title: Increasing the uptake of peritoneal dialysis in New Zealand: a national survey.
abstract: BACKGROUND
  Peritoneal dialysis (PD) has been shown to offer a high quality of life and independence to patients. New Zealand (NZ) is a world leader in home dialysis, yet over the last decade, rates of PD have been steadily decreasing for unknown reasons.
  
  
  OBJECTIVE
  This paper reports on the findings of a national survey which explored the clinicians' perspectives on key factors that influence the rate of PD.
  
  
  METHODS
  Ten multi-answer questions were asked of several groups of dialysis health professionals to assess factors that are barriers and enablers to PD, including patient choice of dialysis modality, information about PD and pre-dialysis education delivery. All NZ nephrologists, pre-dialysis and PD nurses were invited to complete an anonymous online survey. Responses were analysed to identify perceived barriers and enablers influencing the rate of PD uptake amongst incident dialysis patients.
  
  
  RESULTS
  Completed surveys were received from 52% of nephrologists, 100% of pre-dialysis nurses and 50% of PD nurses in NZ. In NZ, patients are offered a choice of dialysis modality with pre-dialysis nurses delivering the majority of education. The most frequently identified barriers to uptake of PD were lack of information about PD, established misconceptions about PD and late referrals to dialysis. Important enablers were early and frequent pre-dialysis education. The only two factors which were reported as very important contraindications to PD were dexterity and decreased cognitive function.
  
  
  CONCLUSIONS
  Early and frequent pre-dialysis education encourages patients to choose PD and enables early identification and resolution of barriers to the uptake of PD.
authors.forename: Rachael Claire
authors.initials: RC
authors.lastname: Walker
authors.forename: Mark Roger
authors.initials: MR
authors.lastname: Marshall
mesh_terms: D002755:Choice Behavior; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy; D009520:New Zealand / Q000453:epidemiology; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data*; D011788:Quality of Life; D011795:Surveys and Questionnaires