Background: There is a paucity of information about the views of dialysis nurses towards dialysis modality\r\nselection, yet nurses often have the most direct contact time with patients. We conducted a survey to better\r\nunderstand nurses� attitudes and perceptions, and hypothesized that nurses with different areas of expertise\r\nwould have differences in opinions.\r\nMethods: We administered an electronic survey to all dialysis/predialysis nurses (n = 129) at a large, tertiary care\r\ncenter. The survey included questions about preferred therapy - in-center hemodialysis (CHD), versus home dialysis\r\n(home hemodialysis and peritoneal dialysis) and ideal modality mix. Responses were compared between nurses\r\nwith home dialysis and CHD experience.\r\nResults: The survey response rate was 69%. Both nursing groups ranked patient caregivers and dialysis nurses as\r\nhaving the least impact on patient modality selection. For most patient characteristics (including age > 70 years and\r\npresence of multiple chronic illnesses), CHD nurses felt that CHD was somewhat or strongly preferred, while home\r\ndialysis nurses preferred a home modality (p < 0.001 for all characteristics studied). Similar differences in responses\r\nwere noted for patient/system factors such as patient survival, cost to patients and nursing job security. Compared\r\nto CHD nurses, a higher proportion of home dialysis nurses felt that CHD was over-utilized (85% versus 58%,\r\np = 0.024).\r\nConclusion: Dialysis nurses have prevailing views about modality selection that are strongly determined by their\r\narea of experience and expertise.
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