自我护理或辅助 PD：一种新方法评估手动腹膜透析实践能力的发展。
Self-care or assisted PD: development of a new approach to evaluate manual peritoneal dialysis practice ability.
机构信息
Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai Jiaotong University, Shanghai, PR China.
出版信息
Ren Fail. 2022 Dec;44(1):1319-1325. doi: 10.1080/0886022X.2022.2108448.
BACKGROUND
Peritoneal dialysis (PD) is a home-based therapy which requires the patients or their caregivers to perform the practice. We aimed to develop a practical approach to evaluate PD practice ability of the patients and to identify berries to self-care PD.
METHODS
A structural form was designed comprising measures of physical, cognitive, and operational abilities which were required to perform manual PD independently. The evaluation was jointly conducted by a PD nurse, a nephrologist and a close family member of the patient. Patients who met all the requirements were deemed as capable of performing PD independently (self-care PD) and others were deemed as needing an assistant (assisted PD).
RESULTS
The evaluation form was applied in 280 prevalent PD patients and 33.9% of them were assessed as needing assisted PD, mainly due to physical (62.1%) or operational (66.3%) disabilities. The evaluation result was consistent with current dialysis status in 79.3% patients and it matched better in patients who performed PD with the help of an assistant (93.0 76.8%, = 0.014). Patients who were evaluated as having barriers to self-care PD but still performed PD without an assistant were older and demonstrated higher prevalence of diabetic nephropathy and PD-related infection, lower education level, and lower serum albumin ( < 0.05).
CONCLUSIONS
The PD practice ability assessment form is useful to identify patients with barriers to self-care PD. It provides objective information to the patients and their family to choose feasible PD practice modality, self-care, or assisted PD.
背景
腹膜透析（PD）是一种居家治疗方式，需要患者或其照护者进行操作。我们旨在开发一种实用的方法来评估患者的 PD 操作能力，并确定能够进行自我护理 PD 的患者。
方法
设计了一种结构形式，包括独立进行手动 PD 所需的身体、认知和操作能力的衡量标准。评估由 PD 护士、肾脏病学家和患者的近亲共同进行。满足所有要求的患者被认为能够独立进行 PD（自我护理 PD），其他患者则被认为需要辅助（辅助 PD）。
结果
评估表应用于 280 名现患 PD 患者，其中 33.9%的患者被评估为需要辅助 PD，主要是由于身体（62.1%）或操作（66.3%）障碍。在 79.3%的患者中，评估结果与当前透析状况一致，在接受辅助 PD 的患者中评估结果更为匹配（93.0%比 76.8%，=0.014）。被评估为存在自我护理 PD 障碍但仍无需辅助进行 PD 的患者年龄更大，且更常患有糖尿病肾病和 PD 相关感染，受教育程度更低，血清白蛋白水平更低（<0.05）。
结论
PD 操作能力评估表有助于识别存在自我护理 PD 障碍的患者。它为患者及其家属提供了客观信息，以选择可行的 PD 实践模式，即自我护理或辅助 PD。
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