Friberg Ingrid O, Mårtensson Lena, Haraldsson Börje, Krantz Gunilla, Määttä Sylvia, Järbrink Krister
Institute of Medicine, Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine, Sahlgrenska Academy, Gothenburg University, Sweden
Centre for Equity in Healthcare, Region Västra Götaland, Sweden.
Perit Dial Int. 2018 Sep-Oct;38(5):334-342. doi: 10.3747/pdi.2017.00243. Epub 2018 Jul 31.
Home-based dialysis, including peritoneal dialysis (PD) and home hemodialysis (HHD), has been shown to be associated with lower costs and higher health-related quality of life than in-center HD. However, factors influencing the choice of dialysis modality, including gender, are still not well understood.
A questionnaire was sent out to all dialysis patients in the western region of Sweden in order to investigate factors affecting choice of dialysis modality. Logistic regression was used to analyze the data.
Patients were more likely to have home dialysis if they received predialysis information from 3 or more sources and, to a greater extent, perceived the information as comprehensive and of high quality. In addition, patients had a lower likelihood of receiving home dialysis with increasing age and if they lived closer to a dialysis center. Men had in comparison with women a greater likelihood of receiving home dialysis if they lived with a spouse. In-center dialysis patients more often believed that the social interaction and support provided through in-center HD treatment influenced the choice of dialysis modality.
This study highlights the need for increased awareness of various factors that influence the choice of dialysis modality and the importance of giving repeated, comprehensive, high-quality information to dialysis and predialysis patients and their relatives. Information and support must be adapted to the needs of individual patients and their relatives if the intention is to improve patients' well-being and the proportion of patients using home dialysis.
家庭透析，包括腹膜透析（PD）和家庭血液透析（HHD），已被证明与中心血液透析相比，成本更低，健康相关生活质量更高。然而，影响透析方式选择的因素，包括性别，仍未得到充分理解。
向瑞典西部地区的所有透析患者发放问卷，以调查影响透析方式选择的因素。采用逻辑回归分析数据。
如果患者从3个或更多来源获得透析前信息，并且在更大程度上认为这些信息全面且质量高，那么他们接受家庭透析的可能性更大。此外，随着年龄的增长以及居住地点离透析中心更近，患者接受家庭透析的可能性降低。与女性相比，如果男性与配偶同住，接受家庭透析的可能性更大。中心血液透析患者更常认为通过中心血液透析治疗提供的社交互动和支持影响了透析方式的选择。
本研究强调需要提高对影响透析方式选择的各种因素的认识，以及向透析患者和透析前患者及其亲属提供重复、全面、高质量信息的重要性。如果想要改善患者的福祉以及使用家庭透析的患者比例，信息和支持必须根据个体患者及其亲属的需求进行调整。
