Jaelani Toni Rahmat, Ibrahim Kusman, Jonny Jonny, Pratiwi Sri Hartati, Haroen Hartiah, Nursiswati Nursiswati, Ramadhani Bunga Pinandhita
Faculty of Nursing, Padjadjaran University, Bandung, West Java, Indonesia.
Nephrology Division, Department of Internal Medicine, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia.
Int J Nephrol Renovasc Dis. 2023 Sep 11;16:207-222. doi: 10.2147/IJNRD.S414447. eCollection 2023.
Peritoneal dialysis (PD) training is essential to ensure patient independence and prevent life-threatening complications, such as peritonitis. The International Society for Peritoneal Dialysis (ISPD) recommends that every PD unit worldwide implement local PD training programs with the goal of improving self-care capabilities. This scoping review aims to give an overview of recent literature and recommendations on PD training programs aiming to improve the quality of care and outcomes for PD patients.
The literature search was conducted using the PC (Population, Concept) approach. The population of interest in this study is PD patients, and the study concept is the PD training program. Several databases were used to conduct the literature search, including PubMed, Science Direct, and CINAHL. The search process began from July 2022 until January 2023. The inclusion criteria for the search included research articles and recommendations.
The search yielded 22 articles recommending training programs lasting from 5-8 days, with 1-3-hour sessions and a nurse-to-patient ratio of 1:1. A cumulative training time of 15 hours or more is recommended to enhance patient independence and reduce peritonitis rates. Home-based or in-unit PD training, conducted by experienced nurses using adult learning strategies, has shown significant value in improving self-care and preventing peritonitis. Evaluating training outcomes should encompass knowledge, skills, and attitudes, and the impact on peritonitis rates. Training programs should be flexible and consider physiological and psychosocial barriers to achieving the best results.
There are a variety of strategies for dialysis training concerning duration, session length, patient-to-trainer ratio, timing, methods, location, compliance, and the need for retraining. More evidence is needed to assess the impact of PD patient training programs on self-care capabilities and peritonitis incidence. Future studies should investigate the effects of training programs on compliance, self-efficacy, and patient and nurse perspectives.
腹膜透析（PD）培训对于确保患者独立并预防危及生命的并发症（如腹膜炎）至关重要。国际腹膜透析学会（ISPD）建议全球每个PD单位实施本地PD培训项目，目标是提高自我护理能力。本范围综述旨在概述近期有关旨在改善PD患者护理质量和结局的PD培训项目的文献及建议。
采用PC（人群、概念）方法进行文献检索。本研究感兴趣的人群是PD患者，研究概念是PD培训项目。使用了几个数据库进行文献检索，包括PubMed、ScienceDirect和CINAHL。检索过程从2022年7月开始至2023年1月。检索的纳入标准包括研究文章和建议。
检索得出22篇文章，推荐的培训项目持续5 - 8天，每次课程时长1 - 3小时，护士与患者比例为1:1。建议累计培训时间达到15小时或更长，以增强患者独立性并降低腹膜炎发生率。由经验丰富的护士采用成人学习策略进行的居家或单位内PD培训，在改善自我护理和预防腹膜炎方面显示出显著价值。评估培训结果应涵盖知识、技能和态度，以及对腹膜炎发生率的影响。培训项目应灵活，并考虑生理和心理社会障碍以取得最佳效果。
关于透析培训在时长、课程长度、患者与培训师比例、时间安排、方法、地点、依从性以及再培训需求等方面存在多种策略。需要更多证据来评估PD患者培训项目对自我护理能力和腹膜炎发生率的影响。未来研究应调查培训项目对依从性、自我效能以及患者和护士观点的影响。
