Problems with Health Services and Assessment of Telehealth needs for Peritoneal Dialysis Patient, Caregiver, and Health Professional’s Perspectives

Main Article Content

Nattaya Rattana-umpa
Aurawamon Sriyuktasuth
Piyatida Jeungsmarn


Purpose: To explore health service problems and assess the needs toward telehealth for peritoneal dialysis in patients undergoing continuous ambulatory peritoneal dialysis, caregivers, and health professionals.  

Design: Mixed methods study.

Methods: A quantitative part was conducted in the first phase to explore health service problems in patients with peritoneal dialysis and telehealth needs in 200 patients/caregivers and 28 health professionals. Data were collected using three questionnaires including 1) personal information form, 2) dialysis health service problem questionnaire, and 3) telehealth needs questionnaire. Descriptive statistics, independent t-test, and one-way ANOVA were applied for data analysis. In the second phase, the researchers conducted focus groups among patient, caregiver, and health professional groups to gain further insights from the data obtained in the first phase. Data were analyzed by using content analysis.

Main findings: The patients/caregivers reported health service problems at a moderate level and overall needs for telehealth at a high level. For health professionals, they identified problems in providing health services and needs for telehealth at high levels. Main care features suggested from all groups included resources for knowledge and skills related peritoneal dialysis and self care, communication channels in various forms, notifications of abnormalities and treatment dues, dialysis fluid follow-up, and recording/monitoring health and dialysis related information.

Conclusion and recommendations: Health services for patients undergoing continuous ambulatory peritoneal dialysis in Thailand are currently a challenge for health problem management of the country. Developing a health service that meets the needs of all key stakeholders by using information technology may improve service efficiency and health outcomes in this population group.

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How to Cite
Rattana-umpa, N., Sriyuktasuth, A., & Jeungsmarn, P. . (2022). Problems with Health Services and Assessment of Telehealth needs for Peritoneal Dialysis: Patient, Caregiver, and Health Professional’s Perspectives. Nursing Science Journal of Thailand, 40(2), 140–156. Retrieved from
Research Papers


The National Health Security Office. Guidelines for obtaining service expenses for chronic renal disease patients. In: Guidelines for obtaining health care expenses. Nonthaburi: Sahamit Printing and Publishing; 2019. p.163-4. (in Thai).

Luz LD, Ankawi G, Digvijay K, Rosner MH, Ronco C. Technique failure in peritoneal dialysis: etiologies and risk assessment. Blood Purif. 2021;50(1):42-9. doi: 10.1159/000508159.

Varitsakul R, Sindhu S. “Let's keep close”: increasing peritoneal dialysis service effectiveness through bridging the gap between patient and provider. Renal Society of Australasia Journal. 2015;11(2):73-7.

Struijk DG. e-Health: remote health care models in peritoneal dialysis. Contrib Nephrol. 2012;178:74-8. doi: 10.1159/000337814.

Dey V, Jones A, Spalding EM. Telehealth: acceptability, clinical interventions and quality of life in peritoneal dialysis. SAGE Open Med. 2016;4:2050312116670188. doi: 10.1177/2050312116670188.

Lew SQ. Telehealth in peritoneal dialysis: review of patient management. Adv Perit Dial. 2018;34(2018):32-7.

Watkins R, Meiers MW, Visser YL. A guide to assessing needs: essential tools for collecting information, making decisions, and achieving development results [Internet]. Washington DC: The World Bank; 2012 [cited 2019 Aug 23]. Available from:

AlDossary S, Martin-Khan MG, Bradford NK, Armfield NR, Smith AC. The development of a telemedicine planning framework based on needs assessment. J Med Syst. 2017;41(5):74. doi: 10.1007/s10916-017-0709-4.

AlDossary S, Armfield NR, Smith AC, MartinKhan MG. A needs-based planning framework for telemedicine services: a practical guide [Internet]. Herston, Queensland: National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Telehealth, Faculty of Medicine, The University of Queensland, Australia; 2019 [cited in 2021 Aug 23]. Available from:

Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60. doi: 10.3758/BRM.41.4.1149.

Cohen J. A power primer. Psychol Bull. 1992;112(1):155-9. doi: 10.1037//0033-2909.112.1.155.

Ngaoratsamee J, Sroisong S. Nursing care for end stage renal disease patients with continuous ambulatory peritoneal dialysis. Journal of Nursing and Health Sciences. 2021;15(1):50-61. (in Thai).

Varitsakul R, Sindhu S, Sriyuktasuth A, Viwatwongkasem C, Dennison Himmelfarb CR. The relationships between clinical, socio-demographic and self-management: factors and complications in Thai peritoneal dialysis patients. Renal Society of Australasia Journal. 2013;9:85-92.

Sukrungraung I, Rongmuang D, Fukfon K. Caring of peritoneal dialysis patients under peritoneal dialysis first policy: from policy to nursing practice. Nursing Public Health and Education Journal. 2020;21(1):3-15. (in Thai).

Lincoln Y, Guba E. Naturalistic inquiry. London: Sage Publication; 1985. 415 p.

Hamine S, Gerth-Guyette E, Faulx D, Green BB, Ginsburg AS. Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. J Med Internet Res. 2015;17(2):e52. doi: 10.2196/jmir.3951.

Ruzic L, Sanford JA. Needs assessment-mHealth applications for people aging with multiple sclerosis. J Healthc Inform Res. 2018;2:71-98. doi: 10.1007/s41666-018-0023-z.

Riangkam C, Sriyuktasuth A, Pongthavornkamol K, Kusakunniran W, Sriwijitkamol A. Effects of a mobile health diabetes self-management program on HbA1c, self-management and patient satisfaction in adults with uncontrolled type 2 diabetes: a randomized controlled trial. J Health Res. 2021;1-11. doi: 10.1108/JHR-02-2021-0126.

Bonoto BC, de Araujo VE, Godoi IP, de Lemos LL, Godman B, Bennie M, et al. Efficacy of mobile apps to support the care of patients with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. JMIR Mhealth Uhealth. 2017;5(3):e4. doi: 10.2196/mhealth.6309.

Hsia BC, Wu S, Mowrey WB, Jariwala SP. Evaluating the ASTHMAXcel mobile application regarding asthma knowledge and clinical outcomes. Respir Care. 2020;65(8):1112-9. doi: 10.4187/respcare.07550.

Athilingam P, Osorio RE, Kaplan H, Oliver D, O’Neachtain T, Rogal PJ. Embedding patient education in mobile platform for patients with heart failure theory-based development and beta testing. Comput Inform Nurs. 2016;34(2):92-8. doi: 10.1097/CIN.0000000000000216.

Mungia R, Mendoza, de la Rosa E, Nguyen T, Reyes SC, Schramm D, et al. Development of a mobile application to enhance knowledge, awareness and communication of dry mouth amongst dental practitioners and patients: a South Texas Oral Health Network Study. Tex Dent J. 2021;138(3):172-85.

Aiyegbajejea FO, Ajayib DD. Mobile health communication: effective reduction of patients’ travel needs to hospitals. Int J Healthc Manag. 2020;13(1):28-34. doi: 10.1080/20479700.2018.1434862. [Internet]. Telehealth needs assessment. Providence, RI: Care Transformation Collaborative of Rhode Island; 2020 [cited 2021 Jun 23]. Available from: