Components of peritonitis preventive self-care education programs associated with self-care knowledge and behavior among patients undergoing peritoneal dialysis in Japan: a cross-sectional study

Abstract

Background: Preventing peritoneal dialysis (PD)-associated peritonitis remains a major concern in continuing safe treatment and improving patient quality of life. This study aimed to determine the self-care education and quality care initiatives performed for patients undergoing PD and explored their association with patient self-care knowledge and behavior regarding peritonitis prevention. Methods: A nationwide cross-sectional survey was conducted with PD patients and their nurses in Japanese hospitals as respondents. Nurses provided the regular practice of self-care education and quality care initiatives for PD patients within the hospital while patients answered questions on their self-care knowledge and behaviors. Multivariate logistic regression analyses were performed to explore the factors of patients’ self-care knowledge and behaviors. Results: We analyzed data on 170 patients (mean age: 65.1 years old) matched with those of 58 nurses from 58 hospitals. Although most educational contents were taught, teaching methods varied; evaluating patients’ learning levels and re-educating during follow-up periods were less frequently performed. As for quality care initiatives, 60% of hospital nurses monitored peritonitis rates, 33% shared peritonitis-associated information with relevant departments, and 47% had performed home visits before PD patients' discharge in the past. The factors of patients’ self-care knowledge include nurses’ re-educating during follow-ups (odds ratio (OR) = 1.11, 95% confidence interval (CI) = 1.01–1.22, p = 0.025), sharing information with relevant departments (OR = 1.66, 95% CI = 1.01–2.74, p = 0.047), and patients’ younger age (OR = 0.98, 95% CI = 0.96–1.00, p = 0.019). Hospitals performing home visits and patients’ perceived social support were associated with both self-care knowledge (OR = 1.16, 95% CI = 1.01–1.34, p = 0.038 and OR = 1.33, 95% CI = 1.10–1.61, p = 0.003, respectively) and behavior (OR = 1.29, 95% CI = 1.02–1.64, p = 0.031 and OR = 1.61, 95% CI = 1.14–2.28, p = 0.007, respectively). Conclusions: Re-education during follow-up visits, sharing information, and home visits before discharge may benefit patients in promoting peritonitis preventive self-care.