SO005BARRIERS TO PERITONEAL DIALYSIS IN SASKATCHEWAN CANADA: RESULTS FROM A PROVINCE WIDE SURVEY
Notice bibliographique
Résumé
Abstract Background and Aims Peritoneal dialysis (PD) offers similar clinical outcomes to hemodialysis (HD) at a fraction of the cost. PD remains underutilized as remote HD patients in the province of Saskatchewan often relocate or travel hundreds of kilometers weekly in order to receive dialysis related care. Many barriers to patient uptake of PD have been described, but the scale of their impact on our patient population have not been quantified. To improve uptake of peritoneal dialysis in Saskatchewan, we need to address the most prominent barriers to patient access to PD to ensure that they truly have a choice in determining the modality with which they choose to dialyze. The purpose of this study was to determine the barriers to receiving PD in Saskatchewan Method We conducted a cross sectional survey of in-center HD patients across the province of Saskatchewan, Canada. A total of 740 in-center HD patients at two academic sites and 7 satellite units were approached by study coordinators. 421 patients (n=268 in the main units and n=153 in the satellite units) agreed to participate in the study. A questionnaire using a five-point Likert scale was created to identify barriers to PD with questions addressing PD awareness and knowledge, accessibility, and risks, fears, beliefs surrounding PD. Responses were anonymous and tabulated using a data collection tool. Survey data were summarized using descriptive statistics. Results 45.9% of participants had more than 12 years of formal education. 11% lived on farm, 19% on reserve, and 71% in town/city. The median (interquartile range=IQR) distance of home to in-center dialysis units was 10 (5-70) kilometers. Only 82% of patients were aware of PD as a treatment option. 35% of patients felt they had no understanding of the benefits or risks of PD. Despite only 13% of patients being told they were unsuitable for PD by their nephrologist, approximately half (47%) had ever considered it as a treatment option. Prominent barriers to PD that we identified were: excellent care in the HD unit (62%), proximity to dialysis unit (41%), unwilling to dialyze daily (36%), and unwilling to learn a new technique (34%). Beliefs held by patients that figured prominently in their decision to choose HD over PD included not wanting to take their disease home (32%), fear of being a burden on family (32%), lack of space (28%), risk of infection, issues with self-image while on PD, and PD being an inferior modality to HD (all approximately 24%). Conclusion Several barriers to PD were identified with a few consistent themes being identified, including deficiencies in knowledge, patient specific beliefs, poor patient education, and perceived benefits of in-center care (satisfaction with current care). The most frequently reported knowledge barrier was a lack of understanding of benefits and risks of PD. These findings suggest that not enough patients are receiving formal education, or active involvement in deciding which modality they would be most suitable for them when initiating dialysis. To improve uptake of PD in Saskatchewan, we will have to generate both increased awareness of PD as a treatment modality, alongside improved educational strategies to enable patients to make an informed choice about how they receive renal replacement therapy. While the study does not reflect the views of all patients, the information gained will be valuable in designing an educational program to improve adoption of PD within our province.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,006 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».