Journal of renal care · 2026
Factors Associated With the Autonomy of Patients Treated by Haemodialysis in Community Centres. A Cross-Sectional Study.
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Achour Akram, Béchade Clémence, Lobbedez Thierry, Edet Stéphane, Ficheux Maxence, Guillouët Sonia
Аннотация
BACKGROUND: In France, haemodialysis is delivered in different settings depending on patients' health status and autonomy. Community centres include self-care and satellite units, which vary in organisation and patient involvement.
OBJECTIVES: To describe the characteristics of patients treated in haemodialysis community centres and to identify factors associated with autonomy in self-care units.
DESIGN: Cross-sectional study.
PARTICIPANTS: All patients receiving haemodialysis in community centres in a French region on December 31, 2021.
MEASUREMENTS: Patient characteristics and multiple dimensions of patient autonomy were recorded. Multivariate analyses assessed associations between patient factors and technical autonomy.
RESULTS: Among 507 patients, 304 were treated in self-care units and 203 in satellite haemodialysis units. Patients in satellite haemodialysis units had a median age of 69 years (IQR 59-78; range 24-90), compared with 66 years (IQR 54-75; range 22-91) in self-care haemodialysis units. They also had more comorbidities. Younger age was associated with greater autonomy in arteriovenous fistula puncture-site dressing (PR 0.97, 95% CI 0.96-0.98), setting the haemodialysis machine (PR 0.97, 95% CI 0.96-0.98), and programming it (PR 0.97, 95% CI 0.95-0.98). Autonomy differed significantly between centres, with centre affiliation significantly associated (p < .001) with autonomy for the arteriovenous fistula puncture-site dressing and machine-related tasks.
CONCLUSIONS: Patient characteristics in self-care haemodialysis units did not fully explain autonomy for haemodialysis tasks. Considerable variability between centres was observed, suggesting that centre-related factors may contribute to differences in patient autonomy.
OBJECTIVES: To describe the characteristics of patients treated in haemodialysis community centres and to identify factors associated with autonomy in self-care units.
DESIGN: Cross-sectional study.
PARTICIPANTS: All patients receiving haemodialysis in community centres in a French region on December 31, 2021.
MEASUREMENTS: Patient characteristics and multiple dimensions of patient autonomy were recorded. Multivariate analyses assessed associations between patient factors and technical autonomy.
RESULTS: Among 507 patients, 304 were treated in self-care units and 203 in satellite haemodialysis units. Patients in satellite haemodialysis units had a median age of 69 years (IQR 59-78; range 24-90), compared with 66 years (IQR 54-75; range 22-91) in self-care haemodialysis units. They also had more comorbidities. Younger age was associated with greater autonomy in arteriovenous fistula puncture-site dressing (PR 0.97, 95% CI 0.96-0.98), setting the haemodialysis machine (PR 0.97, 95% CI 0.96-0.98), and programming it (PR 0.97, 95% CI 0.95-0.98). Autonomy differed significantly between centres, with centre affiliation significantly associated (p < .001) with autonomy for the arteriovenous fistula puncture-site dressing and machine-related tasks.
CONCLUSIONS: Patient characteristics in self-care haemodialysis units did not fully explain autonomy for haemodialysis tasks. Considerable variability between centres was observed, suggesting that centre-related factors may contribute to differences in patient autonomy.