Patient factors and the influence of nephrologists, social workers, and nurses on patient decisions to choose continuous peritoneal dialysis.

To determine which members of the health care team are viewed by ESRD patients as the most helpful in giving information and deciding on a dialysis modality, we surveyed 42 outpatients after they toured the dialysis facility. The tour included discussions with a social worker, PD and HD nurses, watching a videotape, and receipt of written materials. Nephrologists referred patients for tours. Multiple responses were accepted. Patients felt that social workers (70%) and nurses (71%) gave the most useful information. Fifty per cent of patients thought the nurse, 43% the social worker, 21% the nephrologist, and 21% family or friend most helpful in deciding on PD versus HD. Twenty-three patients chose PD, 16 chose in-center HD. Patients choosing PD were more likely to be white (20/29 versus 3/10, p less than 0.05) and employed (11/23 versus 3/16 choosing HD, p less than 0.10). Patients choosing PD were also better educated but this was not independent of race. No differences in gender, age, or the presence of diabetes were seen among those choosing PD versus HD. Social workers and nurses are more influential than nephrologists in helping patients select a dialysis modality. PD patient recruitment efforts should focus on social workers' and nurses' input.