Despite the fact that the results of this study showed no difference in HR-QOL between HD and PD treatment, its review of relevant references can serve as a reference for health professionals. However, patients' conditions must still be taken into account when making suggestions about which dialysis modality a patient should use.

Background The prevalence and incidence of end-stage renal disease (ESRD) in Taiwan are the highest of any country in the world. The different renal replacement therapies that are adopted by patients with ESRD significantly affect their social roles and daily life. However, because of the complexities of different renal replacement therapies, patients may be unsure of which to choose. Purpose The aim of this study was to explore the effectiveness of a shared decision-making (SDM) program regarding different renal replacement therapies for patients with chronic kidney disease. Methods A quasi-experimental design was conducted at two similar regional hospitals in Miaoli County, Taiwan. One hospital hosted the intervention group, and the other hospital hosted the control group. The 31 participants in the intervention group took part in a SDM program. The 36 control group participants took part in the pre-ESRD care program. Data collection included demographic and disease characteristics, decisional conflict scale, and decision self-efficacy scale. Results were analyzed using independent t test, Fisher’s exact test, generalized estimating equation, and paired t tests. Results The study results revealed that the intervention group experienced a significant increase in decision self-efficacy and a significant decrease in decisional conflict at 1 month after receiving the SDM intervention in comparison to before and immediately after receiving the intervention. Moreover, the intervention group had higher decision self-efficacy and lower decisional conflict than the control group. Conclusions/Implications for Practice The SDM program may be an effective intervention for complex decision-making processes, such as the process involved in making renal replacement treatment decisions. The SDM program group intervention improved decisional conflict and decision self-efficacy. Thus, to improve patients’ decision-making processes, the application of an SDM program focused on the personal values and opinions of patients with ESRD will be necessary. Physicians and case managers of patients with ESRD should act in complementary and cooperative roles in SDM programs.

End-stage renal disease (ESRD) is a serious public health problem, and its incidence and prevalence are increasing globally (Wetmore & Collins, 2016). According to a report by the United States Renal Data System, the incidence and prevalence of ESRD in Taiwan have ranked first worldwide for many years (U. S. Renal Data System., 2018). In addition to kidney transplantation and conservative management, haemodialysis and peritoneal dialysis are currently the primary therapies for ESRD. These different treatment options will have different effects on a patient's family, work and social activities (Hamilton et al., 2017;Khan et al., 2019). Through shared decision-making (SDM), patients can obtain information regarding different renal replacement therapies (RRT) and their impacts on future daily life, and thereby make appropriate choices. The purpose of this study, therefore, is to describe the psychological change process of participants with chronic kidney disease (CKD) during the SDM process. It is hoped that improved understanding of this process in participants engaging in SDM may lead to interventions that can increase the effectiveness of SDM and is aimed at assisting patients in choosing the appropriate RRT. | BACKG ROU N DShared decision-making is an approach used in the clinical situation that desires the intentional and cooperative involvement of both patients and healthcare professionals (HCPs) in the process of deliberation about treatment options (Gionfriddo et al., 2014). SDM is viewed as fundamental to safe and effective health care, and when there

(1) Background: The COVID-19 pandemic impacted education systems globally, and numerous strategies were used to transform education into online learning. Caring is recognized as a core competency in nursing; this competency is difficult to cultivate and measure. This study aimed to explore the effect of online team-based learning (TBL) on cultivating nursing students’ caring competency. (2) Method: A mix-methods study design with convenience sampling was used for this study. The intervention was online TBL with field observation. Quantitative data were collected by the modified Peer Caring Measurement (PCM) and analyzed using descriptive and inferential statistics. Qualitative data were collected by dialog in social media and analyzed by content analysis. (3) Result: Both the quantitative and qualitative data showed a significant increase in caring competency. A paired t-test of modified PCM showed significant improvement (p < 0.001), and female students had greater learning performances compared with male students in academic and affective dimensions. Three themes emerged, including that online TBL possesses remarkable benefits, students felt in charge of their learning, and changes in the students’ caring competency were revealed. (4) Conclusion: This online TBL strategy works well in teaching and fostering caring in an online environment among nursing students, which is necessary under COVID-19 restrictions.