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The nurse's role in patient education peritoneal dialysis.
JANSOVÁ, Miroslava
Peritoneal dialysis is one of the possibilities of the chronic renal failure treatment. Its advantage is that the patient is treated alone in his home environment. The main indication of this method is the inability to secure vascular access for hemodialysis. Contraindications include damage to the peritoneum and adhesions in the abdominal cavity. The principle of the method is the exchange of solutes between blood and dialysis solution filled into the peritoneal cavity. Timely and proper education by the nurse is the most important precondition for successful treatment with peritoneal dialysis. The thesis is focused on the role of nurses in the education of patients with peritoneal dialysis. It deals mainly with issues of patient education in connection with the occurrence of complications during their treatment. The first section describes the problems of peritoneal dialysis, including technical aspects, complications and their treatment. Furthermore, the attention is focused on the automated peritoneal dialysis, which takes place mostly at night and therefore the patient has more time to care about his normal daily activities. The second section of the theoretical part is devoted to education. The first target of the research was the examination of the effect of educational activities on the occurence of complications. Before starting treatment, patients have always been educated about the issues of this kond of treatment. The informative materials about the treatment and its related complications were also provided. Some of them did look up the information on the internet, and they discussed it further with the nurse. All of the respondents were able to name and describe the symptoms of complications occurring at the beginning and during the therapy. The second goal was to compare awareness among patients with frequent complications compared to those with the least complications. We did not find any benchmark to determine, whether the inconvenience was caused y the degree of unawareness of the patients, or their attitude to the treatment. The discussion will reflect on the question, which errors did subsequently led to the complications. The third objective was to compare the incidence of complications on patients with APD compared to patients on CAPD. With CAPD, the patient opens and closes the transfer set at least 4 times a day, thereby increasing the risk of infection through the peritoneal catheter. The research shows that among respondents undergoing the APD treatment method, the number of complications is lower. It is not possible to determine, whether the numer of complications on APD is lower due to minimal use of the peritoneal catheter, or because some patients on CAPD have already suffered the complications and have been instructed to approach the APD more responsibly. The empirical part of the thesis is presented by a qualitative research. The survey was carried out in the form of non-standardized interview based on prepared questions, which were extended during interviews. The research group consists of ten patients from dialysis clinics in Tabor, Ceske Budejovice and Jindrichuv Hradec. The patients on CAPD and APD were of different ages and with different duration of treatment. Peritoneal dialysis is the elimination method of replacing the kidneys function, and it is performed by the patient himself, in their own social environment. A prerequisite for successful treatment is high-quality patient education, which is mainly provided by the nurse. This introductory education continues with ongoing reeducation. The results of this thesis may be used as the basis for further research. They can also be used as study material for students of nursing fields. Created brochure can help the patients to decide, how to select the treatment method, or mastering the problems of this treatment.
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