Factors Affecting Rejection of Dialysis in End-Stage Renal Disease Patients Under Universal Health Coverage in Uttaradit Province
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Abstract
Rejection of dialysis has been a barrier to end-stage renal disease treatment. This study aims to identify factors affecting rejection of dialysis in patients under universal coverage scheme in Uttaradit province. This is a retrospective cross-sectional analytical study. Patient’s data were collected from outpatient medical records and screening forms for dialysis planning patients (stage 4-5 chronic kidney disease) at Uttaradit Hospital from October 2015 to September 2017. The factors were analyzed using univariable and multivariable logistic regression.
One hundred and thirty eight (40.12%) ESRD patients (out of 344 included patients) under universal health coverage scheme who received counseling by the multidisciplinary team during the study period reported dialysis rejection. Factors affecting the increase of dialysis rejection were age: over 65 years of age (AOR = 3.00; 95% CI; 1.67-5.39; p ≤.001) and glomerular filtration rate over 6 ml/min/1.73m2 (AOR = 1.72; 95% CI; 1.03 - 2.85; p ≤.037). Furthermore, having caregivers decreased rejection of dialysis had an AOR of 0.16 (95%CI; 0.07-0.38; p ≤.001).
Dialysis counseling should emphasize the patients and caregivers’ understanding. Caregivers should be educated and participate in the multidisciplinary team discussions in order to follow the treatment plan. Given that elderly patients are more likely to reject dialysis, the multidisciplinary team should have a well-organized palliative care system for this sub-set of patients.
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Journal of Nursing and Health Science Research attribution-non-commercial 4.0 international (CC BY-NC 4.0). For more detail please visit https://creativecommons.org/licenses/by-nc/4.0/ . The ideas and opinions expressed in the Journal of Nursing and Health Science Research are those of the authors and not necessarily those of the editor .
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