Abstract: SA-PO479
Psychosocial Barriers to and Enablers of Peritoneal Dialysis Utilization: A Literature Review
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Tng, Janice Jia Ying, Woodlands Health, Singapore, Singapore
- Chew, Melissa, Woodlands Health, Singapore, Singapore
Background
With an ageing population comes the concomitant increase in Chronic Disease prevalence. In Singapore, most patients with End-Stage Renal Disease (ESRD) are on Haemodialysis (HD). Peritoneal Dialysis (PD) take-up rate is rather low at 21% of the total number of dialysis patients compared to other countries. Our Ministry of Health aims to boost PD uptake to 30% by 2025. With rising ESRD prevalence and insufficient HD centres to meet demand, it is crucial for patients to opt for PD. This review aims to identify the psychosocial barriers and enabling factors to PD, service gaps and areas for improvement.
Methods
Medline (OVIDsp) and the Cumulative Index to Nursing & Allied Health Literature databases were used to find studies published in English from year 2000 to present, using relevant key words. Reference lists of selected studies were also perused for relevant literature.
Results
18 studies were selected from databases and 11 met the inclusion criteria. Of these, 6 relevant studies were chosen from the reference lists. A total of 17 studies were reviewed - 3 analytical studies, 1 cross-sectional survey, 2 literature reviews, 4 observational studies, 1 prospective study and 6 qualitative studies.
Lack of social support or PD caregiver are common reasons for choosing HD, especially those who are unable to perform PD on their own. Fear is a salient theme - fear of the failure to perform PD adequately to prevent infection and medical complications, and the fear of social isolation. PD is usually done at home while HD allows for social interactions at the HD centres.
Patient’s health beliefs and insight into their health are enablers to increase PD uptake. Performing PD allows a sense of perceived control as it is done independently in the comforts of their home. Regular reviews by the hospital’s renal team and external PD nurse can motivate patients to cope better and helps the healthcare team to build relationships with patients.
Conclusion
Dialysis is physically demanding and emotionally intensive. There are many factors that influence patients' decision-making when it comes to choosing a dialysis modality and psychosocial factors play a major role. Reducing barriers and increasing enablers can help boost PD uptake. Majority of the existing literature focuses on barriers to PD and this is a good chance for further research to better understand the psychosocial enablers to PD.