Design of therapeutic education workshops for home haemodialysis in a patient-centered chronic kidney diseases research: a qualitative study

Developing and Evaluating a Home Hemodialysis Training Program-A Quality Improvement Study

INTRODUCTION

In 2018, our home hemodialysis training program required 3-4 months to complete, with sessions lasting 4 h, three times a week. Due to the time commitment, some patients who preferred home hemodialysis decided on alternative dialysis modalities. This study aimed to (1) identify potential improvements to Training Program 1.0, (2) develop Training Program 2.0, and (3) assess the outcomes of Training Program 2.0.

METHOD

We reviewed literature, conducted focus groups with home hemodialysis nurses in Helsinki, Finland, and interviewed patients who participated in Training Program 1.0. Training Program 2.0 was developed in collaboration with patients and clinicians, using a "learning by doing" approach. Evaluation included both qualitative interviews and quantitative analysis of patient records.

FINDINGS

Patients' feedback, aligned with the literature and Helsinki's program, led to six major changes: (1) more frequent training sessions, (2) earlier introduction of self-cannulation, (3) a permanent team of training nurses, (4) a shorter and more structured program, (5) individualized weekly schedules, and (6) clearer instructions. Training frequency increased to four sessions per week, with self-cannulation introduced in the second week. The quantitative results showed a trend toward a reduction in the number of training sessions and total training time. The qualitative data indicated a marked improvement in patient experience.

DISCUSSION

The modifications in Training Program 2.0 created a more effective learning environment, as evidenced by improved patient satisfaction. While quantitative measures did not show significant reductions in training time, the qualitative improvements suggest that these changes positively impact the patient experience, aligning with findings from other home hemodialysis studies. These results underscore the importance of tailoring training programs to patient needs and preferences, contributing to better engagement and potentially higher adoption of home hemodialysis.

Evaluation of the experience with the use of telemedicine in a home dialysis program-a qualitative and quantitative study

INTRODUCTION

Assisted home hemodialysis is a therapeutic modality for patients diagnosed with end-stage renal disease who require dialysis replacement therapy and have concomitant health limitations that prevent them from attending a satellite dialysis unit or performing their own treatment.

OBJECTIVE

The main objective of this study was to evaluate whether telemedicine provided through telemonitoring can improve the ongoing relationship between the doctor, the nurse and the patient.

METHOD

This prospective longitudinal, qualitative and quantitative study analyzes the impact of telemedicine through an evaluation of the experiences of patients and nurses. During the study, we performed remote weekly monitoring for 6 months.

RESULTS

A total of 17 patients and 12 nurses were included. We observed that the patients and nurses had positive experiences with telemonitoring and highlighted feelings of being cared for and improved confidence, although they indicated that telemonitoring does not replace face-to-face visits.

CONCLUSION

Telemonitoring is a useful tool to increase satisfaction with and confidence in home hemodialysis.