title: Views of Japanese patients on the advantages and disadvantages of hemodialysis and peritoneal dialysis.
abstract: OBJECTIVE
  The preference for dialysis modalities is not well understood in Japan. This study explored the subjective views of Japanese patients undergoing dialysis regarding their treatments.
  
  
  METHODS
  The participants were receiving in-center hemodialysis (CHD) or continuous ambulatory peritoneal dialysis (CAPD). In Study 1, 34 participants (17 CHD and 17 CAPD) were interviewed about the advantages and disadvantages of dialysis modalities. In Study 2, 454 dialysis patients (437 CHD and 17 CAPD) rated the advantages and disadvantages of CHD and CAPD in a cross-sectional survey.
  
  
  RESULTS
  Interviews showed that professional care and dialysis-free days were considered as advantages of CHD, while independence, less hospital visits, and flexibility were considered as advantages of CAPD. Disadvantages of CHD included restriction of food and fluids and unpleasant symptoms after each dialysis session. Catheter care was an additional disadvantage of CAPD. Survey showed that the highly ranked advantages were professional care in CHD and less frequent hospital visits in CAPD, while the highly ranked disadvantages were concerns about emergency and time restrictions in CHD, and catheter care and difficulty in soaking in a bath in CAPD. The total scores of advantages and disadvantages showed that CHD patients subjectively rated their own modality better CHD over CAPD, while CAPD patients had the opposite opinion.
  
  
  CONCLUSIONS
  The results of this study indicate that the factors affecting the decision-making process of Japanese patients are unique to Japanese culture, namely considering the trouble caused to the people around patients (e.g., families, spouses, and/or caregivers).
authors.affiliation: Center for Research on Human Development and Clinical Psychology, Hyogo University of Teacher Education, Shimokume 2-579-15, Kato-shi, Hyogo, 673-1494, Japan. Nanako775@aol.com
authors.forename: Nanako
authors.initials: N
authors.lastname: Nakamura-Taira
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Muranaka
authors.forename: Masako
authors.initials: M
authors.lastname: Miwa
authors.forename: Seikon
authors.initials: S
authors.lastname: Kin
authors.forename: Kei
authors.initials: K
authors.lastname: Hirai
mesh_terms: D000367:Age Factors; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D003657:Decision Making; D005260:Female; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000208:ethnology*; D017060:Patient Satisfaction; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000523:psychology* / Q000706:statistics & numerical data; D006435:Renal Dialysis / Q000523:psychology* / Q000706:statistics & numerical data; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires