Peritoneal dialysis (PD) is a home-based therapy performed by patients or their relatives in numerous cases, and the role of patients’ educational practices in the risk of peritonitis is not well assessed. Our aim was to evaluate the effect of PD learning methods on the risk of peritonitis. This was a retrospective multicentric study based on data from a French registry. All incident adults assisted by family or autonomous for PD exchanges in France between 2012 and 2015 were included. The event of interest was the occurrence of peritonitis. Cox and hurdle regression models were used for statistical analysis to asses for the survival free of peritonitis, and the risk of first and subsequent peritonitis. 1035 patients were included. 967 (93%) received education from a specialized nurse. Written support was used for the PD learning in 907 (87%) patients, audio support in 221 (21%) patients, and an evaluation grid was used to assess the comprehension in 625 (60%) patients. In the “zero” part of the hurdle model, the use of a written support and starting PD learning with hands-on training alone were associated with a lower survival free of peritonitis (respectively HR 1.59, 95%CI 1.01–2.5 and HR 1.94, 95%CI 1.08–3.49), whereas in the “count” part, the use of an audio support and starting of PD learning with hands-on training in combination with theory were associated with a lower risk of presenting further episodes of peritonitis after a first episode (respectively HR 0.55, 95%CI 0.31–0.98 and HR 0.57, 95%CI 0.33–0.96). The various PD education modalities were associated with differences in the risk of peritonitis. Prospective randomized trials are necessary to confirm causal effect. Caregivers should assess the patient’s preferred learning style and their literacy level and adjust the PD learning method to each individual.

中文翻译：

---

教育实践对腹膜透析腹膜炎风险的影响：一项回顾性队列研究，数据来自法国腹膜透析登记处 (RDPLF)。

腹膜透析 (PD) 是一种由患者或其亲属在许多情况下进行的基于家庭的治疗，并且患者的教育实践在腹膜炎风险中的作用尚未得到很好的评估。我们的目的是评估 PD 学习方法对腹膜炎风险的影响。这是一项基于法国登记处数据的回顾性多中心研究。包括 2012 年至 2015 年在法国进行 PD 交流的所有由家庭协助或自主的成人事件。感兴趣的事件是腹膜炎的发生。Cox 和障碍回归模型用于统计分析，以评估无腹膜炎的存活率，以及首次和随后发生腹膜炎的风险。包括 1035 名患者。967 (93%) 人接受了专业护士的教育。907 名 (87%) 患者使用书面支持进行 PD 学习，221 名 (21%) 患者使用音频支持，并使用评估网格评估 625 (60%) 名患者的理解能力。在障碍模型的“零”部分，使用书面支持和仅通过动手培训开始 PD 学习与较低的无腹膜炎生存率相关（分别为 HR 1.59、95% CI 1.01-2.5 和 HR 1.94 , 95% CI 1.08–3.49)，而在“计数”部分，使用音频支持和开始 PD 学习与实践培训结合理论与之后出现腹膜炎进一步发作的风险较低有关。第一次发作（分别为 HR 0.55、95%CI 0.31–0.98 和 HR 0.57、95%CI 0.33–0.96）。不同的 PD 教育方式与腹膜炎风险的差异有关。需要前瞻性随机试验来确认因果关系。护理人员应评估患者偏好的学习方式和他们的文化水平，并针对每个人调整 PD 学习方法。