Journal of Clinical Nursing

A Mixed Methods Study of Risk Factors for Frailty in Peritoneal Dialysis Patients

ABSTRACT

Objectives

This study uses a convergent mixed methods approach to investigate the frailty phenotypes and risk factors in peritoneal dialysis (PD) patients.

Design

A cross-sectional mixed methods research study was employed.

Methods

This study follows the MMR-RHS reporting guidelines. From November 2023 to August 2024, 213 patients were recruited from the PD centre of a tertiary hospital in Chongqing, China. Quantitative data were collected using a general information questionnaire and standardised scales, including Fried Frailty Phenotype (FFP), Charlson Comorbidity Index (CCI), Mini Nutritional Assessment-Short Form (MNA-SF), Montreal Cognitive Assessment (MoCA) and Hospital Anxiety and Depression Scale (HADS). Concurrently, 19 PD patients in pre-frail or frail states participated in semi-structured interviews. The quantitative and qualitative findings were then integrated for analysis.

Results

Amongst the 213 PD patients, 46.5% were non-frail, 41.3% were pre-frail and 12.2% were frail. Integrated analysis indicated that fatigue and low muscle strength were the primary frailty phenotypes amongst the patients. Age, sedentary behaviour, comorbidities, nutritional status, cognitive function, polypharmacy, psychological state and social connections were identified as risk factors for frailty in this patient population.

Conclusion

Many factors influence the frailty of PD patients. Future research should further explore the complex interactions amongst these factors and effective modulation strategies to mitigate the frailty progression. Incorporating the patients' perspectives in designing comprehensive intervention programmes will help identify key challenges and focal points for intervention.

Impact

This study identifies risk factors for frailty in PD patients, offering healthcare professionals a basis for designing targeted interventions. These factors encompass multiple dimensions, indicating the need for multidisciplinary collaboration in managing frailty.

Patient Contribution

The PD patients in this study provided valuable quantitative data and shared their frailty experiences, enhancing the research conclusions' practical value.