Study on the cognition and acceptance of community-based hemodialysis centers among hemodialysis patients in Yangzhou_West China Medical Journal

Authors：

XU Jun ¹ ,  CHEN Rui ²

1. Blood Purification Center, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu 225000, P. R. China;
2. Department of Nephrology, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu 225000, P. R. China;

Corresponding?author：

CHEN Rui, Email: ruidoc@126.com

Keywords：

Hemodialysis; community; awareness; attention

DOI：

10.7507/1002-0179.202107177

Video：

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Objective To understand the cognition and acceptance of community hemodialysis centers among hemodialysis patients in Yangzhou, and to provide theoretical basis for the development of community hemodialysis centers. Methods A cluster random sampling method was used to select 400 maintenance hemodialysis patients treated in various areas of Yangzhou in April 2021 for a questionnaire survey to analyze the influencing factors of patients’ medical treatment behavior. Results A total of 390 valid questionnaires were recovered, with an effective recovery rate of 97.50%. Among the patients, 40.51% were very concerned about the construction of hemodialysis centers in the community, 56.67% understood the relevant policies, and 56.92% of the patients were willing to choose the community for dialysis treatment. The results of logistic regression analysis showed that the main factors affecting whether patients choose community for hemodialysis treatment include the patients’ residence [Jiangdu vs. Guangling: odds ratio (OR)=7.183, 95% confidence interval (CI) (2.010, 25.674), P=0.002; Gaoyou vs. Guangling: OR=22.512, 95%CI (7.201, 70.373), P<0.001; Yizheng vs. Guangling: OR=25.137, 95%CI (7.636, 82.744), P<0.001; Baoying vs. Guangling: OR=23.784, 95%CI (7.795, 72.569), P<0.001], degree of concern [some concern vs. very concerned: OR=0.267, 95 %CI (0.137, 0.521), P<0.001; not very concerned vs. very concerned: OR=0.062, 95%CI (0.023, 0.168), P<0.001; not concerned vs. very concerned: OR=0.101, 95% CI (0.023, 0.439), P=0.002], awareness [somewhat know vs. know very well: OR=0.025, 95%CI (0.002, 0.318), P=0.004; don’t know very well vs. know very well: OR=0.035, 95%CI (0.003, 0.439), P=0.009; don’t know vs. know very well: OR=0.006, 95%CI (0.000, 0.084), P<0.001]. Conclusions Hemodialysis patients in Yangzhou have a low level of awareness and acceptance of community-based hemodialysis centers. The patients’ residence, degree of attention and awareness of community-based hemodialysis center directly affect whether they choose the community for treatment. The relevant departments and medical institutions can start from the factors that affect patients’ choice of medical treatment, further strengthen the publicity of community dialysis, optimize the allocation of medical resources, and improve the capacity of community health services.

Citation： XU Jun, CHEN Rui. Study on the cognition and acceptance of community-based hemodialysis centers among hemodialysis patients in Yangzhou. West China Medical Journal, 2022, 37(7): 1027-1034. doi: 10.7507/1002-0179.202107177 Copy

