Factors affecting uptake of home hemodialysis among self‐care dialysis unit patients

Abstract

Introduction: Superior outcomes have been reported among hemodialysis (HD) patients who take active control over their dialysis treatment either at self-care satellite dialysis units or home compared to the regular in-center hemodialysis patient. Although the differences between the home hemodialysis (HHD) and self-care in-center HD (SCHD) are not well described, the growing literature on the superior outcomes of HHD suggests that HHD is the better option. Methods: We performed a cross-sectional study in a stand-alone self-care unit to examine the differences in patients that are keen to consider HHD and those who are not. Findings: A cross-sectional sample of 44 patients completed a structured interview and the distress thermometer score used to assess psychological stress. Only 68% of patients reported to have heard about the benefits of HHD despite the long-established history and availability of the modality in the unit. One of the more critical findings in our study was that the cohort of patients who were keen to consider HHD believed that self-care and HHD would improve their quality of life (P < 0.05). Specifically, the perceived benefits stated by those willing to consider HHD were the lack of need to travel, association with better outcomes and the possibility of having the treatment in the comfort of home (P < 0.05). Discussion: We surmise that the answers expressed in this survey likely reflect a difference in perceptions of self-care and beliefs about HHD; hence, the importance of introducing HHD education earlier in the course of their chronic kidney disease journey.

Citizens’ perspectives on relocating care: a scoping review

“…Convenience was most often reported, from the citizens’ perspective, as an advantage of relocating care. This was true for all forms of relocation [ 27 – 30 , 32 – 34 , 38 , 41 , 42 , 45 , 47 , 49 , 52 – 54 , 58 – 60 , 65 – 67 , 69 , 70 , 73 , 78 , 82 , 84 – 86 , 88 , 90 , 93 , 94 ]. Citizens think of relocating as convenient because in most cases it saves travel time [ 26 , 29 , 53 ].…”

“…Convenience was also mentioned as a reason for not wanting to relocate care. This factor was especially mentioned when relocating from the hospital or GP to self-care [ 59 , 60 , 86 ]. With regard to home dialysis, some citizens said that they did not have the space at home to do this.…”

“…With regard to home dialysis, some citizens said that they did not have the space at home to do this. It was, therefore, not convenient [ 60 ]. In addition, for citizens living close to the hospital, self-care was sometimes more expensive and did not save time [ 59 , 86 ].…”

Risk assessment of failure during transitioning from in-centre to home haemodialysis

“…Older patients have also been reluctant to accept that dialysis treatments can be performed safely at home. Fortunately, with wider exposure and better health literacy over recent years, there are now an increasing number of patients keen to participate in HHD as a long-term dialysis modality [9][10][11].…”

Self-Effication in Relation to Personal Care and The Health-Related Quality of Life of Hemodialysis Patients

“…(3) such understanding will then lead to the improvement in their health-related quality of life, and (4) the chance of complications will be reduced, in turn reducing the mortality rate. 11 According to the moderate range theory of chronic illness, factors that influence self-care are experience and skills, motivation, beliefs and cultural values, and self-efficacy. Self-efficacy is the belief in a person's ability to successfully achieve something and is very important for managing chronic diseases like CKD.…”