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. 2022 Sep 24:4:100102.
doi: 10.1016/j.ijnsa.2022.100102. eCollection 2022 Dec.

Nurse-based educational interventions in patients with peritoneal dialysis: A systematic review and meta-analysis

Tanawin Nopsopon  1   2 , Piyawat Kantagowit  1   2 , Chitsanucha Chumsri  1   2 , Piyaporn Towannang  3 , Apinya Wechpradit  4 , Nipa Aiyasanon  5 , Ruchdaporn Phaichan  6 , Talerngsak Kanjanabuch  2   3   7   8 , Krit Pongpirul  1   2   9   10
Affiliations

Nurse-based educational interventions in patients with peritoneal dialysis: A systematic review and meta-analysis

Tanawin Nopsopon et al. Int J Nurs Stud Adv. .

Abstract

Background: Peritoneal dialysis (PD) is a major renal replacement therapy modality for patients with end-stage kidney disease (ESKD) worldwide. As poor self-care of PD patients could lead to serious complications, including peritonitis, exit-site infection, technique failure, and death; several nurse-based educational interventions have been introduced. However, these interventions varied and have been supported by small-scale studies so the effectiveness of nurse-based educational interventions on clinical outcomes of PD patients has been inconclusive.

Objectives: To evaluate the effectiveness of nurse-based education interventions in PD patients.

Design: A systematic review and meta-analysis of Randomized Controlled Trials (RCTs).

Methods: We performed a systematic search using PubMed, Embase, and CENTRAL up to December 31, 2021. Selection criteria included Randomized Controlled Trials (RCTs) relevant to nurse-based education interventions in ESKD patients with PD in the English language. The meta-analyses were conducted using a random-effects model to evaluate the summary outcomes of peritonitis, PD-related infection, mortality, transfer to hemodialysis, and quality of life (QoL).

Results: From 9,816 potential studies, 71 theme-related abstracts were selected for further full-text articles screening against eligibility criteria. As a result, eleven studies (1,506 PD patients in seven countries) were included in our systematic review. Of eleven studies, eight studies (1,363 PD patients in five countries) were included in the meta-analysis. Sleep QoL in the intervention group was statistically significantly higher than control (mean difference = 12.76, 95% confidence intervals 5.26-20.27). There was no difference between intervention and control groups on peritonitis, PD-related infection, HD transfer, and overall QoL.

Conclusions: Nurse-based educational interventions could help reduce some PD complications, of which only the sleep QoL showed statistically significant improvement. High-quality evidence on the nurse-based educational interventions was limited and more RCTs are needed to provide more robust outcomes.

Tweetable abstract: Nurse-based educational interventions showed promising sleep quality improvement and potential peritonitis risk reduction among PD patients.

Keywords: Education; Meta-analysis; Nephrology nursing; Nurses; Nursing intervention; Peritoneal dialysis; Peritonitis; Review.

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Conflict of interest statement

T.K. has received consultancy fees from VISTERRA as a country investigator and current recipient of the National Research Council of Thailand and the Thailand Science Research and Innovation Fund Chulalongkorn University, Thailand and received speaking honoraria from Astra Zeneca and Baxter Healthcare.

Figures

Fig 1
Fig. 1
Flow chart diagram presenting the study selection with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
Fig 2
Fig. 2
Forest plot of the risk of peritonitis in PD patients.
Fig 3
Fig. 3
Forest plot of the risk of hemodialysis transfer/technique failure in PD patients.
Fig 4
Fig. 4
Forest plot of the overall QoL in PD patients.
Fig 5
Fig. 5
Forest plot of the sleep quality in PD patients.
See this image and copyright information in PMC

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