The Associations between the Family Education and Mortality of Patients on Peritoneal Dialysis

Abstract

AimsTo investigate whether education level of family members predicts all-cause and cardiovascular death and initial-episode peritonitis in patients on peritoneal dialysis (PD).MethodsA total of 2264 patients on chronic PD were collected from seven centers affiliated with the Socioeconomic Status on the Outcome of Peritoneal Dialysis (SSOP) Study. All demographic, socioeconomic and laboratory data of patients and the education level of all family members were recorded at baseline. Multivariate Cox regression was used to calculate the hazard ratio (HR) of all-cause and cardiovascular mortality, and initial-episode peritonitis with adjustments for recognized traditional factors.ResultsThere were no significant differences in baseline characteristics between patients with (n = 1752) and without (n = 512) complete education information. According to the highest education level of patients' family, included 1752 patients were divided into four groups, i.e. elementary or lower (15%), middle (27%), high (24%) and more than high school (34%). The family highest education (using elementary school or lower group as reference, hazard ratio and 95% confidence interval of middle school group, high school group and more than high school group was 0.68[0.48–0.96], 0.64[0.45–0.91], 0.66[0.48–0.91], respectively) rather than their average education level or patients' or spouse's education was significantly associated with the higher mortality. Neither patients' nor family education level did correlate to the risk for cardiovascular death or initial-episode peritonitis.ConclusionsFamily members' education level was found to be a novel predictor of PD outcome. Family, as the main source of health care providers, should be paid more attention in our practice.

‘Educational’ Deprivation is Associated with PD Peritonitis

“…Kim et al (28) showed that a ‘lower level of education’ (as defined by an academic background of ‘middle school or lower’) of the patients was an independent risk factor for PD-catheter-associated peritonitis and technique failure. Yang et al (29) discovered that the level of family members’ education strongly predicted PD outcome, with higher level of patient and family education being associated with significantly better outcomes following PD-catheter insertion. These are important findings which highlight the importance of good education for both patients and their family members.…”

Peritoneal dialysis practice in Australia and New Zealand: A call to sustain the action

“…89 The role and education of family and carers are highly relevant and should be included in this support. 90 To facilitate PD as a patient-preferred treatment, assisted PD should be considered as an option. 81,83 For patients residing in rural and remote locations, electronic communication methods could also be used for monitoring and support.…”

“…Over 60% of patients use PD outside of standard office hours, so providing 24 h support is essential for safe and effective care 7 days a week . The role and education of family and carers are highly relevant and should be included in this support . To facilitate PD as a patient‐preferred treatment, assisted PD should be considered as an option .…”

Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System

“…Yang et al . [10] emphasized that family members’ education level was important for mortality outcome of PD patients. There were conflicting results as regards the association between education level and PD outcomes.…”