1 The Department of Medicine and Nephrology C, Faculty of Health Sciences, Aarhus University, Aarhus University
Background Since 2000, a model for Assisted Automated Peritoneal Dialysis (aAPD) for patients in their own home needing chronic dialysis treatment has been developed at Aarhus University Hospital, Skejby, Denmark. The patient group consists of physically or mentally frail elderly who cannot manage the technical aspects of dialysis and are thus assisted by primary care staff. No previous studies have been made on the perceptions, experiences and needs of aAPD patients. Objectives Explore and describe How do patients experience aAPD treatment? What are their needs? How do patients meet their needs and in which areas? Which self-care capacity and which strategies do patients use to satisfy their needs? Methods A qualitative research design was chosen. Inclusion criteria: Patients who started aAPD treatment in the period between June and November 2006 at Aarhus University Hospital, Skejby; five were included, three were excluded due to death or severe medical condition. Two in-depth semi-structured interviews were conducted with each patient. The first interview was three months after initiating aAPD treatment. The second interview was conducted after approximately six months' treatment with aAPD. The starting point of the second interview was a preliminary analysis of the first interview. The interview guide was inspired by Henderson's areas of need and Orem's self care theory combined with problems and symptoms in End Stage Renal Disease patients. Results The results of the study show that patients in their own home strengthen their self-care capacity in the period between three and six months after starting aAPD treatment. Examples of this are initiatives concerning promotion of appetite, sleep, dressing, social contact and prevention of infection and fall. Conclusion Elderly people develop their own strategies for adapting aAPD to the way they have met their needs in their own home. The patients experience the treatment as part of the every day life and show increasing creativity to find solutions to satisfy their needs. Technical assistance concerning dialysis makes it possible for frail elderly to live a dignified life in their own home.