Cardiff and Vale NHS Trust, Cardiff, UK
Renal Unit, Abertawe Bro Morgannwg University Health Board, Swansea, UK.
BMJ Open. 2019 Oct 11;9(10):e031515. doi: 10.1136/bmjopen-2019-031515.
Kidney disease is common, affecting up to 1 in 10 of the adult population, and the numbers are expected to rise over the next decade. There are three main treatments that are available to patients with kidney disease: transplantation, dialysis and supportive care without dialysis. Dialysis can occur in a dialysis unit or in a person's home, but unit-based dialysis remains the most common initial treatment for patients in Wales. This is a cause for concern as most studies suggest that it is associated with the lowest quality of life and the highest mortality, and is a more expensive treatment option.This study aims to identify the factors that lead to patients choosing unit-based haemodialysis rather than home-based dialysis with a view to informing future changes in patient education and service commissioning in Wales. A secondary aim is to determine if the co-production of research leads to more sustainable services.
This mixed-method study taking place between October 2018 and September 2020 will use a sequential explanatory design whereby the descriptive quantitative cross-sectional analysis of linked health and administrative data sets inform qualitative data collection from patients, carers and health and care professionals. Qualitative findings will be used to interpret or explain quantitative descriptive results. Additional strands to the study include a review of materials and education provided to patients and an economic review of treatment modalities.
The study will be conducted in accordance with the principles expressed in the Declaration of Helsinki. It has full approval from Health and Care Research Wales Research Ethics Committee #5. As a co-productive study involving patients, clinicians, third sector partners and academics, findings from this study will be shared on a continual basis. Study results will be published in peer-reviewed journals and presented at national and international conferences.
肾脏疾病很常见，影响了多达十分之一的成年人群体，而且预计在未来十年内这个数字还会上升。对于患有肾脏疾病的患者，有三种主要的治疗方法可供选择：移植、透析和不透析的支持性治疗。透析可以在透析单位或患者家中进行，但单位为基础的透析仍然是威尔士患者最常见的初始治疗方法。这是一个令人担忧的问题，因为大多数研究表明，它与最低的生活质量和最高的死亡率相关，而且是一种更昂贵的治疗选择。本研究旨在确定导致患者选择单位为基础的血液透析而不是家庭为基础的透析的因素，以期为威尔士的未来患者教育和服务委托变更提供信息。次要目标是确定共同生产研究是否会导致更可持续的服务。
这项混合方法研究于 2018 年 10 月至 2020 年 9 月进行，采用顺序解释设计，通过对健康和行政数据集的描述性定量横断面分析，为患者、护理人员和卫生保健专业人员提供定性数据收集。定性结果将用于解释或解释定量描述性结果。研究的其他部分包括对提供给患者的材料和教育进行审查，以及对治疗方式进行经济审查。
该研究将按照《赫尔辛基宣言》中表达的原则进行。它完全获得了威尔士健康和护理研究伦理委员会#5 的批准。作为一项涉及患者、临床医生、第三部门合作伙伴和学者的共同生产性研究，本研究的结果将持续分享。研究结果将发表在同行评议的期刊上，并在国家和国际会议上展示。
