Effects Of Peer Support On Quality Of Life In Peritoneal Dialysis Patients

Objective1.Construct peer support programs for peritoneal dialysis patients.Provide standardized scientific guidance for the conduction of peer support for peritoneal dialysis patients.2.Study the effects of the constructed peer support care programs on quality of life in peritoneal dialysis patients.Methods1.The format and contents of current domestic and international peer support were summarized through literature review.Meanwhile,a qualitative approach was applied through semi-structured interviews with health care experts and peritoneal dialysis patients.All information was analyzed by Colaizzi 7 step analysis method.The format and contents of peer support care were ultimately determined based on discussion of the results of qualitative research on the needs of peer support in peritoneal dialysis patients and which supplemented the literature review.2.Subjects were divided into three groups using randomized controlled method: the conventional group,regular clinic follow-up once/month;intervention group 1(wechat group),in addition to the regular clinic visit,peer support care was carried out through wechat between peer volunteers and subjects;intervention group 2(face-to-face group),in addition to the regular clinic visit,peer support was carried out through face-to-face interventions between peer volunteers and subjects.Comparison of different intervention forms,intra-subject difference before and after the intervention,and inter-group difference was made at three months and six months.Results1.Construction phase of the peer support program: By understanding and exploring the needs of peritoneal dialysis patients and recommendations for peer support program from health care experts,the following was extracted.On the part of health care experts: in favor of the implementation of peer support in peritoneal dialysis patients,emphasizing timely intervention of health care personnel,to implement various forms of peer support,focusing on patients' self-management,emphasizing selection and training of peer volunteers;on the part of peritoneal dialysis patients: peritoneal dialysis patients desire the opportunity for understanding and communication,including the need for psychological support,the demand for information support,and the need for evaluation support.2.Results of the implementation phase of peer support program: Self-management capabilities: Statistically significant difference before and after the intervention was observed in wechat group and face-to-face group in terms of average total score and the three aspects of dietary management,complications monitoring,emotion management and social acceptance;in terms of biochemical indicators,wechat group and face-to-face group showed statistically significant intervention time correlated difference in pre-albumin,hemoglobin,and calcium;as regards KDTA scale,statistically significant intervention time correlated difference was observed in wechat group and face-to-face group in terms of KDTA average total score and the scores of the seven aspects of disease impact,disease burden,quality of social activities,sleep,social support,health care staff encouragement,and patient satisfaction.In group-to-group comparison of the three groups,the difference between the intervention groups and the conventional group were statistically significant in all the above aspects.When wechat group and face-to-face group were compared at different intervention time points,statistically significant difference was only found in hemoglobin,serum phosphorus and patient satisfaction at six-month time point,differences in all remaining aspects were not statistically significant.No statistically significant intervention time correlated difference was found in conventional group in all evaluation aspects.Conclusions1.The peer support program constructed in this study for peritoneal dialysis patients is scientific in certain aspects and is practical to implement.2.The peer support program constructed in this study effectively improved the quality of life for peritoneal dialysis patients.No significant difference was observed between the two forms of intervention,wechat and face-to face.Selection of the two forms of intervention can be made case by case.3.The influence and role of peer volunteers and health care staff in peer support are indispensable.To ensure the scientific effect of peer support,tracking and monitoring of information quality should be actively guided and secured.