Pre-dialysis education and information and the relationship to dialysis treatment type in the Kingdom of Saudi Arabia

Abstract

Patients with End Stage Renal Disease (ESRD) face major challenges in their
lives regarding dialysis therapy for survival, challenges which include making informed treatment choices. No research has been found which investigates what information, or education, patients in the Kingdom of Saudi Arabia (KSA) receive, nor what factors influence the choices made and treatments gained. This issue has been the impetus for this survey research that was designed to
determine what information patients in KSA have been given and to identify patients’ perceptions of the factors that influence the treatment they receive. The data will be used to develop recommendations informing pre-dialysis education for ESRD in KSA.

The questionnaire from the USA study by Mehrotra et al. (2005) was utilised, with additional questions related to patients' views and recommendations for pre-dialysis education. ESRD patients who were ≥ 18 years and who had been receiving dialysis, for at least 3 months to 1 year, were recruited from four hospitals in the western region of the KSA.

Ninety-two patients out of 100 patients recruited completed the questionnaire (a response rate of 92%). The majority (61.9%) of participants were receiving haemodialysis (HD); 38% received peritoneal dialysis (PD). Nearly 20% of patients were not given any option about which treatment they received, although for many this was for clinical reasons. Almost 60% of patients were given a delayed treatment option; i.e. they received an option either after their treatment commenced or less than 1 month before they started dialysis. There was a significant association between participants rating the dialysis education/information as ‘poor’ or ‘totally inadequate’ and receiving HD (p=0.000) and between patients’ needs for additional information and treatment type (HD) (p=0.000). Binary logistic regression indicated that having someone at home to help with treatment was a predictor for patients who opted for PD.
The study provided evidence that just under 20% had no, or delayed,
presentation of treatment options. Just over 60% of patients were placed on HD
and generally were not satisfied. Recommendations to improve pre-dialysis education include the patient’s right to be informed about available treatment options, the provision of more educational materials, and increased time to be spent on education for patients. The provision should be adjusted according to patients’ needs, level of education, and consideration made of family
involvement in decisions.

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Identifiers

ORCID for Sarah Brien: orcid.org/0000-0003-1120-2364

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