1.	張路霞, 王海燕. 中國慢性腎臟病的現狀及挑戰—來自中國慢性腎臟病流行病學調查的啟示. 中華內科雜志, 2012, 51(7): 497-498.
2.	Drawz P, Rahman M. Chronic kidney disease. Ann Intern Med, 2015, 162(11): ITC1-16.
3.	Zouari L, Omri S, Turki S, et al. Quality of life in chronic hemodialysis patients: about 71 cases. Tunis Med, 2016, 94(1): 40-45.
4.	Gray NA, Dent H, McDonald SP. Renal replacement therapy in rural and urban Australia. Nephrol Dial Transplant, 2012, 27(5): 2069-2076.
5.	Chao CT, Lai CF, Huang JW, et al. Association of increased travel distance to dialysis units with the risk of anemia in rural chronic hemodialysis elderly. Hemodial Int, 2015, 19(1): 44-53.
6.	Thompson S, Gill J, Wang X, et al. Higher mortality among remote compared to rural or urban dwelling hemodialysis patients in the United States. Kidney Int, 2012, 82(3): 352-359.
7.	Gorham G, Howard K, Togni S, et al. Economic and quality of care evaluation of dialysis service models in remote Australia: protocol for a mixed methods study. BMC Health Serv Res, 2017, 17(1): 320.
8.	周莉, 付平. 社區開展血液透析可能遇到的問題及可能解決方案. 中國血液凈化, 2017, 16(3): 145-147.
9.	曾琳, 陶立元, 趙英帥. 健康管理學研究中的樣本量估計. 中華健康管理學雜志, 2021, 15(2): 205-208.
10.	曹曉翼, 陳林. 成都市血液透析患者與家屬對社區開展血液透析態度的差異性研究. 中國血液凈化, 2020, 19(7): 492-495.
11.	曹曉翼, 石梅, 魏申毅, 等. 四川省血液透析患者社區血液透析態度影響因素的質性研究. 護士進修雜志, 2019, 34(21): 1967-1970.
12.	Brundisini F, Giacomini M, DeJean D, et al. Chronic disease patients’ experiences with accessing health care in rural and remote areas: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser, 2013, 13(15): 1-33.
13.	Scholes-Robertson NJ, Gutman T, Howell M, et al. Clinicians’ perspectives on equity of access to dialysis and kidney transplantation for rural people in Australia: a semistructured interview study. BMJ Open, 2022, 12(2): e052315.
14.	Genereux D, Fan L, Brownlee K. The psychosocial and somatic effects of relocation from remote Canadian first nation communities to urban centres on indigenous peoples with chronic kidney disease (CKD). Int J Environ Res Public Health, 2021, 18(7): 3838.
15.	Gorham G, Howard K, Cunningham J, et al. Dialysis attendance patterns and health care utilisation of aboriginal patients attending dialysis services in urban, rural and remote locations. BMC Health Serv Res, 2022, 22(1): 251.
16.	Scholes-Robertson N, Gutman T, Howell M, et al. Patients’ perspectives on access to dialysis and kidney transplantation in rural communities in Australia. Kidney Int Rep, 2021, 7(3): 591-600.
17.	曹陽, 程同升. 高郵市城鎮慢性病患者就醫選擇的影響因素研究. 醫學與社會, 2020, 33(10): 37-43.
18.	胡安琪. 疫情期間新型冠狀病毒公眾關注度的時空變化研究. 大學圖書情報學刊, 2021, 39(4): 25-31, 58.
19.	Organ K, MacDonald S. Satellite hemodialysis services for patients with end stage renal disease. CANNT J, 2014, 24(1): 28-33.
20.	段暉, 劉穎, 張英楠, 等. 北京市醫聯體政策背景下慢病患者就醫選擇影響因素研究. 中國衛生政策研究, 2020, 13(6): 14-20.
21.	海鵬程, 玄律, 鄭杰, 等. 北京市醫保高血壓患者門診就醫選擇及其影響因素分析. 中華醫院管理雜志, 2022, 38(2): 115-120.
22.	曹曉婧, 戴力輝, 王燕, 等. 基于混合 Logit 模型的我國農村居民就醫選擇的影響因素分析. 衛生軟科學, 2022, 36(3): 82-86.
23.	吳功華, 姚明宏, 徐嘉悅, 等. 四川省城鄉居民就醫行為現狀及其影響因素分析. 現代預防醫學, 2020, 47(7): 1235-1239.
24.	鄭莉莉. 醫療保險改變了居民的就醫行為嗎?—來自我國 CHNS 的證據. 財政研究, 2017(2): 84-97.
25.	任艷麗, 童恩煜, 狄春紅, 等. 基于 2018 年 CHARLS 調查數據的中老年群體首診就醫選擇及其影響因素. 醫學信息, 2022, 35(10): 40-43.
26.	Matsumoto M, Kashima S, Ogawa T, et al. Do rural and remote areas really have limited accessibility to health care? Geographic analysis of dialysis patients in Hiroshima, Japan. Rural Remote Health, 2013, 13(3): 2507.
27.	Kiani B, Bagheri N, Tara A, et al. Haemodialysis services in the northeastern region of Iran. Geospat Health, 2017, 12(1): 561.
28.	Haroon S, Voo TC, Chua H, et al. Telemedicine and haemodialysis care during the COVID-19 pandemic: an integrative review of patient safety, healthcare quality, ethics and the legal considerations in singapore practice. Int J Environ Res Public Health, 2022, 19(9): 5445.

