Cargando…
Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study
BACKGROUND: Patients with chronic kidney disease (CKD) are asked to choose a renal replacement therapy or conservative management. Education and knowledge transfer play key roles in this decision-making process, yet they remain a partially met need. OBJECTIVE: We sought to understand the dialysis mo...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178119/ https://www.ncbi.nlm.nih.gov/pubmed/30327720 http://dx.doi.org/10.1177/2054358118803323 |
_version_ | 1783361907618480128 |
---|---|
author | Cassidy, Brendan P. Harwood, Lori Getchell, Leah E. Smith, Michael Sibbald, Shannon L. Moist, Louise M. |
author_facet | Cassidy, Brendan P. Harwood, Lori Getchell, Leah E. Smith, Michael Sibbald, Shannon L. Moist, Louise M. |
author_sort | Cassidy, Brendan P. |
collection | PubMed |
description | BACKGROUND: Patients with chronic kidney disease (CKD) are asked to choose a renal replacement therapy or conservative management. Education and knowledge transfer play key roles in this decision-making process, yet they remain a partially met need. OBJECTIVE: We sought to understand the dialysis modality decision-making process through exploration of the predialysis patient experience to better inform the educational process. DESIGN: Qualitative descriptive study. SETTING: Kidney Care Centre of London Health Sciences Centre in London, Ontario, Canada. PATIENTS: Twelve patients with CKD, with 4 patients on in-center hemodialysis, home hemodialysis, and peritoneal dialysis, respectively. MEASUREMENTS: Not applicable. METHODS: We conducted semistructured interviews with each participant, along with any family members who were present. Interviews were transcribed verbatim. Conventional content analysis was used to analyze the transcripts for common themes. Representative quotes were decided via team consensus. A patient collaborator was part of the research team. RESULTS: Three themes influenced dialysis modality decision making: (i) Patient Factors: individualization, autonomy, and emotions; (ii) Educational Factors: tailored education, time and preparation, and available resources; and (iii) Support Systems: partnership with health care team, and family and friends. LIMITATIONS: Sample not representative of wider CKD population. Limited number of eligible patients. Poor recall may affect findings. CONCLUSIONS: Modality decision making is a complex process, influenced by the patient’s health literacy, willingness to accept information, predialysis lifestyle, support systems, and values. Patient education requires the flexibility to individualize the delivery of a standardized CKD curriculum in partnership with a patient-health care team, to fulfill the goal of informed, shared decision making. |
format | Online Article Text |
id | pubmed-6178119 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-61781192018-10-16 Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study Cassidy, Brendan P. Harwood, Lori Getchell, Leah E. Smith, Michael Sibbald, Shannon L. Moist, Louise M. Can J Kidney Health Dis Original Research Article BACKGROUND: Patients with chronic kidney disease (CKD) are asked to choose a renal replacement therapy or conservative management. Education and knowledge transfer play key roles in this decision-making process, yet they remain a partially met need. OBJECTIVE: We sought to understand the dialysis modality decision-making process through exploration of the predialysis patient experience to better inform the educational process. DESIGN: Qualitative descriptive study. SETTING: Kidney Care Centre of London Health Sciences Centre in London, Ontario, Canada. PATIENTS: Twelve patients with CKD, with 4 patients on in-center hemodialysis, home hemodialysis, and peritoneal dialysis, respectively. MEASUREMENTS: Not applicable. METHODS: We conducted semistructured interviews with each participant, along with any family members who were present. Interviews were transcribed verbatim. Conventional content analysis was used to analyze the transcripts for common themes. Representative quotes were decided via team consensus. A patient collaborator was part of the research team. RESULTS: Three themes influenced dialysis modality decision making: (i) Patient Factors: individualization, autonomy, and emotions; (ii) Educational Factors: tailored education, time and preparation, and available resources; and (iii) Support Systems: partnership with health care team, and family and friends. LIMITATIONS: Sample not representative of wider CKD population. Limited number of eligible patients. Poor recall may affect findings. CONCLUSIONS: Modality decision making is a complex process, influenced by the patient’s health literacy, willingness to accept information, predialysis lifestyle, support systems, and values. Patient education requires the flexibility to individualize the delivery of a standardized CKD curriculum in partnership with a patient-health care team, to fulfill the goal of informed, shared decision making. SAGE Publications 2018-10-08 /pmc/articles/PMC6178119/ /pubmed/30327720 http://dx.doi.org/10.1177/2054358118803323 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Article Cassidy, Brendan P. Harwood, Lori Getchell, Leah E. Smith, Michael Sibbald, Shannon L. Moist, Louise M. Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study |
title | Educational Support Around Dialysis Modality Decision Making in
Patients With Chronic Kidney Disease: Qualitative Study |
title_full | Educational Support Around Dialysis Modality Decision Making in
Patients With Chronic Kidney Disease: Qualitative Study |
title_fullStr | Educational Support Around Dialysis Modality Decision Making in
Patients With Chronic Kidney Disease: Qualitative Study |
title_full_unstemmed | Educational Support Around Dialysis Modality Decision Making in
Patients With Chronic Kidney Disease: Qualitative Study |
title_short | Educational Support Around Dialysis Modality Decision Making in
Patients With Chronic Kidney Disease: Qualitative Study |
title_sort | educational support around dialysis modality decision making in
patients with chronic kidney disease: qualitative study |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178119/ https://www.ncbi.nlm.nih.gov/pubmed/30327720 http://dx.doi.org/10.1177/2054358118803323 |
work_keys_str_mv | AT cassidybrendanp educationalsupportarounddialysismodalitydecisionmakinginpatientswithchronickidneydiseasequalitativestudy AT harwoodlori educationalsupportarounddialysismodalitydecisionmakinginpatientswithchronickidneydiseasequalitativestudy AT getchellleahe educationalsupportarounddialysismodalitydecisionmakinginpatientswithchronickidneydiseasequalitativestudy AT smithmichael educationalsupportarounddialysismodalitydecisionmakinginpatientswithchronickidneydiseasequalitativestudy AT sibbaldshannonl educationalsupportarounddialysismodalitydecisionmakinginpatientswithchronickidneydiseasequalitativestudy AT moistlouisem educationalsupportarounddialysismodalitydecisionmakinginpatientswithchronickidneydiseasequalitativestudy |