Longitudinal Changes in the Use of Peritoneal Dialysis Assistance for Patients Maintained on Peritoneal Dialysis
Bibliographic record
Abstract
Background: Home dialysis therapies such as peritoneal dialysis (PD) offer flexibility and improved wellbeing for older individuals. However, a substantial proportion require assistance with personal care and health self-management. The study objective was to assess whether the nature of, and need for, assistance with PD management tasks changes over time. We hypothesized that patients and families would require less assistance as they became more familiar with PD management. Methods: Using a multicentred, prospective observational study design, we recruited patients aged ≥50 years initiating PD. Patients underwent formal evaluation at baseline using validated components of a Comprehensive Geriatric Assessment. They then completed a monthly questionnaire for 6 months about their need for assistance with PD management tasks. Results: 111 patients (age 69 ± 10 years, 68% male, 56% diabetic) were followed for a total of 609 patient-months. Assistance for PD management tasks remained generally stable throughout follow-up, and did not vary according to age, frailty, functional dependence or cognitive impairment. The proportion of patients needing assistance varied widely across the 13 different PD management tasks, but the proportion of patients needing help for each task remained relatively stable across time (Figure 1). Of those who needed assistance, 40% had help from a family member and 33% were helped by nurses. The family/nurse caregiver ratio for the different tasks did not change over time. Conclusions: Older patients initiating PD, in the outpatient setting, have a high need for assistance with PD-related tasks which appears to persist over the initial 6-month period. It emphasizes the importance of starting discussions early, and addressing advance care plans, goals and most importantly expectations, as patients approach dialysis initiation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".