A study on the correlation between discharge preparation and dialysis efficiency in peritoneal dialysis patients during the discharge transition period
腹透患者出院准备度与出院过渡期透析效能相关性研究

摘要

目的 探讨腹膜透析（PD）患者出院准备度与其出院后1个月内居家透析结局的相关性，为制定针对性的出院前干预策略提供依据。方法 采用便利抽样法，选取2025年1月1日至6月30日期间于我院腹膜透析中心置管并规律随访的78例患者为研究对象。于患者出院当日采用出院准备度量表（RHDS）进行评估，以平均分（7分）为界分为高准备度组（≥7分）和低准备度组（<7分）。比较两组患者出院后1个月在腹透相关感染、血压达标率、营养指标、用药依从性（MMAS-8量表）及照顾者负担（Zarit照顾者负担量表）等方面的差异。结果 共纳入患者78例，高准备度组61例（78.21%），低准备度组17例（21.79%）。出院后1个月，低准备度组发生腹透相关性腹膜炎1例、出口处感染2例，高准备度组均未发生。高准备度组血压达标率（82.18%）略高于低准备度组（77.82%）。两组患者血清白蛋白水平均较出院前改善，但组间无统计学差异。高准备度组用药依从性评分（7±0.83分）显著高于低准备度组（6±1.15分）（P=0.013）。高准备度组的照顾者负担评分（38±3.16分）低于低准备度组（41±6.12分）。结论 腹透患者的出院准备度与过渡期居家透析效能显著相关。较高的出院准备度有助于降低感染风险、提高用药依从性、减轻照顾者负担。临床应重视并系统评估患者的出院准备度，实施个体化、结构化的出院前教育，以提升患者自我管理能力，改善远期预后。

Abstract

Objective To explore the correlation between the discharge readiness of peritoneal dialysis (PD) patients and their home dialysis outcomes within one month after discharge, and to provide a basis for developing targeted pre discharge intervention strategies.
Methods Convenience sampling was used to select 78 patients who underwent catheterization and regular follow-up at our peritoneal dialysis center from January 1 to June 30, 2025 as the study subjects. On the day of discharge, the patient was evaluated using the Discharge Readiness Scale (RHDS) and divided into a high readiness group (≥ 7 points) and a low readiness group (<7 points) based on the average score (7 points). Compare the differences in peritoneal dialysis related infections, blood pressure compliance rate, nutritional indicators, medication adherence (MMAS-8 scale), and caregiver burden (Zarit caregiver burden scale) between two groups of patients one month after discharge.
Results A total of 78 patients were included, with 61 cases (78.21%) in the high readiness group and 17 cases (21.79%) in the low readiness group. One month after discharge, one case of peritoneal dialysis related peritonitis and two cases of outlet infection occurred in the low readiness group, while none of them occurred in the high readiness group. The blood pressure compliance rate of the high readiness group (82.18%) was slightly higher than that of the low readiness group (77.82%). The serum albumin levels of both groups of patients improved compared to before discharge, but there was no statistical difference between the groups. The medication adherence score of the high readiness group (7 ± 0.83 points) was significantly higher than that of the low readiness group (6 ± 1.15 points) (P=0.013). The caregiver burden score of the high readiness group (38 ± 3.16 points) was lower than that of the low readiness group (41 ± 6.12 points).
Conclusion   The discharge readiness of peritoneal dialysis patients is significantly correlated with the efficacy of home dialysis during the transition period. A higher level of discharge readiness can help reduce the risk of infection, improve medication adherence, and alleviate the burden on caregivers. Clinical practice should attach importance to and systematically evaluate patients' discharge readiness, implement individualized and structured pre discharge education, in order to enhance patients' self-management abilities and improve long-term prognosis.