School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Clin J Am Soc Nephrol. 2011 Oct;6(10):2478-84. doi: 10.2215/CJN.03590411. Epub 2011 Aug 18.
Dialysis patients are among the most vulnerable patients during a disaster because they are sensitive to a lapse in treatment. Although thorough preparation could mitigate disaster effects, we hypothesized that dialysis patients' personal and medical disaster preparedness was inadequate.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This prevalence study surveyed mentally competent adults requiring care at six regional dialysis centers. We asked questions regarding demographics, general disaster preparedness utilizing Homeland Security recommended item lists, dialysis-specific preparation for an individual to shelter in place, and preparatory steps for a forced evacuation. To determine if preparedness differed by demographic variables (gender, race, age, and education) chi-squared tests were used.
Four hundred forty-two patients were approached, and 311 (70%) completed the survey. Participants were 54% male, 60% black, average age was 58 (± 15) years, and although 79% completed high school, 50% of our sample had marginal or low health literacy. Although all units had a disaster preparedness program in place, the general disaster preparedness of most participants was poor. Age, gender, race, education, literacy, and socioeconomic status did not affect general disaster preparedness. However, home peritoneal dialysis patients were significantly more likely to be prepared for a disaster compared with hemodialysis patients. No other significant associations were noted.
Irrespective of sociodemographic characteristics, most subjects were unprepared for a disaster. Dialysis patients were poorly prepared to shelter in place or to evacuate in the face of a disaster. Education regarding personal and dialysis-specific disaster preparedness is warranted.
在灾难期间,透析患者是最脆弱的患者之一,因为他们对治疗中断很敏感。尽管充分的准备可以减轻灾难的影响,但我们假设透析患者的个人和医疗灾难准备不足。
设计、设置、参与者和测量:这项患病率研究调查了在六个区域透析中心接受护理的有认知能力的成年人。我们询问了有关人口统计学、利用国土安全部推荐清单的一般灾难准备、个人就地避难的透析特定准备以及强制疏散的准备步骤的问题。为了确定准备情况是否因人口统计学变量(性别、种族、年龄和教育程度)而有所不同,我们使用了卡方检验。
共接触了 442 名患者,其中 311 名(70%)完成了调查。参与者中 54%为男性,60%为黑人,平均年龄为 58(±15)岁,尽管 79%完成了高中学业,但有 50%的样本健康素养较低或较差。尽管所有单位都制定了灾难准备计划,但大多数参与者的一般灾难准备情况较差。年龄、性别、种族、教育程度、读写能力和社会经济地位并没有影响一般灾难准备情况。然而,家庭腹膜透析患者比血液透析患者更有可能为灾难做好准备。没有发现其他显著的相关性。
无论社会人口统计学特征如何,大多数患者都对灾难毫无准备。透析患者在面对灾难时,就地避难或疏散的准备不足。需要教育患者有关个人和透析特定的灾难准备。