Palliative Care Education in End-stage Renal Disease Patients Undergoing Hemodialysis

Abstract

Background: End-stage renal disease (ESRD) is a chronic medical condition where 90% or more of the kidneys are nonfunctional (Doig & Huether, 2014). The current treatment for ESRD is Hemodialysis [HD] (National Institute of Diabetes and Digestive and Kidney Disease [NIDDK], 2013). Individuals who have ESRD who undergo HD suffer from tremendous symptom and treatment burden that affects various facets of life (Axelsson, Klang, Hagelin, Jacobson, & Gleissman, 2014; Axelsson et al., 2012; Tamura & Cohen, 2010). Unfortunately, the symptom and treatment burden associated with ESRD are underrecognized and undertreated (Feely et al., 2016; Gelfman & Meyer, 2012; Murtagh, Addington-Hall, & Higginson, 2007; Russon & Mooney, 2010; Tamura & Meier, 2013). Purpose: The purpose of this quality improvement project is to explore if ESRD patients in Davita Desert Dialysis are knowledgeable about palliative care and if providing education might change their behavior. The primary aim is to create awareness in patients about PC services in an effort to improve their quality of care through education. Design: A quantitative pre- and post survey approach using qualtrics software was utilized to assess the baseline and post-education knowledge of patients who met the inclusion criteria. Setting: DaVita Desert Dialysis, Sun City, AZ. Intervention: The educational intervention is the viewing of a three-minute voice over presentation about palliative care. Limitations: The sample size was small and exposes this study to marked bias and non-generalizability due to the limited number of recruited individuals. Results: One hundred percent of the individuals in the posttest had better awareness about and knowledge about PC. Conclusion: PC can improve the quality of life of patients that suffer from the undertreated and underrecognized symptom and treatment burden (Tamura & Meier, 2013). Further data and studies will be needed to establish PC in the field of nephrology as it relates to the ESRD population undergoing HD. However, the quality improvement focus of increasing PC awareness among ESRD patients undergoing HD has shown great promise as all participants had increased awareness, knowledge availability, and readiness for PC services.