Attitudes and perceptions of nephrology nurses towards dialysis modality selection: a survey study

BMC Nephrol. 2013 Sep 10;14:192. doi: 10.1186/1471-2369-14-192.

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).

Conclusion: Dialysis nurses have prevailing views about modality selection that are strongly determined by their area of experience and expertise.

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Canada / epidemiology
  • Dialysis / classification*
  • Dialysis / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nephrology Nursing / statistics & numerical data*
  • Population Surveillance
  • Practice Patterns, Nurses' / statistics & numerical data*
  • Prevalence
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / nursing*