During the study period, 2554 patients started PD treatment at 156 centers in mainland France. Nine hundred and forty patients in 66 centers were registered in the nursing module. Thus, 42% of nursing teams completed the module, and the number of patients included represented 37% of incident patients.
Sex ratio: 32% of incident patients were female and 67% male.
The patients’ average age was 69.5±16 years. It was higher in CAPD (69.7 years) than in APD (57.8 years). The age pyramid is summarized in
Age pyramid for incident PD patients (2022-2023)
Patients’ level of autonomy
| Autonomy | Numbers | Percentage |
|---|---|---|
| Autonomous | 1460 | 60.4% |
| Assisted by a registered nurse | 844 | 34.9% |
| Assisted by family | 103 | 4.3% |
| Assisted (unspecified) | 10 | 0.4% |
One question asks for a subjective description of activity during the 3 months preceding the start of dialysis. Activity is defined as either professional activity or its equivalent at home. A housewife, for example, taking care of all household activities is counted as a full-time activity.
- 26% felt they had the equivalent of a full-time job
- 7% felt they had the equivalent of a part-time job
- 67% felt they had almost no activity
Ninety-six percent of patients started training after catheter insertion, and 4% before. When patient training was started after catheter insertion, the average time between catheter insertion and the start of training was 9.1 days, although there are wide variations (
Waiting time between catheter implantation and start of training, when training is started after catheter implantation.
The average training time was 10 days. Some patients, however, required more than 39 days of training before starting home treatment (
Durations of patient training times before being allowed to be treated at home
Training was given exclusively to the patient in 48% of cases; in 17% of cases, training was given to both a family member and the patient; in 2 % of cases, only to a family member; and in 33 %, exclusively to a nurse (
Person trained to treat the patient at home
Patients in our care may have single or multiple disabilities, which affect their ability to become independent and explain the frequent need for third-party assistance. The relatively high average age probably explains the frequency of disabilities. Deficient visual acuity despite correction existed in 11% of cases (
Presence of a disability at the time of training
Handicap | Numbers | Percentage |
|---|---|---|
Visual | 106 | 11.0% |
Manuel | 48 | 5.0% |
Auditory | 43 | 4.4% |
Moderate intellectual | 42 | 4.3% |
Auditory and visual | 29 | 3.0% |
Severe cognitive impairment | 3 | 0.3% |
Regardless of language, 1.7% of patients had never learned to read or write.
The majority of patients (90 %) had complete freedom of choice of the dialysis technique, without the team seeking to influence their decision. In a small number of cases, the method was imposed, sometimes without information about other techniques. The reasons for this are not known in the database.
Choice of dialysis technique for PD patients
Patient position prior to peritoneal dialysis training
Eighty-seven percent of patients who started PD during this period were in favor of the technique, 9.5% had no opinion, and 3.4% were opposed.
The training tools recorded by the centers in the database are the use of an education booklet, an evaluation grid, a training booklet, and an audiovisual support. The training booklet is a comprehensive document explaining the principles of PD and its various aspects, the education notebook is used to write down what has been done at the end of each training session, and the evaluation grid is a table containing everything that has been covered in the training, with each box ticked as it goes along.
For each patient, the nurse records the different types of tools used. This is summarized in
Tools used by nurses to train patients | ||
|---|---|---|
Education notebook | 66.3% | |
Evaluation grid | 59.3% | |
Booklet | 81.1% | |
Audiovisual support | 53.2% | |
At the time of discharge:
- 92% of patients had assimilated the theoretical concepts taught by the team
- 78% of patients knew how to adapt the types of solutions to their status
- 90% knew how to measure their own blood pressure
Recognition of peritoneal infection by autonomous patients
Ninety-nine percent of autonomous patients received explanations on how to recognize an infection in their peritoneal dialysis fluid; these explanations could be purely theoretical, or practical by showing a cloudy bag.
- In 1% of cases, the patient was not told how to recognize peritonitis.
- In 49% of cases, only theoretical explanations were given.
- In 4% of cases, only a practical explanation was given, showing a cloudy pouch.
- In 47% of cases, recognition of peritonitis was taught using both theoretical explanations and a practical example.
If antibiotics are to be added to the bags:
In certain circumstances, for example when monitoring a peritoneal infection, it may be necessary to add medication to the bags, which can sometimes be done at home. Some patients, or a family member, may be trained to do this during their training. Below are the percentages of patients for whom one type of person is trained to do this at home.
The injection technique in bags, for autonomous patients :
- is not taught in 83% of cases
- is taught only to the patient in 13% of cases
- is taught to both the patient and a family member in 4% of cases