RESUMO
Globally, home dialysis prevalence has been declining relative to the increase in end stage renal disease and renal replacement therapy. The goal of this study was to identify international perceptions and practices. A web-based questionnaire was disseminated to nephrology nurses in 30 home dialysis-prevalent nations. Global telehealth use was low (23%), contrasting with 83% respondents agreeing telehealth would improve care. Only 31% of all programs enabled patient training outside of normal working hours (e.g., nights and weekends), and 31% of all program patients had some cost reimbursement, with a significant difference between U.S. and non-U.S. programs (U.S. 11%, non-U.S. 59%, 2 = 93.6, p < 0.0001). Significant differences in the need for monthly clinic visits (U.S. 72%, non-US 44%, 2 = 83.7, p < 0.0001) were also found. Telehealth provision and patient training flexibility is limited, and patient cost reimbursement is low. Increased telehealth, patient cost reimbursement, and flexible training models may promote home dialysis growth.
Assuntos
Atitude do Pessoal de Saúde , Hemodiálise no Domicílio/enfermagem , Falência Renal Crônica/enfermagem , Enfermagem em Nefrologia , Padrões de Prática em Enfermagem , Humanos , Internacionalidade , Inquéritos e QuestionáriosAssuntos
Competência Clínica , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/terapia , Falência Renal Crônica/complicações , Nefrologia/organização & administração , Papel Profissional , Transtorno Depressivo/etiologia , Prescrições de Medicamentos , Humanos , Enfermeiros Clínicos/organização & administração , Profissionais de Enfermagem/organização & administração , Psiquiatria/organização & administraçãoRESUMO
Nephrologists and nephrology nurses have struggled with the technological, financial, and ethical concerns surrounding the life sustaining treatment of hemodialysis for as long as this treatment as been available. One of the overriding issues for the nephrology community has been appropriate utilization of this technology and the appropriate restraint for prescribing dialysis. Since the inception of dialysis, there has been discussion of guidelines for deciding who should receive and who should not receive this therapy. In 2000, a clinical guideline was developed to assist in directing the care of patients. The knowledge and acceptance of this guideline by nephrologists has been researched in the past. However, there is no data of knowledge and acceptance of the guideline by nephrology clinical nurses or nephrology nurse practitioners. A survey was conducted to begin to ascertain this information in order to better understand the perspectives of nephrology nurses.
