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Training Patients for Nocturnal Home Hemodialysis

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Abstract:

Purpose: 

Nocturnal home hemodialysis (NHHD, 6–7 times weekly 6–9 h) results in better clinical outcome than conventional 3 times weekly hemodialysis. A good training program for patient and partner is a prequisite for success. We developed a training course for patients and partners. Methods: 

Since December 2001, we trained 20 patients and their partners to perform NHHD in 2 succeeding groups. The first group, consisting of 15 patients and their partners, started a NHHD pilot study. During this pilot study, we improved the training course. The second group of 5 were trained with this improved program. All 5 participants were home hemodialysis patients for over 1 month before starting the NHHD course. First, they learned how to handle the single needle system. Then, they performed single needle hemodialysis for 2 weeks at home. This was followed by an in-center NHHD training, consisting of 4 conventional day-time and 3 long (8 h) nocturnal dialysis treatments. Main targets during this training period are to learn to deal with safety precautions, online monitoring, and special machine features, and to check biochemistry and heparinization during long dialysis. 1 month after the training we evaluated the course with all participants. Results: 

For 9 of 15 couples in the first group, the training appeared to be exhausting. Stress factors were an overloaded program and too little experience with several new skills including needle technique before starting NHHD. The second group started the NHHD training 2 weeks after the single needle training. This second group was pleased with the training protocol. Conclusion: 

The training course for NHHD should not be overloaded. Patients need time to learn new skills before starting NHHD.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1492-7535.2004.0085bm.x

Affiliations: Dianet Dialysis Centres, Utrecht, The Netherlands.

Publication date: January 1, 2004

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