1. 張路霞, 王海燕. 中國慢性腎臟病的現狀及挑戰—來自中國慢性腎臟病流行病學調查的啟示. 中華內科雜志, 2012, 51(7): 497-498.
2. Drawz P, Rahman M. Chronic kidney disease. Ann Intern Med, 2015, 162(11): ITC1-16.
3. Zouari L, Omri S, Turki S, et al. Quality of life in chronic hemodialysis patients: about 71 cases. Tunis Med, 2016, 94(1): 40-45.
4. Gray NA, Dent H, McDonald SP. Renal replacement therapy in rural and urban Australia. Nephrol Dial Transplant, 2012, 27(5): 2069-2076.
5. Chao CT, Lai CF, Huang JW, et al. Association of increased travel distance to dialysis units with the risk of anemia in rural chronic hemodialysis elderly. Hemodial Int, 2015, 19(1): 44-53.
6. Thompson S, Gill J, Wang X, et al. Higher mortality among remote compared to rural or urban dwelling hemodialysis patients in the United States. Kidney Int, 2012, 82(3): 352-359.
7. Gorham G, Howard K, Togni S, et al. Economic and quality of care evaluation of dialysis service models in remote Australia: protocol for a mixed methods study. BMC Health Serv Res, 2017, 17(1): 320.
8. 周莉, 付平. 社區開展血液透析可能遇到的問題及可能解決方案. 中國血液凈化, 2017, 16(3): 145-147.
9. 曾琳, 陶立元, 趙英帥. 健康管理學研究中的樣本量估計. 中華健康管理學雜志, 2021, 15(2): 205-208.
10. 曹曉翼, 陳林. 成都市血液透析患者與家屬對社區開展血液透析態度的差異性研究. 中國血液凈化, 2020, 19(7): 492-495.
11. 曹曉翼, 石梅, 魏申毅, 等. 四川省血液透析患者社區血液透析態度影響因素的質性研究. 護士進修雜志, 2019, 34(21): 1967-1970.
12. Brundisini F, Giacomini M, DeJean D, et al. Chronic disease patients’ experiences with accessing health care in rural and remote areas: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser, 2013, 13(15): 1-33.
13. Scholes-Robertson NJ, Gutman T, Howell M, et al. Clinicians’ perspectives on equity of access to dialysis and kidney transplantation for rural people in Australia: a semistructured interview study. BMJ Open, 2022, 12(2): e052315.
14. Genereux D, Fan L, Brownlee K. The psychosocial and somatic effects of relocation from remote Canadian first nation communities to urban centres on indigenous peoples with chronic kidney disease (CKD). Int J Environ Res Public Health, 2021, 18(7): 3838.
15. Gorham G, Howard K, Cunningham J, et al. Dialysis attendance patterns and health care utilisation of aboriginal patients attending dialysis services in urban, rural and remote locations. BMC Health Serv Res, 2022, 22(1): 251.
16. Scholes-Robertson N, Gutman T, Howell M, et al. Patients’ perspectives on access to dialysis and kidney transplantation in rural communities in Australia. Kidney Int Rep, 2021, 7(3): 591-600.
17. 曹陽, 程同升. 高郵市城鎮慢性病患者就醫選擇的影響因素研究. 醫學與社會, 2020, 33(10): 37-43.
18. 胡安琪. 疫情期間新型冠狀病毒公眾關注度的時空變化研究. 大學圖書情報學刊, 2021, 39(4): 25-31, 58.
19. Organ K, MacDonald S. Satellite hemodialysis services for patients with end stage renal disease. CANNT J, 2014, 24(1): 28-33.
20. 段暉, 劉穎, 張英楠, 等. 北京市醫聯體政策背景下慢病患者就醫選擇影響因素研究. 中國衛生政策研究, 2020, 13(6): 14-20.
21. 海鵬程, 玄律, 鄭杰, 等. 北京市醫保高血壓患者門診就醫選擇及其影響因素分析. 中華醫院管理雜志, 2022, 38(2): 115-120.
22. 曹曉婧, 戴力輝, 王燕, 等. 基于混合 Logit 模型的我國農村居民就醫選擇的影響因素分析. 衛生軟科學, 2022, 36(3): 82-86.
23. 吳功華, 姚明宏, 徐嘉悅, 等. 四川省城鄉居民就醫行為現狀及其影響因素分析. 現代預防醫學, 2020, 47(7): 1235-1239.
24. 鄭莉莉. 醫療保險改變了居民的就醫行為嗎?—來自我國 CHNS 的證據. 財政研究, 2017(2): 84-97.
25. 任艷麗, 童恩煜, 狄春紅, 等. 基于 2018 年 CHARLS 調查數據的中老年群體首診就醫選擇及其影響因素. 醫學信息, 2022, 35(10): 40-43.
26. Matsumoto M, Kashima S, Ogawa T, et al. Do rural and remote areas really have limited accessibility to health care? Geographic analysis of dialysis patients in Hiroshima, Japan. Rural Remote Health, 2013, 13(3): 2507.
27. Kiani B, Bagheri N, Tara A, et al. Haemodialysis services in the northeastern region of Iran. Geospat Health, 2017, 12(1): 561.
28. Haroon S, Voo TC, Chua H, et al. Telemedicine and haemodialysis care during the COVID-19 pandemic: an integrative review of patient safety, healthcare quality, ethics and the legal considerations in singapore practice. Int J Environ Res Public Health, 2022, 19(9): 5445.

West China Medical Journal

Study on the cognition and acceptance of community-based hemodialysis centers among hemodialysis patients in Yangzhou

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