title: Attitudes and perceptions of nephrology nurses towards dialysis modality selection: a survey study.
abstract: BACKGROUND
  There is a paucity of information about the views of dialysis nurses towards dialysis modality selection, yet nurses often have the most direct contact time with patients. We conducted a survey to better understand nurses' attitudes and perceptions, and hypothesized that nurses with different areas of expertise would have differences in opinions.
  
  
  METHODS
  We administered an electronic survey to all dialysis/predialysis nurses (n = 129) at a large, tertiary care center. The survey included questions about preferred therapy - in-center hemodialysis (CHD), versus home dialysis (home hemodialysis and peritoneal dialysis) and ideal modality mix. Responses were compared between nurses with home dialysis and CHD experience.
  
  
  RESULTS
  The survey response rate was 69%. Both nursing groups ranked patient caregivers and dialysis nurses as having the least impact on patient modality selection. For most patient characteristics (including age > 70 years and presence of multiple chronic illnesses), CHD nurses felt that CHD was somewhat or strongly preferred, while home dialysis nurses preferred a home modality (p < 0.001 for all characteristics studied). Similar differences in responses were noted for patient/system factors such as patient survival, cost to patients and nursing job security. Compared to CHD nurses, a higher proportion of home dialysis nurses felt that CHD was over-utilized (85% versus 58%, p = 0.024).
  
  
  CONCLUSIONS
  Dialysis nurses have prevailing views about modality selection that are strongly determined by their area of experience and expertise.
authors.affiliation: From the Division of Nephrology, Dalhousie University, 5070 Dickson Building 5820 University Avenue, Halifax, NS, Canada. ktennankore@gmail.com.
authors.forename: Karthik K
authors.initials: KK
authors.lastname: Tennankore
authors.forename: Jay
authors.initials: J
authors.lastname: Hingwala
authors.forename: Diane
authors.initials: D
authors.lastname: Watson
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Bargman
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002170:Canada / Q000453:epidemiology; D003956:Dialysis / Q000145:classification* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064647:Nephrology Nursing / Q000706:statistics & numerical data*; D011159:Population Surveillance; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data*; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000451:nursing*
references.citation: Nephrol Dial Transplant. 2012 Sep;27(9):3568-75
references.pmid: 22391139
references.citation: Semin Dial. 2011 Nov-Dec;24(6):607-13
references.pmid: 22122548
references.citation: Nephrology (Carlton). 2011 May;16(4):446-52
references.pmid: 21518119
references.citation: Nephrology (Carlton). 2012 Nov;17(8):703-9
references.pmid: 22882456
references.citation: J Am Soc Nephrol. 2010 Mar;21(3):499-506
references.pmid: 20133483
references.citation: Adv Chronic Kidney Dis. 2011 Nov;18(6):428-32
references.pmid: 22098661
references.citation: J Am Soc Nephrol. 2012 May;23(5):895-904
references.pmid: 22362906
references.citation: J Am Soc Nephrol. 2012 Mar;23(3):533-44
references.pmid: 22302194
references.citation: BMJ. 2010 Jan 19;340:c112
references.pmid: 20085970
references.citation: NDT Plus. 2008 Dec;1(6):403-408
references.pmid: 19020670
references.citation: J Am Soc Nephrol. 2012 Apr;23(4):696-705
references.pmid: 22362910
references.citation: Adv Chronic Kidney Dis. 2009 May;16(3):205-14
references.pmid: 19393971
references.citation: J Adv Nurs. 2011 Jun;67(6):1213-21
references.pmid: 21382078
references.citation: Nephrol Nurs J. 2007 Sep-Oct;34(5):513-9, 525
references.pmid: 18041453
references.citation: Clin J Am Soc Nephrol. 2006 Nov;1(6):1191-6
references.pmid: 17699347
references.citation: Am J Kidney Dis. 2001 Jan;37(1):22-29
references.pmid: 11136163
references.citation: Int Urol Nephrol. 2010 Sep;42(3):759-64
references.pmid: 20563843
references.citation: Am J Kidney Dis. 2012 Jul;60(1):102-11
references.pmid: 22417786
references.citation: Nephrol Dial Transplant. 2011 Dec;26(12):4038-46
references.pmid: 21482637
references.citation: Am J Surg. 1992 Nov;164(5):417-20; discussion 420-2
references.pmid: 1443364
references.citation: Perit Dial Int. 1999 May-Jun;19(3):263-8
references.pmid: 10433164
references.citation: J Am Soc Nephrol. 2002 Jan;13 Suppl 1:S37-40
references.pmid: 11792760
references.citation: Int J Nurs Stud. 2011 Dec;48(12):1570-86
references.pmid: 21924423
references.citation: Nephrol Dial Transplant. 2011 Jul;26(7):2302-8
references.pmid: 21071546
references.citation: Nephrol Dial Transplant. 2008 Dec;23(12):3953-9
references.pmid: 18586764
references.citation: Blood Purif. 2003;21(1):24-8
references.pmid: 12566657
references.citation: Nephrol Dial Transplant. 2008 Dec;23(12):3972-6
references.pmid: 18577531
references.citation: Nephrol Dial Transplant. 2012 Apr;27(4):1542-7
references.pmid: 21865216
references.citation: Nephrol Dial Transplant. 2002 Dec;17(12):2071-6
references.pmid: 12454213
references.citation: Nurs Inq. 2012 Mar;19(1):29-38
references.pmid: 22212368