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Kidney Week

Abstract: TH-OR095

The Effect of Non-Visual Learning Preferences on Early Home Dialysis Adverse Events

Session Information

  • Home Dialysis
    November 07, 2019 | Location: 143, Walter E. Washington Convention Center
    Abstract Time: 05:54 PM - 06:06 PM

Category: Dialysis

  • 702 Dialysis: Home Hemodialysis

Authors

  • Auguste, Bourne L.A, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • Girsberger, Michael Yannik, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
  • Kennedy, Claire, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
  • Srithongkul, Thatsaphan, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
  • McGrath-Chong, Margaret E., Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
  • Bargman, Joanne M., Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
  • Chan, Christopher T., Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
Background

Current approaches to home dialysis training are not individualized according to patients’ learning preference. We hypothesize that visual learning preferences were associated with fewer adverse events in both peritoneal dialysis (PD) and home hemodialysis (HHD) patients within 6 months of training completion.

Methods

We performed a retrospective single centre cohort study at a large academic medical centre of prevalent HHD and PD patients. Patients received a VARK questionnaire at enrollment. VARK is a validated questionnaire that assesses a combination of individual learning preferences: visual (V), auditory (A), reading-writing (R) and Kinesthetic (K). Adverse events were defined as peritonitis, exit-site and tunnel infection, contamination episodes, access disruption along with needle dislodgement. We performed logistic regression analysis to determine the odds ratio of a single adverse event. We also performed multivariate cox regression analysis, adjusted for age, gender, modality, visual impairment, dialysis vintage, training duration and level of education.

Results

We enrolled 118 (78 HHD and 40 PD) patients with an average age of 52.0 ± 13.5 years. 38% (44) of study participants were non-visual learners. Thirty patients had at least one adverse event within 6 months of training completion; 63% (19) of these patients were non-visual learners. Non-visual learners were 4 times more likely to an adverse event, occurring sooner after training completion compared to visual learners (Table 1 & Figure 1).

Conclusion

Visual learning preference is associated with fewer adverse events in home dialysis patients within the first 6 months of completing training. Individualization of home dialysis training by learning preference is warranted.

Adverse Events
 Number of Patients
N (%)
Age (yrs,)
mean ± SD
Weeks of Training
mean ± SD
Patients with Any Adverse EventUnadjusted
OR
Adjusted OR
Visual Learners
(VARK, VAR, VAK, VRK, VK, VR, V)
74 (63)55.5 ± 14.46.6 ± 5.111 (36.7%)  
Non-Visual Learners
(ARK, AR, AK, K, R, RK)
44 (37)52 ± 146.2 ± 5.519 (63.3%)4.35 (1.82- 10.44)
P = 0.001
4.04 (1.44 – 11.34)
P= 0.008