Shared decision-making in chronic kidney disease: A retrospection of recently initiated dialysis patients in Germany

Robinski, Maxi; Mau, Wilfried; Wienke, Andreas; Girndt, Matthias

doi:10.1016/j.pec.2015.10.014

Cited by 45 publications

(51 citation statements)

References 29 publications

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“…Therefore, decision aids for ESRD patients and caregivers should be implemented in tandem with decision counselling by different professionals (i.e. not just physicians but also nurses, medical social workers etc) who are trained in shared decision making, bias awareness and communication skills to support patients in making decisions that are consistent with their values and preferences . In order to respect patients' autonomy in the fuller, relational sense, professionals must also learn how to involve families in decision making while protecting patients from undue pressure .…”

Section: Discussionmentioning

confidence: 99%

“…Fourthly, as many older ESRD patients in Singapore may first turn to TCM with the understanding that they will undergo dialysis if/when their condition reaches a crit- with their values and preferences. 40,41 In order to respect patients' autonomy in the fuller, relational sense, professionals must also learn how to involve families in decision making while protecting patients from undue pressure. 42 This necessitates training on resolving patient-family disagreements and treading the fine line between persuasion and coercion, the latter of which has been defined as the use of 'threats, harassment, berating, intimidation, or other manipulative tactics designed to force vulnerable patients to change well-established beliefs or preferences'.…”

Section: Key Findings and Recommendationsmentioning

confidence: 99%

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Perspectives on decision making amongst older people with end‐stage renal disease and caregivers in Singapore: A qualitative study

Han

Haldane

Koh

et al. 2019

Health Expectations

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BackgroundEnd‐stage renal disease (ESRD) is increasing both globally and in Asia. Singapore has the fifth highest incidence of ESRD worldwide, a trend that is predicted to rise. Older patients with ESRD are faced with a choice of haemodialysis, peritoneal dialysis or conservative management, all of which have their risks and benefits.ObjectiveThis study seeks to explore perspectives on decision making amongst older (≥70) Singaporean ESRD patients and their caregivers to undergo (or not to undergo) dialysis.DesignQualitative study design using semi‐structured interviews.Setting and participantsTwenty‐three participants were recruited from the largest tertiary hospital in Singapore: seven peritoneal dialysis patients, five haemodialysis patients, four patients on conservative management and seven caregivers.ResultsWhile some patients believed that they had made an independent treatment decision, others reported feeling like they had no choice in the matter or that they were strongly persuaded by their doctors and/or family members to undergo dialysis. Patients reported decision‐making factors including loss of autonomy in daily life, financial burden (on themselves or on their families), caregiving burden, alternative medicine, symptoms and disease progression. Caregivers also reported concerns about financial and caregiving burden.Discussion and conclusionThis study has identified several factors that should be considered in the design and implementation of decision aids to help older ESRD patients in Singapore make informed treatment decisions, including patients' and caregivers' decision‐making factors as well as the relational dynamics between patients, caregivers and doctors.

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Section: Discussionmentioning

confidence: 99%

Section: Key Findings and Recommendationsmentioning

confidence: 99%

Perspectives on decision making amongst older people with end‐stage renal disease and caregivers in Singapore: A qualitative study

Han

Haldane

Koh

et al. 2019

Health Expectations

View full text Add to dashboard Cite

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“…This hypothesis was supported by a study of Robinski et al . () which concluded that patients with advanced kidney disease need comprehensive information, combined with a successful and unbiased shared decision‐making process when choosing dialysis mode.…”

Section: Introductionmentioning

confidence: 99%

Developing and pilot testing a shared decision‐making intervention for dialysis choice

Finderup

Jensen

Lomborg

2018

Journal of Renal Care

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“…; Robinski et al . ). Additionally, there is evidence that despite their belief that initiating RRT should be the patient's decision, many patients perceive that the choice to begin dialysis was not their own (Ladin et al .…”

Section: Introductionmentioning

confidence: 97%

“…However, while apparently critical to the RRT preparation process, shared decision‐making is not well tracked or regulated (Robinski et al . ).…”

Section: Introductionmentioning

confidence: 97%

Patient perspectives on the optimal start of renal replacement therapy

Henry

Munoz-Plaza

Delgadillo

et al. 2017

Journal of Renal Care

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(2017). Patient perspectives on the optimal start of renal replacement therapy. Journal of Renal Care 43(3),143-155. S U M M A R YBackground: Healthcare systems and providers are encouraged to prepare their patients with advanced chronic kidney disease (CKD) for a planned start to renal replacement therapies (RRT). Less well understood are the socioemotional experiences surrounding the optimal start of RRT versus suboptimal haemodialysis (HD) starts with a central catheter. Objectives: To characterise the experiences of patients beginning RRT. Design: Qualitative, semi-structured phone interviews. Participants: A total of 168 patients with stage 5 CKD initiating RRT in an integrated, capitated learning healthcare system. Approach: Qualitative data from patients were collected as part of a quality improvement initiative to better understand patient-reported themes concerning preparation for RRT, patients' perceptions of their transition to dialysis and why suboptimal starts for RRT occur within our healthcare system. Dual review and verification was used to identify key phrases and themes within and across each domain, using both deductive a priori codes generated by the interview guide and grounded discovery of emergent themes. Results: From the patient perspective, preparing for RRT is an experience rooted in deep feelings of fear. In addition, a number of key factors contributed to patients' preparation (or failure to prepare) for RRT. While the education provided by our system was viewed as adequate overall, patients often felt that their emotional and psychosocial needs went unmet, regardless of whether or not, they experienced an optimal dialysis start. Conclusions: Future efforts should incorporate additional strategies for helping patients with advanced CKD achieve emotional and psychological safety while preparing for RRT.

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Shared decision-making in chronic kidney disease: A retrospection of recently initiated dialysis patients in Germany

Cited by 45 publications

References 29 publications

Perspectives on decision making amongst older people with end‐stage renal disease and caregivers in Singapore: A qualitative study

Perspectives on decision making amongst older people with end‐stage renal disease and caregivers in Singapore: A qualitative study

Developing and pilot testing a shared decision‐making intervention for dialysis choice

Patient perspectives on the optimal start of renal replacement therapy

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