与腹膜透析患者获得护士协助相关的因素：来自法语腹膜透析登记处的队列研究。
Factors associated with nurse assistance among peritoneal dialysis patients: a cohort study from the French Language Peritoneal Dialysis Registry.
机构信息
Service de Néphrologie, CHU de Caen, Caen Cedex 9, France.
Registre de Dialyse Péritonéale de Langue Française, Pontoise, France.
出版信息
Nephrol Dial Transplant. 2018 Aug 1;33(8):1446-1452. doi: 10.1093/ndt/gfx338.
BACKGROUND
No information is available regarding nurse-assisted peritoneal dialysis (PD) in non-elderly subjects. This study was carried out to estimate the rate of nurse-assisted PD among non-elderly patients and to assess which individual and centre factors were associated with nurse-assisted PD. The other objective was to estimate the magnitude of the centre effect on the utilization of nurse-assisted PD using hierarchical modelling.
METHODS
This was a retrospective study based on data from the French Language Peritoneal Dialysis Registry. Patients incident on PD > 18 and < 65 years of age were included.
RESULTS
There were 2269 incidents of PD initiation between January 2008 and December 2012 in 127 PD centres with 114 (5%) on family-assisted PD and 272 (12%) on nurse-assisted PD. At the individual level, compared with autonomous patients, nurse assistance was associated with age {odds ratio [OR] 1.79 [95% confidence interval (CI) 1.51-2.13]}, gender [OR 0.47 (95% CI 0.35-0.64)], comorbidities and underlying nephropathy. There was significant heterogeneity between centres in the nurse assistance utilization (variance of random effect 0.12). At the centre level, the type of centre, centre experience, centre organization and private nurse density were not associated with nurse-assisted PD.
CONCLUSIONS
The rate of nurse-assisted PD among non-elderly patients was 12%. There was a significant centre effect in the utilization of nurse assistance that was not explained by the centres' characteristics. Nurse-assisted PD utilization in non-elderly patients is associated with patient characteristics and also with centre practices.
背景
针对非老年患者的护士辅助腹膜透析（PD），目前尚无相关信息。本研究旨在评估非老年患者中护士辅助 PD 的比例，并评估与护士辅助 PD 相关的个体和中心因素。另一个目的是使用层次模型估计中心效应对护士辅助 PD 使用的影响程度。
方法
这是一项基于法国腹膜透析登记处数据的回顾性研究。纳入年龄大于 18 岁且小于 65 岁开始 PD 的患者。
结果
在 127 个 PD 中心，有 2269 例 PD 起始病例（2008 年 1 月至 2012 年 12 月），其中 114 例（5%）为家庭辅助 PD，272 例（12%）为护士辅助 PD。在个体水平上，与自主患者相比，护士辅助与年龄相关（优势比[OR] 1.79 [95%置信区间（CI）1.51-2.13]）、性别（OR 0.47 [95% CI 0.35-0.64]）、合并症和基础肾病有关。在护士辅助 PD 使用方面，中心间存在显著异质性（随机效应方差 0.12）。在中心水平上，中心类型、中心经验、中心组织和私人护士密度与护士辅助 PD 无关。
结论
非老年患者中护士辅助 PD 的比例为 12%。护士辅助 PD 的使用存在显著的中心效应，无法用中心特征来解释。非老年患者中护士辅助 PD 的使用与患者特征以及中心实践有关。
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