Making Sense of Prognostic Information About Maintenance Dialysis versus Conservative Care for Treatment of Advanced Kidney Disease

Wong, Susan; O’Hare, Ann M.

doi:10.1159/000479804

Cited by 1 publication

(1 citation statement)

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“…Kidney care services are central to preparing patients with ESKD for EoLC, and palliative care options, as their health continues to deteriorate. Relatives are often involved in planning care with patients as they fit treatments into their lives; in some cases, patients can lose cognitive function and become unable to make decisions meaning relatives make decisions on their behalf [ 2 , 3 ]. Patients and their relatives may find these decisions difficult.…”

Section: Introductionmentioning

confidence: 99%

Shared decision-making and planning end-of-life care for patients with end-stage kidney disease: a protocol for developing and testing a complex intervention

Buur

Finderup

Søndergaard³

et al. 2022

Pilot Feasibility Stud

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Background Internationally, it has been stressed that advance care planning integrated within kidney services can lead to more patients being involved in decisions for end-of-life care. In Denmark, there is no systematic approach to advance care planning and end-of-life care interventions within kidney services. A shared decision-making intervention for planning end-of-life care may support more effective treatment management between patients with end-stage kidney disease, their relatives and the health professionals. The purpose of this research is to find evidence to design a shared decision-making intervention and test its acceptability to patients with end-stage kidney disease, their relatives, and health professionals in Danish kidney services. Methods This research project will be conducted from November 2020 to November 2023 and is structured according to the UK Medical Research Council framework for complex intervention design and evaluation research. The development phase research includes mixed method surveys. First, a systematic literature review synthesising primary empirical evidence of patient-involvement interventions for patients with end-stage kidney disease making end-of-life care decisions will be conducted. Second, interview methods will be carried out with patients with end-stage kidney disease, relatives, and health professionals to identify experiences of involvement in decision-making and decisional needs when planning end-of-life care. Findings will inform the co-design of the shared decision-making intervention using an iterative process with our multiple-stakeholder steering committee. A pilot test across five kidney units assessing if the shared decision-making intervention is acceptable and feasible to patients, relatives, and health professionals providing services to support delivery of care in kidney services. Discussion This research will provide evidence informing the content and design of a shared decision-making intervention supporting patient-professional planning of end-of-life care for patients with end-stage kidney disease, and assessing its acceptability and feasibility when integrated within Danish kidney units. This research is the first step to innovating the involvement of patients in end-of-life care planning with kidney professionals.

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Section: Introductionmentioning

confidence: 99%