Köksal Cevher Şimal, Altınok Ersoy Neşe, Çoşkun Yenigün Ezgi, Tuncay Mehmet, Arınsoy Selim Turgay, Çankaya Erdem, Dede Fatih
Department of Nephrology, Ankara Bilkent City Hospital, Ankara, Turkey.
Faculty of Nursing, Internal Disease Nursing Department, Hacettepe University, Ankara, Turkey.
Ther Apher Dial. 2024 Dec 30. doi: 10.1111/1744-9987.14248.
End-stage kidney disease patients face a critical decision regarding kidney replacement therapy options, which include kidney transplantation, hemodialysis, or peritoneal dialysis (PD). This study aims to evaluate the impact of nurse-led education (NE) alone vs. NE combined with peer support on the patients' decision over PD treatment in chronic kidney disease patients.
The study was conducted between 2018 and 2020, and patients were prospectively followed for the years 2018-2020. A total of 238 patients were selected from 500 outpatient clinic patients based on inclusion criteria and the principle of voluntary participation. Among 238 patients, 112 patients who received NE plus peer support as well as NE. Generalized linear models (GLM) analysis was employed to investigate the influence of NE and NE plus peer support on the decision of PD by patients.
In the NE plus peer support group, 38% were aged 45-59, and 65% were male. Similarly, in the NE group, 38% were aged 45-59, and 60% were male. The study utilized GLM to analyze patients' decisions regarding the PD treatment. Model 1 examined the duration of NE plus peer support (Akaike Information Criterion [AIC] = 130.46, McFadden's pseudo-R-squared (ρ) = 0.569), Model 2 focused on the duration of NE (AIC = 294.11, McFadden's ρ = 0.011), Model 3 assessed the sufficiency of NE plus peer support (AIC = 142.98, McFadden's ρ = 0.526), and Model 4 evaluated the sufficiency of NE alone (AIC = 296.53, McFadden's ρ = 0.085).
Education provided by nurse and supported by peer affects patients' decision of kidney replacement treatment. Through the implementation of effective peer education, healthcare providers can enable patients to make informed decisions that align with their personal values, preferences, and treatment objectives, thereby enhancing clinical outcomes and overall patient satisfaction.
终末期肾病患者面临关于肾脏替代治疗方案的关键决策，这些方案包括肾移植、血液透析或腹膜透析（PD）。本研究旨在评估单纯护士主导教育（NE）与NE联合同伴支持对慢性肾病患者PD治疗决策的影响。
该研究于2018年至2020年进行，对2018 - 2020年的患者进行前瞻性随访。根据纳入标准和自愿参与原则，从500名门诊患者中选取了238名患者。在这238名患者中，112名患者接受了NE加同伴支持以及NE。采用广义线性模型（GLM）分析来研究NE和NE加同伴支持对患者PD决策的影响。
在NE加同伴支持组中，38%的患者年龄在45 - 59岁之间，65%为男性。同样，在NE组中，38%的患者年龄在45 - 59岁之间，60%为男性。该研究利用GLM分析患者关于PD治疗的决策。模型1检验了NE加同伴支持的时长（赤池信息准则[AIC] = 130.46，麦克法登伪R平方（ρ）= 0.569），模型2关注NE的时长（AIC = 294.11，麦克法登ρ = 0.011），模型3评估NE加同伴支持的充分性（AIC = 142.98，麦克法登ρ = 0.526），模型4评估单纯NE的充分性（AIC = 296.53，麦克法登ρ = 0.085）。
护士提供并由同伴支持的教育会影响患者的肾脏替代治疗决策。通过实施有效的同伴教育，医疗服务提供者可以使患者做出符合其个人价值观、偏好和治疗目标的明智决策，从而改善临床结局和患者总体满意度。
