A qualitative study on shared decision‐making of patients with chronic kidney disease

Abstract

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

The experience of shared decision‐making for patients with end‐stage kidney disease undergoing haemodialysis and their families—A scoping review

“…Only one research study, (Ho & Chen, 2021) used Charles et al (1999) SDM theory with another two studies including a reference to Charles et al (1999) SDM theory in their reference list (Barrett et al, 2019 and Ladin et al, 2017). The other studies used the term SDM but did not include a definition or reference to support their findings underpinning their SDM approach (Aresdt et al, 2019; Finderup et al, 2021; Ghodsian et al, 2021; Han et al, 2019; Ho & Chen, 2021; Hussain et al, 2015; Schellarts et al, 2021; Thomas et al, 2016).…”

“…Despite the core principles of SDM, many people agreed with physicians in making their final choices suggesting that decisions were often medically driven instead of person‐centred (Barrett et al, 2019; Finderup et al, 2021; Han et al, 2019; Ho & Chen, 2021; Kim et al, 2022; Ladin et al, 2017; Schellarts et al, 2021; Sledge et al, 2022). Many of those involved further felt that they did not receive the level of SDM that they desired, particularly in areas such as finances, and quality of life that they felt were important and underdiscussed (Barrett et al, 2019).…”

“…Further, they wished to consider the needs of those around them (Sledge et al, 2022). Family members influenced self‐determination and the autonomy of the person undergoing HD and were often present throughout the entire process(Ho & Chen, 2021). Han et al (2019) recommended that family dynamics and the relationships between the patient and their family as well as between family and HCPs, requires consideration.…”

Supporting Factors in Continuing Life of Chronic Renal Failure Patients Undergoing Hemodialysis

“…The action taken to get up from the participants was to tell the nurses and closest family. Research conducted by Ho YF et al (11) shows that there are three things that influence a person in accepting his condition, namely the stages in acceptance, the decision-making process and the facilitating factors. Two factors that are important in facilitating acceptance are from the nurse and the patient's own family.…”

“…Patients undergoing hemodialysis require psychological adjustment. This is important so that the patient can adjust to the next stage, especially in undergoing therapy (11) . To find out these factors, the researchers are interested in conducting qualitative research on the supporting factors of patients who experience chronic kidney failure and undergo hemodialysis in continuing their life.…”