Abstract: SA-PO476
Provider Perspectives on Patient Burnout in Peritoneal Dialysis
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
- King, Spencer A., Harbor-UCLA Medical Center, Torrance, California, United States
- Manera, Karine E., The University of Sydney, Sydney, New South Wales, Australia
- Shen, Jenny I., Harbor-UCLA Medical Center, Torrance, California, United States
Background
Peritoneal dialysis (PD) can provide more independence and flexibility for patients compared with in-center hemodialysis (ICHD). However, this self-adminstered home-based modality can also cause burnout, which we define as mental, emotional, or physical exhaustion leading to negative attitudes towards PD. These attitudes can lead to poor outcomes, including depression, increased risk of peritonitis, and transfer to ICHD. We aimed to describe the perspectives on PD burnout by nephrologists with patients on PD.
Methods
We conducted semi-structured interviews of 29 nephrologists with experience with treating patients on PD in Australia, Canada, Columbia, Hong Kong, Japan, New Zealand, Singapore, US, UK, Uruguay, and Thailand from Apr 2017 to Nov 2019. Transcripts were analyzed thematically.
Results
Two major themes were identified that was similar to previous themes noted from a parallel study on patients’/carers’ perspectives on burnout. 1) Suffering an unrelenting responsibility: providers viewed their patients and carers being overwhelmed by the daily regimen and bearing alone the burden and uncertainty of what to expect from PD. 2) Adapting and building resilience: providers witnessed patients drawing hope and support from family and finding meaning in other activities. A third theme was coping with the aid of therapy: providers oberved patients and caregivers benefitting from meeting with a psychologist, psychiatrist, social worker and support groups, but also noted that such resources are not always readily accessible.
Conclusion
Nephrologists with patients on PD are aware of burnout among their patients on PD and of means of coping. Further work is needed to identify effective ways for providers, patients, and families to openly communicate about burnout and to more broadly implement interventions to prevent it.
Illustrative Quotes
| Theme | Quote | |
| Suffering an unrelenting responsibility | "I think the long PD treatment can cause the patient to feel burnout. And the high frequency of the bag exchange by themselves, many times of the bag exchange cause patients feeling burnout." "If they find that they don't have enough time in their day to do their daily activities as well...they really burnout and they are really down in the dumps." | |
| Adapting and building resilience | "And we see a lot of cases have caregiver burnout...But normally in Asian countries, I think we have a big family. So they can rotate to the other son, or daughter." "But I think having a family, children around for elderly is helpful." | |
| Coping with the aid of therapy | "I think it would be good to have early psychological support or counseling if they, if we find that they're really struggling, because we can only do so much to help them, but we need to be able to refer them early on to a professional that can help, if they're feeling like they're starting to burn out or they're not coping with their diagnosis and their medical conditions, and the burden of debt. Because sometimes it hits them really hard, starting treatment." "And then we don't have a lot of resource. So we have one psychiatrists, but she just retired. And like every centers, we don't have that much help." |