Development and preliminary evaluation of a mobile-based situational simulation retraining system for patients...

Peritoneal dialysis (PD) is a home-based therapy that requires sustained technical competence; however, technique degradation and infection risk may occur over time. This pilot study aimed to examine the preliminary effects of a developed mobile-based situational simulation peritoneal dialysis training system (Mbs-PDTS) as a retraining intervention for adult patients undergoing PD.

An exploratory, two-arm, open-label cluster trial was conducted at a university hospital in Taiwan, with PD nurses serving as the unit of allocation. The intervention group received Mbs-PDTS in addition to usual care, whereas the control group received usual care alone. PD-related knowledge and technical skills were assessed at baseline and at 1 and 2 months. Infection-related outcomes, including peritonitis and PD catheter-related infection, were monitored over a 6-month follow-up. Linear mixed-effects models, generalized estimating equations, and exploratory time-to-event analyses were used.

Thirty participants completed the study, with 15 in each group. Compared with usual care, the Mbs-PDTS intervention was associated with significant group × time interactions for PD-related knowledge and technical skills (both p < 0.001), with improvements observed in the intervention group. No statistically significant differences were observed in infection-related outcomes. Given the small number of infection-related events, these analyses were interpreted descriptively.

This pilot study provides preliminary evidence that the Mbs-PDTS may improve PD-related knowledge and technical skills in adult patients undergoing PD. Larger multicenter studies with longer follow-up are needed to confirm its effects and evaluate its potential impact on infection-related outcomes.