Factors Associated With the Autonomy of Patients Treated by Haemodialysis in Community Centres. A Cross‐Sectional Study

Background In France, haemodialysis is delivered in different settings depending on patients' health status and autonomy. Community centres include self‐care and satellite units, which vary in organisation and patient involvement. Objectives To describe the characteristics of patients treated in haemodialysis community centres and to identify factors associated with autonomy in self‐care units. Design Cross‐sectional study. Participants All patients receiving haemodialysis in community centres in a French region on December 31, 2021. Measurements Patient characteristics and multiple dimensions of patient autonomy were recorded. Multivariate analyses assessed associations between patient factors and technical autonomy. Results Among 507 patients, 304 were treated in self‐care units and 203 in satellite haemodialysis units. Patients in satellite haemodialysis units had a median age of 69 years (IQR 59–78; range 24–90), compared with 66 years (IQR 54–75; range 22–91) in self‐care haemodialysis units. They also had more comorbidities. Younger age was associated with greater autonomy in arteriovenous fistula puncture‐site dressing (PR 0.97, 95% CI 0.96–0.98), setting the haemodialysis machine (PR 0.97, 95% CI 0.96–0.98), and programming it (PR 0.97, 95% CI 0.95–0.98). Autonomy differed significantly between centres, with centre affiliation significantly associated ( p < .001) with autonomy for the arteriovenous fistula puncture‐site dressing and machine‐related tasks. Conclusions Patient characteristics in self‐care haemodialysis units did not fully explain autonomy for haemodialysis tasks. Considerable variability between centres was observed, suggesting that centre‐related factors may contribute to differences in patient autonomy.