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Background and Aims A quarter of the patients did not receive any information on any modality before the start of Renal Remplacement Therapy (RRT). We have therapeutic education workshops for all RRT except for home haemodialysis (HHD). We aimed to identify and describe the needs of patients and caregivers for RRT with HHD. Lastly, to conceive and carry out a Therapeutic Education Workshop. Method Two sequential methods of qualitative data collection were undertaken: (1) interviews with a patient who had been on HHD and a doctor specialized in HHD. (2) semi-structured interviews with HHD patients in our center. Analytic Approach Thematic analysis. We used thematic analysis and systematically coded and identified themes inductively from data. To ensure that the range and depth of data were reflected in the analysis, transcripts were independently analyzed by 2 research team members experienced in qualitative research. Transcribed interviews were entered into RQDA 3.6.1 (2019-07-05) software for data organization and coding purposes (Version 3.6.1). Patient interviews were ceased when no new codes were identified (data saturation) after five consecutive interviews. Results We identified six themes related to the barriers, facilitators, and potential solutions to home dialysis therapy: (1) HHD allows autonomy and freedom with constraints, (2) safety of the care environment, (3) the caregiver and family environment, (4) patient’s experience and experiential knowledge, (5) self-treatment experience - Impact on life, and (6) factors that impact the choice of treatment with HHD. we designed a model for a therapeutic education workshop in a group of 4 patients and 4 caregivers. Our approach is the person-centered model of care. The workshop is composed of 4 educational sequences Conclusion Our study confirmed previous results obtained about the major barriers, facilitators, and potential solutions to HHD. There are three important points regarding HHD: (1) the impact of the HHD on the caregiver, (2) the experience of patients already treated with HHD, and (3) the role of nurses and nephrologists in informing and educating. A program to develop patient-to-patient peer mentorship, allowing patients to discuss their dialysis experience, would be invaluable.

Background and Aims End Stage renal disease (ESRD) and hemodialysis are associated with a decrease in quality of life (QOL). Self-reported QOL symptoms are not always prioritized by the medical team, potentially leading to conflicting priorities with patients. Electronic patient-reported outcome measures (ePROMs) allow physicians to better describe these symptoms. The objective was to describe the prevalence of symptoms self-reported by HD patients. Method A multicenter cross-sectional study was conducted in three HD centers. Patients were included if they were 18 years old or over and treated with HD for at least three months in a center. Data were collected by the patient via a self-administered ePROMs questionnaire. Data included patient characteristics, post-dialysis fatigue and intensity, recovery time after a session, perceived stress, impaired sleep the day before the dialysis session, current state of health, and the one-year change. Results In total, we included 173 patients with a mean age of 66.2 years, a mean ± SD hemodialysis duration of 48.9 ± 58.02 months, mainly treated in self-dialysis unit (67%) and having at least one comorbidity (72.5%). The prevalence of fatigue was 72.1% [IC 95% 64.7% to 78.7%] with a mean severity score of 5.84± 2.12. 66.4% had a high level of stress (level B or C). Recovery time was more than 6 hours for 24.9% of patients and 78 % declared they had a better or unchanged health status than the previous year. The self-perceived health status of patients was 6.2± 2.12 and 77.5% [IC 95% 70.5% to 83.5%] of patients stated that they had not a worsened health status than the year before. No statistical differences were observed between centers for the PROMS. Despite significant differences in patient characteristics from the three centers including age, comorbidities or type of dialysis, no differences were found on the prevalence of the various PROMs, in favor of internally Conclusion Fatigue and stress were the main symptoms reported by HD patients. There was no association between symptoms reported and comorbidities clinical results of patients. The patient’s care teams should better consider these symptoms.

Background and Aims The health crisis linked to the COVID-19 epidemic has required lockdown measures in France and changes in practices in dialysis centers. The objective was to assess the depressive and anxiety symptoms during lockdown in hemodialysis patients and their caregivers, to assess their coping strategies during this period and to assess the symptoms of depression, anxiety and post traumatic stress beyond confinement. Method We sent, during lockdown period, between April and May 2020, self-questionnaires to voluntary subjects (patients and caregivers), treated by hemodialysis or who worked in hemodialysis in one of the 14 participating centers in France. We analyzed their perception of dialysis sessions (beneficial or worrying), their stress level (VAS rated from 0 to 10), their anxiety and depressive symptoms (HADS). Factors associated with stress, anxiety and depression were analyzed with multiple logistic regression models. We will look for associations between coping strategies, participant characteristics and symptoms of stress, anxiety and depression using chi-square tests. A second questionnaire was sent out in October to collect symptoms of depression, anxiety and post-traumatic stress beyond confinement. Symptoms will be described and factors associated with stress, anxiety and depression will be analyzed with multiple logistic regression models. Results 669 patients and 325 caregivers agreed to participate. 70% of participants found it beneficial to come to dialysis during confinement. The proportions of subjects with a stress level ≥ 6 linked to the epidemic, confinement, fear of contracting COVID-19 and fear of infecting a loved one were respectively 23.9%, 26.2%, 33.4% and 42%. 39.2% presented with certain (13.7%) or doubtful (19.2%) anxious symptoms. 21.2% presented a certain (7.9%) or doubtful (13.3%) depressive symptomatology. Age, gender, history of psychological disorders and perception of dialysis sessions were associated with levels of stress, anxiety and depression. 685 subjects participated in the second part of the study (68.9% of the participants of the first part). Analyzes of this data are in progress. Conclusion During the lockdown period, in France, the majority of hemodialysis patients and caregivers found it beneficial to come to dialysis. One in 3 subjects had anxiety symptoms and one in 5 subjects had depressive symptoms. It will be interesting to investigate if there was an association between the coping strategies implemented by the participants and their level of stress, anxiety and depression during confinement and to analyze the evolution of the anxiety-depressive symptoms over time.