Authors (including presenting author) :
KHOO BH (1)(2) NG YC (1)(2) LEUNG SN (1)(2)
Affiliation :
(1)Department of Occupational Therapy Department (2)Pamela Youde Nethersole Eastern Hospital2
Introduction :
Previous studies found that patients with End Stage Renal Failure (ESRF) experience declined hand functions (51%) and cognitive impairment (19.2%) in performing peritoneal dialysis at home. Occupational therapy (OT) could empower the patient to perform peritoneal dialysis (PD) at home safely and independently.
Objectives :
To assist patients with ESRF to formulate an appropriate and client-centred dialysis planning in renal ward of PYNEH
Methodology :
In-patients in K8 renal ward who would have self-conducted or helper-conducted peritoneal dialysis at home, were referred to OT service. An appropriate and client-centred dialysis planning could be formulated according to the results of hand functional assessments (including power and pinch grip, Monofilament and 9-Hole Peg Test) and cognitive assessment (Montreal Cognitive Assessment - HK version). Patients with physical or cognitive limitation would receive 4-8 approximately weeks rehabilitation training before attending renal nurse peritoneal dialysis training.
Result & Outcome :
From November 2016 to July 2019, a total of 241 in-patients were referred to OT service. Overall 26% of them changed PD planning. 37 patients, up to 15.3%, had changed their dialysis plan from self-conducted PD to helper. Among this population, 7 patients with cognitive impairment, 23 patients experience hand function impairment and 7 patients had both hand and cognitive function impairments. On the other hand, 26 patients changed their PD plan from helper-conducted to self-conducted. 7 patients had improved confidence after OT training, and 7 patients were demonstrated independent PD procedures with use of assistive device. A total of 12 patients showed hand function improvement after training. The results showed that OT enhanced patient safety and independency in patients with ESRF in PD planning. It is essential to involve Occupational Therapist in dialysis planning for patient with ESRF.
