title: A retrospective survey of attitudes toward acceptance of peritoneal dialysis in Chinese end-stage renal failure patients in Hong Kong--from a cultural point of view.
abstract: OBJECTIVE
  We undertook to study the attitudes toward dialysis of patients approaching end-stage renal failure and to analyze those attitudes from a cultural perspective.
  
  
  METHODS
  The study was performed in the pre-dialysis clinic of a tertiary referral renal center.
  
  
  METHODS
  All patients of Chinese ethnic origin seen in the pre-dialysis clinic from 1995 to 2000 for assessment of dialysis therapy were included.
  
  
  METHODS
  We performed a retrospective analysis of patient records with regard to attitudes of the patients toward dialysis, reasons for those attitudes, and factors that could lead to a subsequent change in attitude.
  
  
  RESULTS
  We assessed 462 patients over the 6-year period. Their mean age was 65.5 +/- 13.3 years, and 43.9% of the patients had diabetes. Peritoneal dialysis (PD) was offered to 74% of the patients, and hemodialysis (HD) to 3.9%. Among the patients offered PD, only 44% accepted dialysis. After counselling, 54% of the patients who originally declined PD ultimately accepted it. The major reasons for refusing PD were the ideas of "having lived long enough" and "lack of family support." Most other reasons could be overcome by counselling. Only a minority of patients demanded hemodialysis.
  
  
  CONCLUSIONS
  Declining an offer of dialysis was common. Counselling helped patients to accept PD. Certain cultural elements that hindered acceptance of dialysis were involved in the ideas of "having lived long enough" and "lack of family support." Those cultural elements should be tackled more specifically during counselling.
authors.affiliation: Department of Medicine, Tung Wah Hospital, The University of Hong Kong, Hong Kong SAR, China. wkloc@hkucc.hku.hk
authors.forename: W K
authors.initials: WK
authors.lastname: Lo
authors.forename: F K
authors.initials: FK
authors.lastname: Li
authors.forename: C B
authors.initials: CB
authors.lastname: Choy
authors.forename: S W
authors.initials: SW
authors.lastname: Cheng
authors.forename: W L
authors.initials: WL
authors.lastname: Chu
authors.forename: S Y
authors.initials: SY
authors.lastname: Ng
authors.forename: C Y
authors.initials: CY
authors.lastname: Lo
authors.forename: S L
authors.initials: SL
authors.lastname: Lui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002681:China / Q000208:ethnology; D003469:Culture; D005260:Female; D006723:Hong Kong; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010530:Peritoneal Dialysis / Q000523:psychology*; D012111:Residence Characteristics; D012189:Retrospective Studies; D016312:Treatment Refusal