Arabia. Kidney International Reports, 6(3), 817–820. https://doi.org/10.1016/j.ekir.2020.12.029
Murali, K. M., Mullan, J., Roodenrys, S., Hassan, H. C., Lambert, K., & Lonergan, M. (2019). Strategies to Improve Dietary, Fluid, Dialysis or Medication Adherence in Patients with End Stage Kidney Disease on Dialysis: A Systematic Review and Meta-Analysis of Randomized Intervention Trials. PLoS ONE, 14(1), 1-27. https://doi.org/10.1371/journal.pone.0211479
Neto, M. G., de Lacerda, F. F. R., Lopes, A. A., Martinez, B. P., & Saquetto, M. B. (2018). Intradialytic Exercise Training Modalities on Physical Functioning and Health-Related Quality of Life in Patients Undergoing Maintenance Hemodialysis: Systematic Review and Meta-Analysis. Clinical Rehabilitation, 32(9), 1189–1202. https://doi.org/10.1177/0269215518760380
Opiyo, R.O., Nyawade, S. A., McCaul, M., Nyasulu, P. S., Lango, D. B., Were, A. J. O., Nabakwe, E. C., Bukania, Z. N., & Olenja, J. M. (2020). Perceptions on Adherence to Dietary Prescriptions for Adults with Chronic Kidney Disease on Hemodialysis: A Qualitative Study. Diseases, 8(3), 1-16. https://doi.org/10.3390/diseases8030029
Papastergiou, D., Kokaridas, D., Bonotis, K., Diggelidis, N., & Patsiaouras, A. (2018). Exercise, Supportive Group Therapy, and Mood Profile of Greek Cancer Patients: Intervention Effect and Related Comparisons. Supportive Care in Cancer, 26, 3571–3578. https://doi.org/10.1007/s00520-018-4219-9
Parker, J. R. (2019). Use of an Educational Intervention to Improve Fluid Restriction Adherence in Patients on Hemodialysis. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 46(1), 43–48. https://www.proquest.com/openview/62d8cdd8c77c5e89d059ac41125e3ed6/1?pq-origsite=gscholar&cbl=45638
Picariello, F., Moss-Morris, R., Macdougall, I. C., & Chilcot, J. (2018). ‘It’s When You’re Not Doing Too Much You Feel Tired’: A Qualitative Exploration of Fatigue in End-Stage Kidney Disease. British Journal of Health Psychology, 23(2), 311–333. https://doi.org/10.1111/bjhp.12289
Ratnasari, D. (2020). Hubungan Lama Hemodialisa dengan Status Nutrisi pada Pasien Gagal Ginjal Kronik di Ruang Hemodialisa. Jurnal Skolastik Keperawatan, 6(1), 16–23. https://doi.org/10.35974/jsk.v6i1.2321
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Sanyaolu, A., Okorie, C., Annan, R., Turkey, H., Akhtar, N., Gray, F., Hamdy, K., Isina, A., Maharjan, G., Maghroudi, W., & Nwaduwa, I. C. (2018). Epidemiology and Management of Chronic Renal Failure: a Global Public Health Problem. Biostatistics and Epidemiology International Journal, 1(1), 11–16. https://doi.org/10.30881/beij.00005
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Shahgholian, N., & Yousefi, H. (2018). The Lived Experiences of Patients Undergoing Hemodialysis with the Concept of Care: A Phenomenological Study. BMC Nephrology, 19(338), 1–7. https://doi.org/10.1186/s12882-018-1138-4
Stevenson, J., Tong, A., Gutman, T., Campbell, K. L., Craig, J. C., Brown, M. A., & Lee, V. W. (2018). Experiences and Perspectives of Dietary Management among Patients on Hemodialysis: An Interview Study. Journal of Renal Nutrition, 28(6), 411–421. https://doi.org/10.1053/j.jrn.2018.02.005
Taylor, K. S., Umeukeje, E. M., Santos, S. R., McNabb, K. C., Crews, D. C., & Hladek, M. D. (2022). Context Matters: A Qualitative Synthesis of Adherence Literature for People on Hemodialysis. Kidney360. https://doi.org/10.34067/kid.0005582022
