Abstract: SA-PO922

Patient Impressions of Hemodialysis and Peritoneal Dialysis

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Corapi, Kristin M., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Sorat, Warissara, university of Massachusetts Lowell, Lowell, Massachusetts, United States
  • Bhan, Ishir, None, West Newton, Massachusetts, United States
Background

It is established that the more a patient knows about peritoneal dialysis (PD), the more likely he is to select it. At our center, patients with advanced chronic kidney disease (CKD) are referred to a dialysis options visit with a nurse educator to learn about PD and hemodialysis (HD). In the current project, we spoke to CKD patients to collect feedback about the visit.

Methods

Patients with stage 4 or 5 chronic kidney disease (CKD) were invited to a semi-structured interview immediately following their education visit. The interviews were recorded and transcribed. Qualitative content analysis was conducted by two staff members using NVivo 11 software. Basic demographics were collected.

Results

The mean age of the 10 CKD patients interviewed was 62 years (SD = 9.4). 60% were female, 40% were married, and 40% were Caucasian. 40% were not educated beyond high school, 60% reported an annual income of < $20,000.

Most patients did research before their education appointment. This typically involved an internet search (n=7), however others also spoke to dialysis patients, talked with their doctors/nurses, and one patient visited a unit. Only three patients said they knew nothing about dialysis before the visit.

The patients interviewed displayed a preference for HD because of the perceived ease of therapy. The major advantages described were the schedule (with days off) and the fact that the therapy was delivered by others (the notion of just needing to show up). Only a minority of patients identified shortcomings of HD. One patient described the time commitment as a disadvantage and a few patients voiced concerns about the need for a fistula and needles.

PD in contrast was overwhelmingly viewed as a burdensome therapy. Patients were dismayed by the need to store supplies at home, to complete dialysis daily on their own, and the potential for infection. A couple of patients did not want the nurse to explain PD. Only two patients seemed to be considering PD as an option.

Conclusion

The patients interviewed displayed little confidence they would be able to successfully complete PD and were left with a negative impression. In contrast, there was little perceived downside to HD. These results may reflect the shortcomings of our current model of education. Further research is needed to determine different styles of education can overcome these barriers and improve utilization of PD.

Funding

  • Commercial Support