title: Older peoples' satisfaction with home-based dialysis.
abstract: BACKGROUND
  The proportion of older people receiving dialysis is rapidly increasing. The typical choice for older patients is between home-based peritoneal dialysis (PD) and clinic-based haemodialysis (HD). Some centres have been successful in encouraging all patients - including older patients - to have home-based self-administered PD or HD.
  
  
  OBJECTIVE
  To (i) describe the overall satisfaction with renal services among older patients dialysing, or in training, with HD or PD at home; and (ii) examine the relationship between residential distance from the nephrology unit and satisfaction with home-based dialysis.
  
  
  METHODS
  Participants were aged 60 years or more; and were either dialysing at home or training for dialysis at home. Two methods of cross-sectional data collection were used: (i) structured quantitative interviews with all participants; and (ii) qualitative interviews with a selected subgroup.
  
  
  RESULTS
  Participants comprised 45 patients on dialysis (94% of 48 eligible). Their average age was 68 years. Duration of dialysis averaged 28 months (range 3-150 months). Ratings of 'very good or excellent' were reported for dialysis treatment by 40 (89%) patients. Patients on dialysis, despite experiencing frustration with dialysis itself, expressed satisfaction across four categories: staff, information provision, involvement in decision-making and confidence in managing dialysis. Dissatisfaction was infrequent.
  
  
  CONCLUSIONS
  This pilot study suggests that older patients trained to dialyse at home using PD or HD are highly satisfied with the nephrology service - even when living remote from the nephrology unit. Home-based dialysis is possible in older patients with levels of comorbidity and disease severity as serious as elsewhere.
authors.affiliation: Injury Prevention Research Unit, Dunedin School of Medicine, University of Otago, Dunedin Hospital, Dunedin, New Zealand.
authors.forename: Sarah
authors.initials: S
authors.lastname: Derrett
authors.forename: Maryann
authors.initials: M
authors.lastname: Darmody
authors.forename: Sheila
authors.initials: S
authors.lastname: Williams
authors.forename: Merrin
authors.initials: M
authors.lastname: Rutherford
authors.forename: John
authors.initials: J
authors.lastname: Schollum
authors.forename: Rob
authors.initials: R
authors.lastname: Walker
mesh_terms: D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006437:Hemodialysis, Home; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007407:Interviews as Topic; D007674:Kidney Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010530:Peritoneal Dialysis; D010865:Pilot Projects; D036301:Qualitative Research; D012111:Residence Characteristics; D014187:Transportation of Patients; D016896:Treatment Outcome