Piccoli G B, Mezza E, Iadarola A M, Bechis F, Anania P, Vischi M, Iacuzzo C, Gai M, Martino B, Garofletti Y, Giraudo G, Jeantet A, Segoloni G P
Cattedra di Nefrologia, University of Turin, Italy.
Adv Perit Dial. 2000;16:186-90.
Therapeutic compliance and patient education are presently considered crucial parts of end-stage renal disease (ESRD) therapy. In the center where Italian home and self-care dialysis treatment started, an education program was designed as multi-step pathway--following patients from chronic renal failure to dialysis and eventual graft--employing lessons, booklets, and books. Each step was validated in various subsets of patients. Lessons involved two hours of informal discussion on the main aspects of ESRD and renal replacement therapy (RRT); booklets were created from tape recordings of the lessons. Patient participation was good, with 28 of 33 patients on charge in the center for 6 months or more taking part in more than one lesson in 1999. In 16 of 16 patients who answered a questionnaire after two lessons, expressed opinion was "good" to "fair." All asked for further material. With regard to books, 500 copies of the book What does dialysis mean? were given out in the region; this book was validated in 22 patients on peritoneal dialysis (PD) and 18 on hemodialysis (HD). It helped patients to accept dialysis in 65% of cases and to comprehend it in 90%. Four thousand copies of the book Stories, containing 18 interviews on transplantation, were printed, and this book was validated in 21 patients on self-care and 35 on hospital dialysis (potential candidates for graft). Of 56 patients, 53 asked for further material; 19 changed their initial opinion (10 choose transplantation, despite initial skepticism; 9 put off transplantation, despite initial acceptance). On a local scale, the program led 12 of 18 new patients, who followed at least part of the program, to choose self-dialysis (PD, home, and self-care dialysis).
治疗依从性和患者教育目前被视为终末期肾病（ESRD）治疗的关键部分。在意大利家庭和自我护理透析治疗起步的中心，设计了一个教育项目，作为多步骤路径——跟踪患者从慢性肾衰竭到透析以及最终移植——采用课程、小册子和书籍。每个步骤都在不同患者亚组中得到验证。课程包括两小时关于ESRD和肾脏替代治疗（RRT）主要方面的非正式讨论；小册子由课程录音制作而成。患者参与度良好，1999年中心33名接受治疗6个月或更长时间的患者中有28名参加了不止一堂课程。在16名上完两堂课后回答问卷的患者中，所有表达的意见都是“良好”到“尚可”。所有人都索要更多资料。关于书籍，该地区发放了500本《透析意味着什么？》这本书；这本书在22名腹膜透析（PD）患者和18名血液透析（HD）患者中得到验证。在65%的案例中它帮助患者接受了透析，在90%的案例中帮助患者理解了透析。印刷了4000本包含18个移植访谈的《故事》这本书，这本书在21名自我护理患者和35名医院透析患者（潜在移植候选人）中得到验证。在56名患者中，53名索要更多资料；19名改变了他们最初的看法（10名尽管最初持怀疑态度但选择了移植；9名尽管最初接受但推迟了移植）。在当地范围内，该项目使得18名至少部分参与了该项目的新患者中有12名选择了自我透析（PD、家庭和自我护理透析）。
