Design of therapeutic education workshops for home haemodialysis in a patient-centered chronic kidney diseases research: a qualitative study

Abdallah Guerraoui,Pierre Sauvajon,Odile Didier,Flora Belkahla-Delabruyere,Fréderic Riquier,Agnes Caillette-Beaudoin,Veronique Berger,Christian Serve,Jean Charles Zuriaga,Roula Galland

doi:10.1186/s12882-022-02683-0

Abstract

Rationale & ObjectiveA quarter of patients do not receive any information on the modalities of renal remplacement therapy (RRT) before its initiation. In our facility, we provide therapeutic education workshops for all RRT except for home hemodialysis (HHD). The objectives of this study were to identify and describe the needs of CKD patients and caregivers for RRT with HHD and design therapeutic education workshops.Setting & participantsTwo sequential methods of qualitative data collection were conducted. Interviews with patients treated with HHD and doctors specialized in HHD were performed to define the interview guide followed by semi-structured interviews with the help of HHD patients from our center.Analytic approachThematic analysis was conducted and were rooted in the principles of qualitative analysis for social scientists. Data were analyzed by two investigators. Transcribed interviews were entered into RQDA 3.6.1 software for data organization and coding purposes (Version 3.6.1).ResultsIn total, five interviews were performed. We identified six themes related to the barriers, facilitators, and potential solutions to home dialysis therapy: (1) HHD allows autonomy and freedom with constraints, (2) safety of the care environment, (3) the caregiver and family environment, (4) patient’s experience and experiential knowledge, (5) self-care experience and impact on life, and (6) factors that impact the choice of treatment with HHD. We designed therapeutic education workshops in a group of patients and caregivers.ConclusionsOur study confirmed previous results obtained in literature on the major barriers, facilitators, and potential solutions to HHD including the impact of HHD on the caregiver, the experiences of patients already treated with HHD, and the role of nurses and nephrologists in informing and educating patients. A program to develop patient-to-patient peer mentorship allowing patients to discuss their dialysis experience may be relevant.

Highlights

Kidney transplantation is the best renal remplacement therapy (RRT) option for many patients with endstage renal disease (ESRD)
We identified six themes related to the barriers, facilitators, and potential solutions to home dialysis therapy: (1) home haemodialysis (HHD) allows autonomy and freedom with constraints, (2) safety of the care environment, (3) the caregiver and family environment, (4) patient’s experience and experiential knowledge, (5) self-care experience and impact on life, and (6) factors that impact the choice of treatment with HHD
Our study confirmed previous results obtained in literature on the major barriers, facilitators, and potential solutions to HHD including the impact of HHD on the caregiver, the experiences of patients already treated with HHD, and the role of nurses and nephrologists in informing and educating patients

Summary

Introduction

Kidney transplantation is the best renal remplacement therapy (RRT) option for many patients with endstage renal disease (ESRD). Guerraoui et al BMC Nephrology (2022) 23:53 need to spend time on dialysis prior to transplantation or when a transplant fails [1,2,3,4,5]. The quality of life and treatment satisfaction are higher with home haemodialysis (HHD). – Autonomy at home – Patients Control the flexibility of their dialysis schedule, – Lowers mortality and morbidity. – Eliminates transportation to dialysis centers, Reduces travel time/cost – Improves quality of life, patient mood, sleep, depression – More independence, personal freedom, time for family and community engagement – Enhances ability to work – reduces fatigue – The Patients who benefit from this system feel much less tired – Autonomy at home – Patients Control the flexibility of their dialysis schedule, – Lowers mortality and morbidity. – Eliminates transportation to dialysis centers, Reduces travel time/cost – Improves quality of life, patient mood, sleep, depression – More independence, personal freedom, time for family and community engagement – Enhances ability to work – reduces fatigue – The Patients who benefit from this system feel much less tired

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Conclusion