Patient perspectives of target weight management and ultrafiltration in haemodialysis: a multi-center survey.

Keane, David, Glyde, Megan, Dasgupta, Indranil, Gardiner, Claire, Lindley, Elizabeth, Mitra, Sandip, Palmer, Nicholas, Dye, Louise, Wright, Mark and Sutherland, Ed (2021) Patient perspectives of target weight management and ultrafiltration in haemodialysis: a multi-center survey. BMC nephrology, 22 (1). p. 188. ISSN 1471-2369. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

BACKGROUND

Decisions around planned ultrafiltration volumes are the only part of the haemodialysis prescription decided upon at every session. Removing too much fluid or too little is associated with both acute symptoms and long-term outcomes. The degree to which patients engage with or influence decision-making is not clear. We explored patient perspectives of prescribing ultrafiltration volumes, their understanding of the process and engagement with it.

METHODS

A questionnaire developed for this study was administered to 1077 patients across 10 UK Renal Units. Factor analysis reduced the dataset into factors representing common themes. Relationships between survey results and factors were investigated using regression models. ANCOVA was used to explore differences between Renal Units.

RESULTS

Patients generally felt in control of their fluid management and that they were given the final say on planned ultrafiltration volumes. Around half of the respondents reported they take an active role in their treatment. However, respondents were largely unable to relate signs and symptoms to fluid management practice and a third said they would not report common signs and symptoms to clinicians. A fifth of patients reported not to know how ultrafiltration volumes were calculated. Patients responded positively to questions relating to healthcare staff, though with significant variation between units, highlighting differences in perception of care.

CONCLUSIONS

Despite a lack of formal acknowledgement in fluid management protocols, patients have significant involvement in decisions regarding fluid removal during dialysis. Furthermore, substantial gaps remain in patient knowledge and engagement. Formalizing the role of patients in these decisions, including patient education, may improve prescription and achievement of target weights.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WJ Urogenital system. Urology
WLM Psychology
Divisions: Planned IP Care > Urology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 03 Jun 2021 12:10
Last Modified: 03 Jun 2021 12:10
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4362

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