Barriers to Education and Shared Decision Making in the Chronic Kidney Disease Population: A Narrative Review

Cassidy, Brendan; Getchell, Leah; Harwood, Lori; Hemmett, Juliya; Moist, Louise

doi:10.1177/2054358118803322

Cited by 44 publications

(51 citation statements)

References 84 publications

(228 reference statements)

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“…Through our narrative review, we have also found that patient-important outcomes are underreported and that incorporating patients into the research process itself can help inform methodology to incorporate the patient perspective. 51 We have taken this novel approach with the involvement of M.S., a patient on dialysis, which we believe has enriched our findings through the prioritization of CKD patients’ lived experiences.…”

Section: Discussionmentioning

confidence: 96%

“…We have recently reviewed the influencers of renal replacement decision making and found that comprehensive education programs through multidisciplinary teams are vital to overcoming educational barriers and bringing about shared decision making. 51 A standardized CKD education plan that is delivered in an individualized manner should be the ultimate goal in predialysis CKD management. Through our narrative review, we have also found that patient-important outcomes are underreported and that incorporating patients into the research process itself can help inform methodology to incorporate the patient perspective.…”

Section: Discussionmentioning

confidence: 99%

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Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study

Cassidy

Harwood

Getchell

et al. 2018

Can J Kidney Health Dis

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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.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study

Cassidy

Harwood

Getchell

et al. 2018

Can J Kidney Health Dis

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“…Literature shows that there is a need for more interactive patient education. However, the desired education modalities of patients with renal disease are currently unknown [ 38 ]. We would suggest that web-based sources should offer more assessment modes because these are crucial to evaluating knowledge and can assist patients by providing insight into their personal goals [ 21 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Topics, Delivery Modes, and Social-Epistemological Dimensions of Web-Based Information for Patients Undergoing Renal Transplant and Living Donors During the COVID-19 Pandemic: Content Analysis

Klaveren¹,

Jong²,

Hendriks³

et al. 2020

J Med Internet Res

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Background The COVID-19 pandemic has markedly affected renal transplant care. During this time of social distancing, limited in-person visits, and uncertainty, patients and donors are relying more than ever on telemedicine and web-based information. Several factors can influence patients’ understanding of web-based information, such as delivery modes (instruction, interaction, and assessment) and social-epistemological dimensions (choices in interactive knowledge building). Objective The aim of this study was to systemically evaluate the content, delivery modes, and social-epistemological dimensions of web-based information on COVID-19 and renal transplantation at time of the pandemic. Methods Multiple keyword combinations were used to retrieve websites on COVID-19 and renal transplantation using the search engines Google.com and Google.nl. From 14 different websites, 30 webpages were examined to determine their organizational sources, topics, delivery modes, and social-epistemological dimensions. Results The variety of topics and delivery modes was limited. A total of 13 different delivery modes were encountered, of which 8 (62%) were instructional and 5 (38%) were interactional; no assessment delivery modes were observed. No website offered all available delivery modes. The majority of delivery modes (8/13, 62%) focused on individual and passive learning, whereas group learning and active construction of knowledge were rarely encountered. Conclusions By taking interactive knowledge transfer into account, the educational quality of eHealth for transplant care could increase, especially in times of crisis when rapid knowledge transfer is needed.

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“…Additionally, a protocol for a scoping review on the information available for SDM with older patients with AKD considering their treatment options has been published 41. Finally, numerous narrative reviews and overview papers on these topics in the context of kidney failure have been published as well 42–63. All of these papers are either limited to a single aspect of the decision-making process or their methodological framework limits their validity due to uncertainties in the generalisability and reproducibility of the reported findings.…”

Section: Introductionmentioning

confidence: 99%

Shared decision-making in advanced kidney disease: a scoping review protocol

Engels¹,

Graav

Nat

et al. 2020

BMJ Open

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Protocol © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Strength and limitations of this study ► The proposed scoping review will be the first paper to systematically search and map shared decisionmaking (SDM) interventions for treatment modality decisions in advanced kidney disease, evaluate the evidence on their reported outcomes and report on new developments or ongoing studies in this field. ► It will provide a comprehensive overview by collecting information from both quantitative and qualitative research, as well as the grey literature and key experts on SDM. ► Research in SDM is heterogeneous in its methodology and the reporting of outcomes; therefore a scoping review will be better suited to map, summarise and present this information than traditional systematic reviews or meta-analyses. ► Included studies will not undergo a formal quality assessment as scoping reviews attempt to provide an overview of all the existing evidence, regardless of its quality. ► Potentially relevant findings from papers written in other languages will be missed, as this study will only include papers written in English. AbStrACtIntroduction Patients with advanced kidney disease (AKD) have to make difficult treatment modality decisions as their disease progresses towards end-stage kidney disease. International guidelines in nephrology suggest shared decision-making (SDM) to help patients make timely treatment modality decisions that align with their values and preferences. However, systematic reviews or scoping reviews on these SDM interventions and on their reported use or outcomes are lacking. This limits the adoption of SDM in clinical practice and hampers further research and development on the subject. Our aim is to provide a comprehensive and up-to-date overview of these SDM interventions by means of a scoping review of the literature. Scoping reviews can provide a broad overview of a topic, identify gaps in the research knowledge base and report on the types of evidence that address and inform practices. This paper presents our study protocol. Methods and analysis The proposed scoping review will be performed in accordance with the Joanna Briggs Institute's (JBI) methodology for scoping reviews. It will cover both qualitative and quantitative scientific literature, as well as the grey literature on SDM interventions for treatment modality decisions in AKD. Only literature written in English will be considered for inclusion. Two independent reviewers will participate in an iterative process of screening the literature, paper selection and data extraction. Disagreements between the reviewers will be resolved by discussion until consensus is reached or after consultation with the research team when needed. Results will be reported with descriptive statistics and diagrammatic or tabular displayed information, accompanied by narrative summaries as explained in the JBI guidelines. Ethics and dissemination Ethical approval for the cond...

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Barriers to Education and Shared Decision Making in the Chronic Kidney Disease Population: A Narrative Review

Cited by 44 publications

References 84 publications

Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study

Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study

Topics, Delivery Modes, and Social-Epistemological Dimensions of Web-Based Information for Patients Undergoing Renal Transplant and Living Donors During the COVID-19 Pandemic: Content Analysis

Shared decision-making in advanced kidney disease: a scoping review protocol

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