Hemodialysis patients' perceptions of home hemodialysis and self-care.

Home hemodialysis (HHD) is an optimal option for patients requiring renal replacement therapy. It has been noted through research that this type of therapy is more cost-effective than in-centre therapies, and the benefits to patients are well documented (Harwood & Leitch, 2006). As stated by the Ministry of Health and Long-Term Care (MoHLTC), a total of 40% of renal failure patients are expected to do home dialysis (either peritoneal dialysis or HHD) by the year 2010 (Kashani & Motiwala, 2007). Even though the literature indicates that the numbers of those doing home dialysis are declining every year, there is no evidence to demonstrate why the numbers are declining. A quantitative cross-sectional descriptive study was conducted using the Patient Perception Survey and the Jo Pre-Training Assessment Tool (JPAT) to assess in-centre hemodialysis patients' perceptions regarding home dialysis, as well as their self-care ability. The two frameworks utilized were the Theory of Planned Behavior and Orem's Theory of Self-Care. According to the Theory of Planned Behavior, the 26 patients out of 49 who had positive perceptions regarding home dialysis would be expected to participate in home dialysis. However, according to the patients' responses to the domains within the JPAT, only eight out of the 26 would be considered suitable to participate in home dialysis. Only two of the domains, communication and social support, were found to be significantly related to patients'perceptions regarding home dialysis. Health care professionals need to implement interventions that incorporate assessment of communication and social support when addressing home dialysis therapy with a patient with end-stage renal disease (ESRD).