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.	张路霞, 王海燕. 中国慢性肾脏病的现状及挑战—来自中国慢性肾脏病流行病学调查的启示. 中华内科杂志, 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. 社区开展血液透析可能遇到的问题及可能解决方案. 中国血液净化, 2017, 16(3): 145-147.
9.	曾琳, 陶立元, 赵英帅. 健康管理学研究中的样本量估计. 中华健康管理学杂志, 2021, 15(2): 205-208.
10.	曹晓翼, 陈林. 成都市血液透析患者与家属对社区开展血液透析态度的差异性研究. 中国血液净化, 2020, 19(7): 492-495.
11.	曹晓翼, 石梅, 魏申毅, 等. 四川省血液透析患者社区血液透析态度影响因素的质性研究. 护士进修杂志, 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.	曹阳, 程同升. 高邮市城镇慢性病患者就医选择的影响因素研究. 医学与社会, 2020, 33(10): 37-43.
18.	胡安琪. 疫情期间新型冠状病毒公众关注度的时空变化研究. 大学图书情报学刊, 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.	段晖, 刘颖, 张英楠, 等. 北京市医联体政策背景下慢病患者就医选择影响因素研究. 中国卫生政策研究, 2020, 13(6): 14-20.
21.	海鹏程, 玄律, 郑杰, 等. 北京市医保高血压患者门诊就医选择及其影响因素分析. 中华医院管理杂志, 2022, 38(2): 115-120.
22.	曹晓婧, 戴力辉, 王燕, 等. 基于混合 Logit 模型的我国农村居民就医选择的影响因素分析. 卫生软科学, 2022, 36(3): 82-86.
23.	吴功华, 姚明宏, 徐嘉悦, 等. 四川省城乡居民就医行为现状及其影响因素分析. 现代预防医学, 2020, 47(7): 1235-1239.
24.	郑莉莉. 医疗保险改变了居民的就医行为吗?—来自我国 CHNS 的证据. 财政研究, 2017(2): 84-97.
25.	任艳丽, 童恩煜, 狄春红, 等. 基于 2018 年 CHARLS 调查数据的中老年群体首诊就医选择及其影响因素. 医学信息, 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. 张路霞, 王海燕. 中国慢性肾脏病的现状及挑战—来自中国慢性肾脏病流行病学调查的启示. 中华内科杂志, 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. 社区开展血液透析可能遇到的问题及可能解决方案. 中国血液净化, 2017, 16(3): 145-147.
9. 曾琳, 陶立元, 赵英帅. 健康管理学研究中的样本量估计. 中华健康管理学杂志, 2021, 15(2): 205-208.
10. 曹晓翼, 陈林. 成都市血液透析患者与家属对社区开展血液透析态度的差异性研究. 中国血液净化, 2020, 19(7): 492-495.
11. 曹晓翼, 石梅, 魏申毅, 等. 四川省血液透析患者社区血液透析态度影响因素的质性研究. 护士进修杂志, 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. 曹阳, 程同升. 高邮市城镇慢性病患者就医选择的影响因素研究. 医学与社会, 2020, 33(10): 37-43.
18. 胡安琪. 疫情期间新型冠状病毒公众关注度的时空变化研究. 大学图书情报学刊, 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. 段晖, 刘颖, 张英楠, 等. 北京市医联体政策背景下慢病患者就医选择影响因素研究. 中国卫生政策研究, 2020, 13(6): 14-20.
21. 海鹏程, 玄律, 郑杰, 等. 北京市医保高血压患者门诊就医选择及其影响因素分析. 中华医院管理杂志, 2022, 38(2): 115-120.
22. 曹晓婧, 戴力辉, 王燕, 等. 基于混合 Logit 模型的我国农村居民就医选择的影响因素分析. 卫生软科学, 2022, 36(3): 82-86.
23. 吴功华, 姚明宏, 徐嘉悦, 等. 四川省城乡居民就医行为现状及其影响因素分析. 现代预防医学, 2020, 47(7): 1235-1239.
24. 郑莉莉. 医疗保险改变了居民的就医行为吗?—来自我国 CHNS 的证据. 财政研究, 2017(2): 84-97.
25. 任艳丽, 童恩煜, 狄春红, 等. 基于 2018 年 CHARLS 调查数据的中老年群体首诊就医选择及其影响因素. 医学信息, 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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