Patient and nurse trainer perspectives on a structured PD training programme: A process evaluation of the TEACH-PD feasibility trial

Background: This study aims to describe patient and nurse trainer perspectives on a structured training programme for peritoneal dialysis (PD) as part of the Targeted Education ApproaCH to improve Peritoneal Dialysis outcomes (TEACH-PD) trial. Methods: Two semi-structured interviews were conducted with 13 patients receiving PD and 10 PD nurses involved in training patients in PD before and after receiving training at 2 dialysis units. Transcripts were analysed thematically. Results: Five themes were identified: (1) clear, comprehensive and culturally appropriate (clarity of content and wording to prevent disengagement, gauging patient progress, sufficiency, succinctness and flow); (2) competing priorities and burden (clinical emergencies and tasks taking priority, overwhelmed by amount of content, time pressure demands); (3) improving patient outcomes and safety (ability to assess safety, patient empowerment and personal responsibility, fostering trust and patient wellbeing, increasing technique survival, minimising risk of infection); (4) individualising the approach for patients (setting an appropriate pace, adapting to preferred learning styles, attuning to comprehension and literacy, symptoms and complications limiting capacity for learning) and (5) strengthening competence (motivation for continued learning, putting learning into practice, relevance to real-world practice, requiring structure and consistency, self-efficacy and confidence in problem solving). Conclusion: Patients felt that their training was sufficient and reported feeling confident about doing PD themselves. The adult learning focus of the modules helped the nurse trainers to better adapt their teaching approaches to patients’ individual needs. TEACH-PD training programmes were viewed as an opportunity to upskill nurses involved in patient training and as flexible enough to be adapted to the individual needs of patients. However, nurses also highlighted challenges related to the volume of content to be covered and time constraints due to competing clinical demands.