腹腔内透析対血液透析による透析ケアに関する患者評価
Haya R Rubin1, Nancy E Fink, Laura C Plantinga
1Department of Medicine, Quality of Care Research, The Johns Hopkins School of Medicine, Baltimore, Md 21205, USA. hrubin@jhmi.edu
JAMA
|February 12, 2004
まとめ
腹膜透析を始める患者は,血液透析と比較して,ケアに対する満足度が高いと報告しています. 腎臓置換療法を開始する患者には,腹膜透析の選択肢に関するより多くの情報が推奨されます.
科学分野:
- ネフロロジーと腎臓医学
- 患者の報告したアウトカム
- 医療の質 医療の質とは
背景:
- 透析方式が患者の生存に与える差異的な影響について,矛盾する証拠が存在する.
- 患者の経験は,血液透析と腹膜透析の選択において重要な要因です.
- 患者の満足度を理解することは,末期性腎臓病の治療法の選択に不可欠です.
研究 の 目的:
- 血液透析と腹膜透析の患者の満足度を比較する.
- 最近,透析治療を開始した患者の満足度を評価するために.
- 異なる透析方式における患者の満足度に影響を与える医療の特定の側面を特定する.
主な方法:
- インシデント透析患者の間で横断調査が行われました.
- CHOICE研究では,37の透析センターの656人の患者からデータを収集した.
- 患者によるアンケートでは,全般的な満足度と透析治療の20の具体的側面を評価した.
主要な成果:
- 腹膜透析を受けている患者は,血液透析を受けている患者 (56%が優秀) よりも,全体的な満足度 (85%が優秀) が有意に高いと報告した.
- 腹膜透析の患者は,ケアのすべての特定の側面,特に情報提供 (69%対30%が優秀) を高く評価しました.
- これらの差異は,人口統計的および臨床的要因を調整した後も持続した.
結論:
- 腹腔内透析は,開始直後に患者によって評価されたより高いケア品質と関連しています.
- 臨床医は,治療の選択肢として腹膜透析に関する患者の教育を強化すべきである.
- 情報に基づいた選択を通じて患者の経験を改善することは,末期腎疾患の管理において極めて重要です.
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