LEARNING STYLE OF PERSONNEL PERFOMING PERITONEAL DIALYSIS AFFECTS OUTCOMES IN PATIENTS ON CHRONIC PERITONEAL DIALYSIS

Background

Educational theories suggest adults with different learning styles, namely “Visual”(V), “Auditory”(A), “Read”(R) and “Kinesthetic”(K), may respond uniquely to training curriculums.  Standardised peritoneal dialysis (PD) training may have differing effectiveness in patients with varying learning techniques, affecting PD outcomes.

Objectives

To determine whether learning style of the caregiver, when receiving a standardised PD training curriculum, is associated with PD clinical outcomes.

Methods

This is a prospective cohort study recruiting caregivers of PD patients undergoing PD training from 2012-2016. Learning styles were determined using the VARK questionnaire developed by Fleming. Patients were followed-up until September 2017 for the development of peritonitis, exit-site infection (ESI) or technique failure.

Results

77 subjects were recruited, with caregivers as follows - Self: n=35, 45.5%; Helpers: n=6, 7.8%; Family: n=36, 46.8%. Majority were “Kinesthetic” (n=39, 50.6%) [“Visual”: n=4, 5.2%; “Auditory”: n=12, 15.6%; “Read”: n=9, 11.7%], a few having 2 different styles [n=13, 16.9%]. Baseline patient and caregiver characteristics were similar between learning styles. Peritonitis and ESI occurred in 27 (35.1%) and 12 patients (15.6%) respectively. On logistic regression, “Read” appears to protect against development of peritonitis in the first 6 months completely, whilst the others show no differences in infective outcomes. Survival analysis demonstrated “Kinesthetic” learners were associated with increased risk of peritonitis (HR 2.86 [1.09, 7.52], p=0.03) with a mean time to peritonitis of 17.6±13.8 months.

Conclusion

Learning style of caregivers receiving a standardised PD training curriculum, appears to impact on PD patient outcomes. Further research is needed to support customising PD training curriculum to individual learning styles.