Effects of modified-continuous ambulatory peritoneal dialysis (CAPD) patient’s handling process among community nurses towards patient’s quality of life and treatment outcomesin Nan province, Thailand

Abstract

Background: Continuous Ambulatory Peritoneal Dialysis (CAPD) is an important kidney replacement therapy that highly increased after increasing ESRD patients which required renal replacement therapy and after the Thai government promoted PD first policy under a universal coverage scheme in the year 2008. The potential advantage of CAPD modality is home therapy which is less costly than haemodialysis nevertheless, CAPD’s patients facing lifelong physical, psychological and social problems related to their illness and its treatment care especially lack CAPD programme in primary care level. Consequently, this study aims to assess the “modified CAPD patient’s handling process” among healthcare providers at the primary care level.

Methods: In this quasi-experimental study, 47 community nurses in a health-promoting hospital in 8 districts of Nan renal node was completed the modified-continuous ambulatory peritoneal dialysis (CAPD) patient’s handling process intervention which based on case management (CM) and integrated with CAPD web-based programme. The main outcome measures were knowledge (K), perception and the performance of CAPD care among community nurses at the primary care level. In addition, the secondary outcomes of CAPD patient’s quality of life and treatment outcomes were examined.

Results: The “Modified CAPD patient’s handling process” was developed for Community nurse with nurse case management through patient’s assessment, nursing care planning, communication, advocacy and health education, health resource management, and service facilitation by the collaboration of multidisciplinary team by Care-map and Clinical Practice Guideline (CPG) and added-up with Web base programme for patient’s information and monitoring of CAPD care among hospital renal node and health-promoting hospitals. After the applied intervention, the knowledge of CAPD care, perception and performance of CAPD care in the intervention were higher than the control group significantly (p<.001). The Quality of Life and treatment outcomes of CAPD patients in the intervention group illustrated higher Quality of Life and effective treatment outcomes significantly (p<.001).

Conclusion and recommendation: Modified CAPD patient’s handling process programme effects on the performance of care and illustrated the Quality of Life and treatment outcomes in CAPD patients. Probably, case management which integrated with eHealth should be established in other aria and other chronic diseases purpose to increase the performance of care and efficiency on treatment outcomes and quality of life.