New directions in peritoneal dialysis patient training.
OBJECTIVE
To study the effect of training methods on selected patient outcomes in peritoneal dialysis patients.


METHODS
Multi-center, longitudinal prospective quasi-experimental design study conducted over a 2-year period.


METHODS
Thirty-two Gambro Healthcare peritoneal dialysis (PD) home training programs in the United States.


METHODS
New patients starting PD were trained on PD technique and diet using either an adult learning theory-based curriculum in the experimental group (PG) or non-standardized conventional training programs in the control group (CG). Excluded were patients who were non-English speaking, legally blind without sighted caregiver, nursing home residents, and those with previous exposure to PD training.


METHODS
Information was collected by means of manual data collection tools and though the use of Gambro Healthcare computer system and was analyzed for statistical significance by Gambro Healthcare biostatistician.


RESULTS
Compared with the CG, initial training took longer in the PG (PG = 29 hrs; CG = 22.6 hrs; p < .0001), and time required for retraining was less but not statistically significant (PG = 8.7 hrs; CG = 12.5 hrs; p = .1324). The peritonitis rate was less in the PG (28.2 per 1000 patient months) than in the CG (36.7 per 1000 patient months), but did not achieve statistical significance (p = .09783). Exit site infections (ESIs) were less in the PG than the CG (PG = 18.5; CG = 31.8; p = .00349). Dropout from PD to hemodialysis secondary to infection was less in the PG (1.6%) than in the CG (5.6%) (p = .0069). Measured on a scale with 4 being the best score, mean fluid balance scores in the PG were 3.41 compared to 3.25 in the CG (p < .0001), and mean compliance scores for the PG versus the CG were 3.62 and 3.52, respectively (p < .0001). Laboratory parameters between the two groups were significantly different only for Kt/V (PG = 2.4; CG = 2.3; p = 0.0107).


CONCLUSIONS
Use of the adult learning theory-based training method curriculum was positively associated with improved patient outcomes in the PD population studied.
Hall
Gayle
G
Gambro Healthcare, Orange Park, FL, USA.
Bogan
Amy
A
Dreis
Sandra
S
Duffy
AnnMarie
A
Greene
Suzanne
S
Kelley
Karen
K
Lizak
Holly
H
Nabut
Jose
J
Schinker
Vicky
V
Schwartz
Netta
N
D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010538:Peritonitis / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D012648:Self Care; D013663:Teaching / Q000379:methods; D014882:Water-Electrolyte Balance