title: A Qualitative Assessment of Mismatch Between Dialysis Modality Selection and Initiation.
abstract: At our institution, we have noted that end-stage renal disease patients choosing a home dialysis modality after education often initiate renal replacement therapy with in-center hemodialysis (HD) instead. We interviewed 24 such patients (23 choosing peritoneal dialysis [PD], one choosing home HD) to determine reasons for this mismatch. The most common reasons cited for not starting home dialysis were: lack of confidence/concerns about complications, lack of space or home-related issues, a feeling of insufficient education, and perceived medical or social contraindications. We propose several potential strategies to help patients start with their preferred modality.
authors.affiliation: Stanford University School of Medicine, Palo Alto, CA.
authors.forename: Susan
authors.initials: S
authors.lastname: Ziolkowski
authors.affiliation: University of Rochester Medical Center, Rochester, NY Scott_liebman@urmc.rochester.edu.
authors.forename: Scott
authors.initials: S
authors.lastname: Liebman
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D018579:Patient Selection; D010530:Peritoneal Dialysis; D012648:Self Care; D012649:Self Concept
keywords: Home dialysis; dialysis modality selection; pre-dialysis education