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Kidney Week

Abstract: FR-PO520

Patient Perspectives on the Training and Early Initiation Phase of Peritoneal Dialysis

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Knapp, Christopher D., Hennepin Healthcare, Minneapolis, Minnesota, United States
  • Reule, Scott, VISN 23 VA Midwest Health Care Network, Minneapolis, Minnesota, United States
  • Johansen, Kirsten L., Hennepin Healthcare, Minneapolis, Minnesota, United States
  • Hart, Allyson, Hennepin Healthcare, Minneapolis, Minnesota, United States
Background

Patients initiating peritoneal dialysis are at higher risk for PD catheter dysfunction, peritonitis, and transfer to hemodialysis during the first 90 days of treatment, making it an important window to target interventions to reduce PD failure rates. However, qualitative data on patient perspectives and barriers during this time is lacking.

Methods

25 semi-structured interviews of incident PD patients were conducted from six dialysis centers in the Minneapolis area. Participants were interviewed during the last week of their PD training and re-interviewed approximately 90 days after initiation. A grounded theory approach was used to develop an interview codebook and identify themes.

Results

The first theme that emerged is “mismatched concerns between patients and family”. Patients’ concerns were oriented towards maximizing independence whereas family members were concerned about medical safety. The second theme is “Comfort with process of PD training.” Patients reported comfort with the technical aspects of PD during their training period or confidence asking for help. The third theme is “Surprising negative experiences”. Unexpected negative experiences that were not discussed prior to starting PD caused patients stress. The fourth theme is “Coping strategies to overcome barriers”. Patients reported that focusing on expected long term benefits of PD and talking to peer mentors helped them. The fifth theme is “Expected benefits of starting peritoneal dialysis”. Patients reported that PD would allow them to maintain their roles within their family and community and improve their sense of ownership about their health.

Conclusion

Better preparing patients for potential negative medical experiences with starting PD and improving communication between patients and their families could be targets to improve the patient experience during PD training. A focus on coping strategies and expected benefits of PD could be useful strategies for peer mentorship and provider to patient communication in this period.

Funding

  • Private Foundation Support