Juergensen Erika, Wuerth Diane, Finkelstein Susan H, Juergensen Peter H, Bekui Ambek, Finkelstein Fredric O
Hospital of St. Raphael, Yale University and the Renal Research Institute, New Haven, Connecticut, USA.
Clin J Am Soc Nephrol. 2006 Nov;1(6):1191-6. doi: 10.2215/CJN.01220406. Epub 2006 Aug 30.
This study was undertaken to examine patient satisfaction with peritoneal dialysis (PD) and hemodialysis (HD) therapies, focusing attention on the positive and negative impact of the therapies on patients' lives. Patients were recruited from a free-standing PD unit and two free-standing HD units. A total of 94% (n = 62) of eligible PD and 84% (n = 84) of eligible HD patients participated. HD patients were significantly older and had higher Charlson Comorbidity Index scores than the PD patients, but there were no differences in duration of dialysis treatment, prevalence of diabetes, educational backgrounds, or home situations. Patients were asked to rate their overall satisfaction with and the overall impact of their dialysis therapy on their lives, using a 1 to 10 Likert scale. In addition, patients were asked to rate the impact of their therapy on 15 domains that had been cited previously as being important for patients' quality of life. The mean satisfaction score for PD patients (8.02 +/- 1.41) was higher than for HD patients (7.4 +/- 1.4; P = 0.15). PD patients indicated that there was less impact of the dialysis treatment on their lives globally (7.25 +/- 2.12 versus 6.19 +/- 2.83; P = 0.019). In addition, PD patients noted less impact of the therapy in 14 of the 15 domains examined. With the use of a proportional odds model analysis, the only significant predictor of overall satisfaction and impact of therapy was dialysis modality (P = 0.037 and P = 0.021, respectively). Patients also were asked to comment freely on the positive and negative effects of the dialysis treatments on their lives, and a taxonomy of patient perceptions and concerns was developed. This study suggests that PD patients in general are more satisfied with their overall care and believe that their treatment has less impact on their lives than HD patients.
本研究旨在调查患者对腹膜透析（PD）和血液透析（HD）治疗的满意度，重点关注这些治疗方法对患者生活的积极和消极影响。患者来自一个独立的腹膜透析单元和两个独立的血液透析单元。共有94%（n = 62）符合条件的腹膜透析患者和84%（n = 84）符合条件的血液透析患者参与了研究。血液透析患者的年龄显著大于腹膜透析患者，且Charlson合并症指数评分更高，但在透析治疗时长、糖尿病患病率、教育背景或家庭状况方面并无差异。患者被要求使用1至10的李克特量表对其透析治疗的总体满意度以及对生活的总体影响进行评分。此外，患者还被要求对其治疗在之前被认为对患者生活质量很重要的15个领域的影响进行评分。腹膜透析患者的平均满意度得分（8.02±1.41）高于血液透析患者（7.4±1.4；P = 0.15）。腹膜透析患者表示，透析治疗对其生活的总体影响较小（7.25±2.12对6.19±2.83；P = 0.019）。此外，在15个被检查的领域中，腹膜透析患者指出治疗在14个领域的影响较小。通过使用比例优势模型分析，治疗总体满意度和影响的唯一显著预测因素是透析方式（分别为P = 0.037和P = 0.021）。患者还被要求自由评论透析治疗对其生活的积极和消极影响，并制定了患者认知和担忧的分类。本研究表明，总体而言，腹膜透析患者对其整体护理更满意，并认为其治疗对生活的影响小于血液透析患者。
