Dialyzing at Home: Examining Barriers
Jocelyn Day & Lyn Miles
University of Victoria BScN Nursing Students
Assessing Barriers to Modalities through Patient Engagement

Introduction

Data Hypotheses

Next Steps

Currently, 30.5% of dialysis patients in British Columbia
are utilizing independent dialysis therapies with 26.1%
of them on peritoneal dialysis (BC Renal, 2020). The
home renal program (HRP) based out of KBRH services
both the East and West Kootenays. Despite evidence of
improved clinical presentations and lifestyle enrichment,
the number of renal replacement patients utilizing home
modalities remains low.

Listed below are barriers we hypothesize will be identified through our survey results and
onward during the patient engagement opportunity that will be arranged. This was compiled
from common themes found in a literature review:

To ensure sustainability of our project,
we are assisting to develop a 3 rd year
nursing student community practicum
where students will organize a patient
engagement opportunity. The
potential patient population involved
includes:
• Clients who have yet to decide on
their modality
• Those who have since changed
modalities.
This opportunity will bring patients
together to discuss their perceived
barriers to HRT which will provide
additional data to utilize for quality
improvement.

Barriers

Rationale

Trends in Coping & Stages of
Change

Fear and apprehension can greatly deter
changes that people should ideally make
for the benefit of their health, both in
their progression from stage to stage of
change and in their maintenance of
change (Prochaska & DiClimente,
1983; Kutner et al., 2010).

Social Determinants of Health

Circumstances, realities of our individual
existence greatly impact our health and
health outcomes, for our benefit or
detriment (Mikkonen & Raphael, 2010).

Aim
Focuses on increasing the use of home renal therapy
(HRT) modalities, including peritoneal dialysis and
hemodialysis, within the Kootenay Boundary region. Our
findings, obtained through patient engagement, will guide
the focus of interventions that may be implemented to
facilitate the use of HRT modalities.

Methods
• Literature review & assessing data from past and
current research and reviewing patient charts.
• Engaging in renal patient education sessions, BC
Renal webinars, and assisting with 3rd year nursing
renal lab simulations.
• Conducting a patient survey for the HRT patients.
• Compiling and organizing qualitative patient data.
• Collaborating to develop a
3rd year nursing student community
practicum to engage additional patient perspectives.
• Present findings to the renal nursing managers
meeting.

Awareness & Uninformed Decision
Making

Knowledge and consultation around HRT
is a predictor for overall uptake, maximal
or minimal (Harwood & Dominski, 2017).

Acknowledgments
Field Guide: Kimiko Simpson
Renal Staff: Margaret Daum, Marlene
Johnson

Instructors: Shannon Shah, Kristen Bird,
Alyssa Franklin

References
BC Renal. (2020). In and out monitoring report for peritoneal dialysis. In Patient-Reported Outcomes Measurement Information System
(PROMIS). Provincial Health Services Authority.
Harwood, L. & Dominski, C. (2017). Home dialysis therapies. In Bodin, S. M. (Eds.) Contemporary nephrology nursing, (3rd ed., 713-721).
American Nephrology Nurses Association.
Kutner, N. G., Zhang, R., Huang, Y., & Johansen, K. L. (2010). Depressed mood, usual activity level, and continued employment after
starting dialysis. Clinical Journal of the American Society of Nephrology: CJASN, 5(11), 2040–2045.
https://doi.org/10.2215/CJN.03980510

Mikkonen, J., & Raphael, D. (2010). Social determinants of health: The Canadian facts. Toronto: York University School of Hea lth Policy
and Management. http://www.thecanadianfacts.org/the_canadian_facts.pdf
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self -change of smoking: Toward an integrative model of change.
Journal of Consulting and Clinical Psychology, 51(3), 390–395. https://doi.org/10.1037/0022-006X.51.3.390