Health professionals' perceptions of the JPAT - an assessment tool for home haemodialysis suitability

Background: Home haemodialysis (HHD) is a cost-effective modality with associated improvements of health status, lifestyle and quality of life among people with end-stage renal disease (ESRD). However, it is challenging to increase the uptake of HHD. Suitability for HHD is critical for successful training and thus compliance. The validated Jo-Pre-training Assessment Tool (JPAT version 2.1) is a tool to assess suitability for HHD among referred candidates. The tool has been adopted in clinical practice in dialysis facilities in Australia. Aim: This study was to evaluate the JPAT in terms of clinical applicability and identify areas for the tool refinement. Method: A cross-sectional survey was completed by a purposive sample of nurses and allied health professionals (n=27, 60% response rate), who provided HHD training or patient support in 23 dialysis facilities across Australia. The study participants indicated the relevance of JPAT items on a five-point Likert scale (strongly disagree, disagree, undecided, agree and strongly agree). Results were presented as frequency and percentage. Recommendations were summarised according to each evaluated domain of the tool. Results: Overall, 80% of the participants agreed that the JPAT questions were relevant, ranging from 68% for communication, 73% for nutritional status, 81% ability to maintain care, 85% psychological to 92% for social support subscales. Recommendations for further items include patient communication, English proficiency, nutrition assessment and diet, and some common mental health symptoms. Conclusion: The necessity of a comprehensive, nurse-led assessment of HHD candidates prior to training and adequate resources for dialysis training facilities is paramount. The JPAT was perceived as a well-structured tool with a high level of clinical applicability. Future research into refinement of the tool is worthwhile.