辅助性腹膜透析是曼尼托巴省北部的解决方案吗？
Is Assisted Peritoneal Dialysis a Solution for Northern Manitoba?
作者信息
Lavoie Josée G, Zacharias James, Kaufert Joseph, Krueger Nicholas, Kinew Kathi Avery, Mcleod Lorraine, Chartrand Caroline
机构信息
Professor, University of Manitoba, Winnipeg, MB.
Assistant Professor, University of Manitoba, Winnipeg, MB.
出版信息
Healthc Policy. 2019 May;14(4):52-65. doi: 10.12927/hcpol.2019.25856.
BACKGROUND
End-stage kidney disease (ESKD) continues to fundamentally impact the lives of First Nations (FN) patients. Home peritoneal dialysis (PD) offers patients more mobility and flexibility, but few Manitoba FNs have availed themselves of this option.
OBJECTIVE
This paper discusses Manitoba FNs' experience of PD, to highlight enablers and barriers to expanding the use of PD in rural and remote Manitoba communities.
METHODS
We analyzed interviews of individuals living with ESKD (N = 14), family caregivers (N = 14) and healthcare providers and administrators (N = 27).
RESULTS
Barriers to PD uptake include medical suitability, patients' distrust of home modalities and fear in their ability to manage. Other factors include limited family support and lack of appropriate housing.
CONCLUSIONS
Assisted peritoneal dialysis (APD) is an emerging model where PD supplies are centrally located, and where a cohort of PD patients can provide mutual support with added assistance from an APD worker. This model could mitigate existing treatment barriers.
背景
终末期肾病（ESKD）持续对原住民（FN）患者的生活产生根本性影响。家庭腹膜透析（PD）为患者提供了更大的行动能力和灵活性，但曼尼托巴省的原住民很少选择这种治疗方式。
目的
本文探讨曼尼托巴省原住民腹膜透析的经历，以突出在曼尼托巴省农村和偏远社区扩大腹膜透析使用的促进因素和障碍。
方法
我们分析了对终末期肾病患者（N = 14）、家庭护理人员（N = 14）以及医疗保健提供者和管理人员（N = 27）的访谈。
结果
采用腹膜透析的障碍包括医学适用性、患者对家庭治疗方式的不信任以及对自身管理能力的担忧。其他因素包括家庭支持有限和缺乏合适的住房。
结论
辅助腹膜透析（APD）是一种新兴模式，腹膜透析用品集中放置，一群腹膜透析患者可以在APD工作人员的额外协助下相互支持。这种模式可以缓解现有的治疗障碍。
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