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评估伊朗患者对血液透析和腹膜透析护理的满意度及相关因素。

Assessing patient satisfaction with hemodialysis and peritoneal dialysis care and associated factors in Iran.

作者信息

Nemati Nastaran, Yousefi Mahmood, Keshvari-Shad Fatemeh, Akbari Soleiman, Barfar Eshagh

机构信息

Department of Health Management & Policy, University of Kentucky, Kentucky, USA.

Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Int Urol Nephrol. 2025 May;57(5):1633-1638. doi: 10.1007/s11255-024-04346-5. Epub 2024 Dec 28.

Abstract

PURPOSE

With the increasing demand for dialysis, there is a growing emphasis on patient-centered care. This study investigated patients' satisfaction levels with peritoneal dialysis (PD) and hemodialysis (HD) care in Iran.

METHODS

A cross-sectional multicenter study was conducted among 346 patients with chronic kidney disease (CKD) covered by the Iran Health Insurance Organization who received dialysis services from October to December 2022 across the country. Data were gathered using a self-made questionnaire through telephone interviews. Data analysis included descriptive statistics, t tests, ANOVA, and linear logistic regression using R software.

RESULTS

Patients reported high satisfaction with doctors and nurses, health care facilities, and costs. PD patients had higher overall satisfaction (P < 0.001) and were more satisfied with costs (P < 0.001), while HD patients reported greater satisfaction with doctor and nurse behavior (P = 0.012). Significant factors associated with satisfaction included marital status (P = 0.012), insurance coverage duration (P = 0.027), dialysis type (P < 0.001), and time to dialysis initiation (P = 0.027). Doctor and nurse behavior had the greatest impact on satisfaction (P < 0.001).

CONCLUSION

While patients were generally satisfied with the care provided, the findings revealed areas for improvement, particularly regarding the availability of medical centers and costs among dialysis patients. Focusing on patient education, communication, and supportive insurance policies has the potential to significantly enhance patient satisfaction and improve quality of life for dialysis patients.

摘要

目的

随着透析需求的不断增加,以患者为中心的护理越来越受到重视。本研究调查了伊朗患者对腹膜透析(PD)和血液透析(HD)护理的满意度。

方法

对伊朗健康保险组织覆盖的346例慢性肾脏病(CKD)患者进行了一项横断面多中心研究,这些患者于2022年10月至12月在全国范围内接受透析服务。通过电话访谈使用自制问卷收集数据。数据分析包括描述性统计、t检验、方差分析以及使用R软件进行的线性逻辑回归。

结果

患者对医生和护士、医疗保健设施以及费用表示高度满意。腹膜透析患者的总体满意度更高(P < 0.001),对费用更满意(P < 0.001),而血液透析患者对医生和护士的行为满意度更高(P = 0.012)。与满意度相关的显著因素包括婚姻状况(P = 0.012)、保险覆盖时长(P = 0.027)、透析类型(P < 0.001)以及开始透析的时间(P = 0.027)。医生和护士的行为对满意度影响最大(P < 0.001)。

结论

虽然患者对所提供的护理总体满意,但研究结果揭示了有待改进的方面,特别是透析患者医疗中心的可及性和费用方面。关注患者教育、沟通以及支持性保险政策有可能显著提高患者满意度并改善透析患者的生活质量。

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