Effect of an educational program on the predialysis period for patients with chronic renal failure.
Effect of an educational program on the predialysis period for patients with chronic renal failure.
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DOI：
10.1007/s10157-006-0439-2
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发表时间：
2006-12-01
影响因子：
2.3
通讯作者：
Kurata, Kei
中科院分区：
文献类型：
--
作者：
Inaguma, Daijo;Tatematsu, Miho;Kurata, Kei
背景：透析前期慢性肾功能衰竭的治疗和管理的目的主要是延缓肾功能恶化的进展。最佳透析起始对改善患者治疗后的预后很重要。我们调查了通过原始教育计划提供信息是否可以促进透析的开始，使患者处于更好的状态，从而提高成本效益。方法：2002年4月至2005年3月在我院接受慢性肾功能衰竭透析治疗的患者176例，按是否参加教育项目分为两组。参加教育计划是他们自己的自由意志。指导人员包括肾病专家、护理人员、临床工程技术人员、国家注册营养师和医务社会工作者。我们通过比较开始时的血液检查结果、心力衰竭症状的存在、供血途径类型、计划开始的百分比、住院天数和住院费用作为参与组和非参与组之间的指标，来调查教育计划是否促进了无故障透析的开始。结果：参与组在训练期间使用双腔透析导管的患者数量、住院时间和住院费用均显著少于未参与组。虽然两组在肾替代治疗（RRT）开始时的肾功能无显著差异，但参与组的血清白蛋白、血红蛋白和红细胞压积明显高于未参与组。结论：本研究提示，在透析开始前提供足够的信息，通过对透析的了解，可以有效地改善透析开始时的身体状况，并获得医疗经济效益。
BACKGROUND: The purpose of the treatment and management of chronic renal failure during the predialysis period is mainly to retard the progression of the deterioration of renal function. Optimal dialysis initiation is important to improve the patient's outcome after therapy. We investigated whether providing information through an original educational program could facilitate dialysis initiation, with the patient in a better condition, and therefore greater cost-effectiveness.METHODS: One hundred and seventy-six patients who underwent dialysis initiation for chronic renal failure in our hospital between April 2002 and March 2005 were divided into two groups according to their participation or nonparticipation in an educational program. Participation in the education program was of their own free will. The instructors consisted of nephrologists, nursing staff, clinical engineering technologists, national registered dietitians, and medical social workers. We investigated whether the education program facilitated trouble-free dialysis initiation by comparing findings of blood tests at the start, the existence of heart-failure symptoms, type of blood access, percentage of scheduled initiation, and the number of days and cost of hospitalization as indices between participating and nonparticipating groups.RESULTS: The number of patients using a double-lumen dialysis catheter, and the duration and cost of hospitalization in training the participating group, were significantly less than those in the nonparticipating group. Although there was no significant difference in renal function at the initiation of renal replacement therapy (RRT) between the two groups, serum albumin, hemoglobin, and hematocrit in the participating group were significantly higher than those of the nonparticipating group.CONCLUSIONS: This study suggests that providing sufficient information before dialysis initiation may be effective in both physical condition at dialysis initiation, and medical economic benefits through the understanding of the dialysis.