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Başer, E., & Mollaoğlu, M. (2019). The Effect of a Hemodialysis Patient Education Program on Fluid Control and Dietary Compliance. Hemodialysis International, 23(3), 392–401. https://doi.org/10.1111/hdi.12744
CDC. (2021). Chronic Kidney Disease in the United States, 2021. https://www.cdc.gov/kidneydisease/pdf/Chronic-Kidney-Disease-in-the-US-2021-h.pdf
Charles, C., & Ferris, A. H. (2020). Chronic Kidney Disease. Primary Care: Clinics in Office Practice, 47(4), 585–595. https://doi.org/10.1016/j.pop.2020.08.001
Dalvi, V., & Mekoth, N. (2017). Patient Non-Dherence: An Interpretative Phenomenological Analysis. International Journal of Health Care Quality Assurance, 30(3), 274–284. https://doi.org/10.1108/IJHCQA-03-2016-0033
Daniels, G. B., Robinson, J. R., & Walker, C. A. (2018). Adherence to Treatment by African Americans Undergoing Hemodialysis. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 45(6), 561–568. https://www.proquest.com/openview/de7428dbd76391e83e69a0efce737a35/1?pq-origsite=gscholar&cbl=45638
Decaux, G., Musch, W., Kengne, F. G., Couturier, B., Soupart, A., & Vandergheynst, F. (2020). Low-Solute Intake in Chronic Asymptomatic Hyponatraemia Related to Syndrome of Inappropriate Secretion of ADH (SIADH): Think about Food Beyond Water Intake! Nephrology Dialysis Transplantation, 35(11), 2013–2014. https://doi.org/10.1093/ndt/gfaa147
Di-Iorio, B. R., Bellasi, A., Raphael, K. L., Santoro, D., Aucella, F., Garofano, L., Ceccarelli, M., Di Lullo, L., Capolongo, G., Di Iorio, M., Guastaferro, P., & Capasso, G. (2019). Treatment of Metabolic Acidosis with Sodium Bicarbonate Delays Progression of Chronic Kidney Disease: The UBI Study. Journal of Nephrology, 32(6), 989–1001. https://doi.org/10.1007/s40620-019-00656-5
Glyde, M., Keane, D., Dye, L., & Sutherland, E. (2019). Patients’ Perceptions of Their Experience, Control and Knowledge of Fluid Management When Receiving Haemodialysis. Journal of Renal Care, 45(2), 83–92. https://doi.org/10.1111/jorc.12275
Hecking, M., McCullough, K. P., Port, F. K., Bieber, B., Morgenstern, H., Yamamoto, H., Suri, R. S., Jadoul, M., Gesualdo, L., Perl, J., & Robinson, B. M. (2019). Self-Reported Urine Volume in Hemodialysis Patients: Predictors and Mortality Outcomes in the International Dialysis Outcomes and Practice Patterns Study (DOPPS). American Journal of Kidney Diseases, 74(3), 425–428. https://doi.org/10.1053/j.ajkd.2019.02.012
Jacobson, J., Ju, A., Baumgart, A., Unruh, M., O’Donoghue, D., Obrador, G., Craig, J. C., Dapueto, J. M., Dew, M. A., Germain, M., Fluck, R., Davison, S. N., Jassal, S. V., Manera, K., Smith, A. C., & Tong, A. (2019). Patient Perspectives on the Meaning and Impact of Fatigue in Hemodialysis: A Systematic Review and Thematic Analysis of Qualitative Studies. American Journal of Kidney Diseases, 74(2), 179–192. https://doi.org/10.1053/j.ajkd.2019.01.034
Jones, D. J. W., Harvey, K., Harris, J. P., Butler, L. T., & Vaux, E. C. (2018). Understanding the Impact of Haemodialysis on UK National Health Service Patients’ Well-Being: A Qualitative Investigation. Journal of Clinical Nursing, 27(1–2), 193–204. https://doi.org/10.1111/jocn.13871
Kim, S., & Yang, J. (2021). An Alternative View of a Hemodialysis–Life Balance: Life Reorganization of Korean Patients Undergoing Hemodialysis. Journal of Transcultural Nursing, 32(6), 664–671. https://doi.org/10.1177/1043659620988339
Ladesvita, F., & Sukmarini, L. (2019). Berat Badan Interdialisis terhadap Adekuasi Hemodialisa pada Pasien Hemodialisa Kronik. Jurnal Keperawatan Widya Gantari Indonesia, 3(1), 1–6. https://doi.org/10.52020/jkwgi.v3i1.1080
