Authors (including presenting author) :
Tam SL (1)(3), Chan K (2), Kwok CP (1), Chan HY (1), Wu SY (1), Law PY (1), Chan E (1), Lo MW (1), Wong PN (1)
Affiliation :
(1) Department of Medicine and Geriatrics, Kwong Wah Hospital (2) School of Nursing, The Hong Kong Polytechnic University (3) Nursing Services Department, Kwong Wah Hospital
Introduction :
Telehealth strategies for end-stage renal disease patients who require dialysis, such as remote devices, teleconsultation, and apps, are widely embraced due to better monitoring in daily practice in home environments with improved outcomes. However, it is a challenge for older patients due to technology barriers and limited access.
Objectives :
This study aims to examine the effectiveness of the telehealth service for education and monitoring of patients who had completed the continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD) training. Videoconferencing was the predominant method for the teleconsultations.
Methodology :
A tele-renal nurse clinic service model was created to evaluate PD techniques at home. Sessions, lasting 45-60 minutes, occur two weeks post PD training. Patients received follow-ups via phone, in-person, or virtually within 1 to 4 weeks post-session based on the nurse's assessment.
Participants from the nurse-led renal clinic at Kwong Wah Hospital for CAPD/APD were invited to join teleconsultation sessions. The cross-sectional survey using a self-developed 12-item instrument on a 5-point Likert scale. This study assessed service satisfaction, blinded to the practitioner. Survey and qualitative feedback were collected a month later post-teleconsultation sessions. Teleconsultation notes were analysed to evaluate patient needs and motivations for their engagement.
Result & Outcome :
Within the study period between July 2023 to March 2024, 53 (CAPD: n = 23, APD, n=20) eligible participants were invited to join telehealth services. There were 22 candidates who refused to join telehealth due to no smart phone, no internet network or no helper available to help in the process. Among the 31 participants (response rate 58.5%), three individuals defaulted on attending the renal nurse telehealth sessions, one of the reasons was due to hospitalization. The satisfaction survey showed an excellent score ranging from 4.24 to 4.9. The nurses found real-time problem solving in patients' daily lives and educating older adults on technology crucial for effective teleconsultations.
Conclusions:
The study findings indicated improved patient motivation for follow-up appointments in teleconsultations
