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Learning needs of persons on home hemodialysis Niskala, Helena

Abstract

What the home hemodialysis patient knows and wants to know about his health problem and its management forms the principal target of the present investigation but it also takes into account socio-emotional concerns, skill in administering therapy, and use of information sources. The respective perceptions of the patient and staff members about these factors have been compared. This study also examines the relationship between the amount of health information held by the patient and selected biographical characteristics, and the relationship between staff estimates of health information possessed by the patient and their selected biographical characteristics. Forty-four patients on home hemodialysis and twenty-nine staff members involved in the Training Program at three British Columbia hospitals were studied. Data were gathered through personal interviews and hospital records, and were analyzed by simple frequency and percentage distributions, along with a Pearson product-moment correlation, One-way Analysis of Variance, Chi-square and T-values. Both the patients themselves and the staff considered the patient to be knowledgeable about critical aspects of home dialysis management. Significant differences were found between assessments made by patients and by staff about the patient's level of knowledge, additional requests for information, the information sources preferred, past and present socio-emotional Concerns and sources of information for solving such Concerns. Greater knowledge was displayed by patients with higher social status, fewer children and higher levels of education. Those with children and who were external in orientation had a greater need for additional health information. Patients who spent the longest time in the Training Program admitted to the greatest number of present Concerns and the farther patients lived from the renal unit the more knowledgeable they were about preparation and hook-up procedures. Greater use of information sources was reported by patients with fewer children, higher social status, and who were older. Patients living at greater distances from the renal unit, those with fewer children and external in orientation preferred using more sources of information. The staff estimated that patients would report more past and present Concerns than were actually reported. While patients were misinformed about various aspects of management of dialysis, cannula care, diet and medical problems, their knowledge was greater than estimated by staff members. Patients also used and preferred fewer information sources than estimated by the staff. Staff members who were younger, had residency experience and lower social status estimated that patients were knowledgeable about their health problem. Staff members with shorter residency training estimated patients to have had more past Concerns while those with longer residency training and more teaching involvement felt that patients had more present Concerns. Staff members with longer residency training estimated patients to have used more information sources, while those with shorter residency training suggested that patients would prefer more information sources for additional information. Implications for patient and staff in-service education programs and the diffusion of information have been included in the discussion.

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