Lazarus, E. R. (2019). Effectiveness of Education and Exercise on Quality of Life among Patients Undergoing Hemodialysis. Clinical Epidemiology and Global Health, 7(3), 402–408. https://doi.org/10.1016/j.cegh.2018.07.003
Lee, E. J., Chang, A. K., & Chung, Y. C. (2021). Socioecological Factors Affecting Fluid Restriction Adherence Among Korean Patients Receiving Hemodialysis: A Qualitative Study. Journal of Transcultural Nursing, 32(3), 239–247. https://doi.org/10.1177/1043659620919162
Mahjubian, A., Bahraminejad, N., & Kamali, K. (2018). The Effects of Group Discussion Based Education on the Promotion of Self-Management Behaviors in Hemodialysis Patients. Journal of Caring Sciences, 7(4), 225–232. https://doi.org/10.15171/jcs.2018.034
Mailani, F., Muthia, R., Herien, Y., Huriani, E., Chan, C. M., & Abdullah, K. L. (2021 Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study. Nurse Media Journal of Nursing, 11(3), 389–403. https://doi.org/10.14710/nmjn.v11i3.38838
Maimani, Y. Al, Elias, F., Salmi, I. Al, Aboshakra, A., Alla, M. A., & Hannawi, S. (2021). Interdialytic Weight Gain in Hemodialysis Patients: Worse Hospital Admissions and Intradialytic Hypotension. Open Journal of Nephrology, 11(02), 156–170. https://doi.org/10.4236/ojneph.2021.112013
Mansouri, S., Jalali, A., Rahmati, M., & Salari, N. (2020). Educational Supportive Group Therapy and the Quality of Life of Hemodialysis Patients. BioPsychoSocial Medicine, 14(27), 1–10. https://doi.org/10.1186/s13030-020-00200-z
Maqhfirah, D., & Ginting, D. A. B. (2021). The Relationship between Social Support and the Meaning of Life in Patients Undergoing Hemodialysis at the Special Kidney Hospital Medan. International Research Journal of Advanced Engineering and Science, 6(1), 301–305. http://irjaes.com/wp-content/uploads/2021/03/IRJAES-V6N1P240Y21.pdf
Matarese, M., Lommi, M., De Marinis, M. G., & Riegel, B. (2018). A Systematic Review and Integration of Concept Analyses of Self-Care and Related Concepts. Journal of Nursing Scholarship, 50(3), 296–305. https://doi.org/10.1111/jnu.12385
Matsuzawa, R., & Roshanravan, B. (2018). Management of Physical Frailty in Patients Requiring Hemodialysis Therapy. Contributions to Nephrology, 196, 101–109. https://doi.org/10.1159/000485707
Mochizuki, Y., Harada, H., Yokokawa, M., Kinoshita, N., Kubota, K., Okado, T., & Fukayama, H. (2018). Oral and Maxillofacial Surgery in Patients Undergoing Dialysis for Advanced Renal Disease: Report of Five Cases. BMC Oral Health, 18(166), 1–10. https://doi.org/10.1186/s12903-018-0634-z
Mousa, D., Alharbi, A., Helal, I., Al-homrany, M., Alhujaili, F., Alhweish, A., Marie, M. A., & Al Sayyari, A. (2021). Prevalence and Associated Factors of Chronic Kidney Disease among Relatives of Hemodialysis Patients in Saudi Arabia. Kidney International Reports, 6(3), 817–820. https://doi.org/10.1016/j.ekir.2020.12.029
Murali, K. M., Mullan, J., Roodenrys, S., Hassan, H. C., Lambert, K., & Lonergan, M. (2019). Strategies to Improve Dietary, Fluid, Dialysis or Medication Adherence in Patients with End Stage Kidney Disease on Dialysis: A Systematic Review and Meta-Analysis of Randomized Intervention Trials. PLoS ONE, 14(1), 1-27. https://doi.org/10.1371/journal.pone.0211479
Neto, M. G., de Lacerda, F. F. R., Lopes, A. A., Martinez, B. P., & Saquetto, M. B. (2018). Intradialytic Exercise Training Modalities on Physical Functioning and Health-Related Quality of Life in Patients Undergoing Maintenance Hemodialysis: Systematic Review and Meta-Analysis. Clinical Rehabilitation, 32(9), 1189–1202. https://doi.org/10.1177/0269215518760380
