Treatment Options – Teaching

Home Dialysis Education Resources available

See below for links and information about our new:

  • photo fact sheets
  • consolidated fact sheets
  • alternative language tools
  • power-point presentations
  • existing fact sheets and links to other resources

Pre-dialysis education is the most significant process in determining choice of dialysis modality.
The role of pre-dialysis educators is clearly established in most programmes but time limitations may reduce the impact of this role. Highlighting the importance of education, Kidney Health Australia found that only 54% of surveyed patients in 2010 chose their current modality. A recent education survey of Australian pre-dialysis education services shows that the delivery of pre-dialysis education does impact on the rates of home dialysis.

Pre-dialysis Education Survey – summary
Pre-dialysis Education Survey – one page summary

Health Professional Influence
Patients are influenced by their nephrologists. This is demonstrated by the wide range in uptake of various modalities in different hospitals and even within the practising group at each site. Careful examination of programmes to determine whether co-morbidities, patient choice or personal bias influences the uptake of home is required for objective data. Personal biases and beliefs need to be addressed.

Education Referral
An official referral pathway is required to capture patients at a time deemed appropriate by the individual units, and prevent late referrals.

Education Timing
Stage 2-3: Promote healthy lifestyle with renal failure considerations
–  Stage 3-4: Promote healthy lifestyle and introduce all options for treatment
–  Stage 5: Confirmation regarding dialysis choice

Pre-education regarding modality choice should be given at stage 4-5, or 6-12 months prior to commencing treatment option.67

Education Content

  • Education must be delivered to promote patient choice.67,70
  • The educator needs to offer hope and find out about the patient’s priorities and expectations.71,72
  • Patients and family caregivers highly value treatment that enhances survival and can be performed at home.67
  • Understanding why RRT is required or the consequences of no treatment is an inevitable part of education.
  • The practical aspects, advantages and disadvantages of each option then need discussion with positive marketing for the ideal modality to achieve best outcomes.
  • Costs to the individual for each treatment type should be detailed.
  • Information regarding any incentives provided by the State should be available.
  • More educational hours is linked with home dialysis uptake.
  • Patient narratives do influence treatment decision making.72

Education Delivery

  • Solo with an individual and their significant others.
  • Group as lectures and interactive workshops.
  • Using media i.e. teleconferencing, webinars.
  • Utilising a combination of verbal, written and demonstration.
  • Personal experience – networking or visiting others who are experiencing home dialysis.
  • Networking and use of human resources are positive outcomes of group education.

Recommended training materials/tools

  • Simple tool for decision making regarding suitable modality.
  • Written information regarding normal kidney function and how peritoneal and haemodialysis replace these.
  • Written information regarding transplant and choosing supportive care (no dialysis).
  • DVDs or computer links re the above.
  • Models/posters/demo models of dialysis machines/peritoneal dialysis equipment.
  • Written materials or computer links for materials that are culturally/linguistically specific.
  • Risk assessment tool for home dialysis.

All references can be found in Model for Home Dialysis reference list.

Modality selection tool
It is recommended that a modality selection tool will support objective decision making for the consumer with the support of the health professionals. The Australian ‘My Kidneys, My Choice’ decision aid is now available to support patient education and decision making. Visit health professionals publication page for more information.

Pre-Dialysis assessment tool
This tool is under development by Hunter New South Wales Health Service – Pre-Dialysis Assessment Tool. If you want more details about the contacts, send an email to homedialysis@kidney.org.au

Cultural considerations
Only 11 of 273 chronic disease programmes that were examined to determine cultural appropriateness met benchmarks.75 Program and education materials should be examined for and aligned with culturally appropriate resources and communication. The message to consider home must be based on the value and belief system of the individual. Health trained interpreters must be used if the message cannot be sent and received in English.

Translated Resources fact sheets (click here to visit KHA page)
The main Kidney Health Australia site has translated fact sheets in 18 languages providing information on: are you at risk, chronic kidney disease, nutrition and all treatment options.

Simple versions of some of our Kidney Health Australia education resources are provided in these languages: 
Arabic, Burmese, Chinese Simplified: Mandarin,
Chinese  Traditional: Cantonese, French, German, Greek, Hindi, Italian, Japanese, Kirundi, Korean, Macedonian, Maltese, Polish, Samoan, Spanish, Tongan, and Vietnamese. Click link to view Translated Education Resources list – to 17 07 13

Included are two new simple fact sheets: Treatment Options  *  Linking kidney health heart health blood pressure and diabetes

Translations

Rural Considerations
Renal nurses in satellite units can perform the education role however they must be adequately educated in all modalities and have access to the training materials. Roving educators or teleconferencing can overcome the distance barrier. Nurse practitioners conducting remote CKD clinics would be a potential model for providing rural education and support.

Patient education brochures, publications and DVD are recommended in the patient focused pages on this site, or go to:
Kidney Health Australia – Fact Sheets
Renal Resource Centre
Princess Alexandra Hospital QLD – Home HD DVD
Vimeo at http://vimeo.com and search for these DVDs under ‘Kidney Health Australia’

These very simple information sheets provide photos and very simple language about all end stage kidney disease treatment options:
Chronic Kidney Disease
Early Stage CKD – So you need education Poster
Haemodialysis
Peritoneal Dialysis
Supportive Care
Kidney Transplant

PowerPoint presentations are now available for you to use when teaching your patients.
PDF available below or email to: homedialysis@kidney.org.au if you’d like a copy of these presentations to adapt.
Chronic Kidney Disease
End Stage Kidney Disease
Peritoneal Dialysis
Haemodialysis
Kidney Transplant
Supportive Care

For all enquiries: homedialysis@kidney.org.au – or call 1800 454 363.

Page updated 24 February 2014