Choice of dialysis modality-clinical and psychosocial variables related to treatment

Among the dialysis modalities, there is a prevalence of hemodialysis (HD).

To verify who chooses the dialysis modality and which variables reflect the perception of patients and health care team about treatment.

The study was conducted at three clinics of HD and peritoneal dialysis (PD). Two hundred and twenty patients participated in the study, of whom 69.5% were on HD and 30.5% on PD. Included voluntary patients on treatment from 90 days to 2 years, with. Of the 54 health workers, 18.5% were doctors, 20.4% nurses and 61.1% nurse technicians: Two questionnaires were applied: one for professionals and one for patients.

Most patients had their modality of dialysis chosen by doctors: 76.3%. Most patients rejected a change of treatment in both HD (83%) and PD (92.5%). There was a significant association by PD patients of their modality with greater safety (p = 0.041), well-being (p = 0.002), near normal life (p = 0.002), freedom (p < 0.001) and high-spirits (p = 0.021). HD patients perceive PD as allowing more freedom (p = 0.003), autonomy (p = 0.001) and high spirits (p = 0.019). In assessing the medical and nursing staff for clinical and psychosocial variables, professionals indicated a greater frequency for variables related to quality of life (p = 0.007), psychosocial well-being (p = 0.007) and clinical well-being (p = 0.004) when associated with PD therapy.

The choice of dialysis modality was a decision solely of doctors in 76.3% of cases. PD was considered by the health care team as the best modality therapy with regard to quality of life, clinical and psychosocial well-being.