Opiyo, R.O., Nyawade, S. A., McCaul, M., Nyasulu, P. S., Lango, D. B., Were, A. J. O., Nabakwe, E. C., Bukania, Z. N., & Olenja, J. M. (2020). Perceptions on Adherence to Dietary Prescriptions for Adults with Chronic Kidney Disease on Hemodialysis: A Qualitative Study. Diseases, 8(3), 1-16. https://doi.org/10.3390/diseases8030029
Papastergiou, D., Kokaridas, D., Bonotis, K., Diggelidis, N., & Patsiaouras, A. (2018). Exercise, Supportive Group Therapy, and Mood Profile of Greek Cancer Patients: Intervention Effect and Related Comparisons. Supportive Care in Cancer, 26, 3571–3578. https://doi.org/10.1007/s00520-018-4219-9
Parker, J. R. (2019). Use of an Educational Intervention to Improve Fluid Restriction Adherence in Patients on Hemodialysis. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 46(1), 43–48. https://www.proquest.com/openview/62d8cdd8c77c5e89d059ac41125e3ed6/1?pq-origsite=gscholar&cbl=45638
Picariello, F., Moss-Morris, R., Macdougall, I. C., & Chilcot, J. (2018). ‘It’s When You’re Not Doing Too Much You Feel Tired’: A Qualitative Exploration of Fatigue in End-Stage Kidney Disease. British Journal of Health Psychology, 23(2), 311–333. https://doi.org/10.1111/bjhp.12289
Ratnasari, D. (2020). Hubungan Lama Hemodialisa dengan Status Nutrisi pada Pasien Gagal Ginjal Kronik di Ruang Hemodialisa. Jurnal Skolastik Keperawatan, 6(1), 16–23. https://doi.org/10.35974/jsk.v6i1.2321
Rhee, S. Y., Song, J. K., Hong, S. C., Choi, J. W., Jeon, H. J., Shin, D. H., Ji, E. H., Choi, E. H., Lee, J., Kim, A., Choi, S. W., & Oh, J. (2019). Intradialytic Exercise Improves Physical Function and Reduces Intradialytic Hypotension and Depression in Hemodialysis Patients. Korean Journal of Internal Medicine, 34(3), 588–598. https://doi.org/10.3904/kjim.2017.020
Sanyaolu, A., Okorie, C., Annan, R., Turkey, H., Akhtar, N., Gray, F., Hamdy, K., Isina, A., Maharjan, G., Maghroudi, W., & Nwaduwa, I. C. (2018). Epidemiology and Management of Chronic Renal Failure: a Global Public Health Problem. Biostatistics and Epidemiology International Journal, 1(1), 11–16. https://doi.org/10.30881/beij.00005
Saran, R., Robinson, B., Abbott, K. C., Agodoa, L. Y. C., Bhave, N., Bragg-Gresham, J., Balkrishnan, R., Dietrich, X., Eckard, A., Eggers, P. W., Gaipov, A., Gillen, D., Gipson, D., Hailpern, S. M., Hall, Y. N., Han, Y., He, K., Herman, W., Heung, M., Hirth, R. A., & Shahinian, V. (2018). US Renal Data System 2017 Annual Data Report: Epidemiology of Kidney Disease in the United States. AJKD: American Journal of Kidney Diseases, 71(3). https://doi.org/10.1053/j.ajkd.2018.01.002
Shahgholian, N., & Yousefi, H. (2018). The Lived Experiences of Patients Undergoing Hemodialysis with the Concept of Care: A Phenomenological Study. BMC Nephrology, 19(338), 1–7. https://doi.org/10.1186/s12882-018-1138-4
Stevenson, J., Tong, A., Gutman, T., Campbell, K. L., Craig, J. C., Brown, M. A., & Lee, V. W. (2018). Experiences and Perspectives of Dietary Management among Patients on Hemodialysis: An Interview Study. Journal of Renal Nutrition, 28(6), 411–421. https://doi.org/10.1053/j.jrn.2018.02.005
Taylor, K. S., Umeukeje, E. M., Santos, S. R., McNabb, K. C., Crews, D. C., & Hladek, M. D. (2022). Context Matters: A Qualitative Synthesis of Adherence Literature for People on Hemodialysis. Kidney360. https://doi.org/10.34067/kid.0005582022
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