Developing a conceptual model of older patients’ decision‐making process in choosing dialysis or conservative care using meta‐ethnography

Kim, Eun Young; Son, Youn‐Jung

doi:10.1111/jan.14945

Cited by 4 publications

(5 citation statements)

References 67 publications

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“…Engagement in decision‐making is another central theme identified in the included studies. The findings of this review share similarities with previous reviews on decision‐making during the transition to dialysis 21,67–70 . While diverse models of decision‐making exist (e.g., the paternalistic model, the informed model and the shared model), this review, consistent with previous reviews, underscores the significance of recognizing patients' needs, beliefs and preferences and enabling their active participation in decision‐making through tailored education, effective communication and equitable relationships.…”

Section: Discussionsupporting

confidence: 79%

“…The findings of this review share similarities with previous reviews on decision-making during the transition to dialysis. 21,[67][68][69][70] While diverse models of decision-making exist (e.g., the paternalistic model, the informed model and the shared model), this review, consistent with previous reviews, underscores the significance of recognizing patients' needs, beliefs and preferences and enabling…”

Section: Engagement In Self-caresupporting

confidence: 68%

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Patient engagement during the transition from nondialysis‐dependent chronic kidney disease to dialysis: A meta‐ethnography

Liu,

Zhou,

Tang

et al. 2023

Health Expectations

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IntroductionPatient engagement, encompassing both patient experience and opportunities for involvement in care, has been associated with increased patient satisfaction and the overall quality of care. Despite its importance, there is limited knowledge regarding patient engagement in the transition from nondialysis‐dependent chronic kidney disease (CKD) to dialysis‐dependent treatment. This systematic review employs meta‐ethnography to synthesize findings from qualitative studies examining patients' experiences of engagement during this transition, with the aim of developing a comprehensive theoretical understanding of patient engagement in the transition from nondialysis‐dependent CKD to dialysis.MethodsA systematic search of six databases, namely the Cochrane Library, PsycINFO, Scopus, Embase, PubMed and Web of Science was conducted to identify eligible articles published between 1990 and 2022. Meta‐ethnography was utilized to translate and synthesize the findings and develop a novel theoretical interpretation of ‘patient engagement’ during the transition to dialysis.ResultsA total of 24 articles were deemed eligible for review, representing 21 studies. Patient engagement during a transition to dialysis was found to encompass three major domains: psychosocial adjustment, decision‐making and engagement in self‐care. These three domains could be experienced as an iterative and mutually reinforcing process, guiding patients toward achieving control and proficiency in their lives as they adapt to dialysis. Additionally, patient engagement could be facilitated by factors including patients' basic capability to engage, the provision of appropriate education, the establishment of supportive relationships and the alignment with values and resources.ConclusionsThe findings of this review underscore the necessity of involving patients in transitional dialysis care, emphasizing the need to foster their engagement across multiple domains. Recommendations for future interventions include the provision of comprehensive support to enhance patient engagement during this critical transition phase. Additional research is warranted to explore the effects of various facilitators at different levels.Patient or Public ContributionThe studies included in our review involved 633 participants (547 patients, 14 family members, 63 healthcare providers and 9 managers). Based on their experiences, views and beliefs, we developed a deeper understanding of patient engagement and how to foster it in the future.

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Section: Discussionsupporting

confidence: 79%

Section: Engagement In Self-caresupporting

confidence: 68%

Patient engagement during the transition from nondialysis‐dependent chronic kidney disease to dialysis: A meta‐ethnography

Liu,

Zhou,

Tang

et al. 2023

Health Expectations

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“…Recent publications have shown benefit of dedicated approaches of shared decision making to support renal clinicians and patients, and provide a practical and holistic approach to inform treatment choices. 55 , 56 End-of-life conversations and planning must be embedded as an early, ongoing, and standard practice with continuity and adaptability according to patient circumstances, analogous to any other medical intervention.…”

Section: Discussionmentioning

confidence: 99%

Kidney Clinicians’ Perceptions of Challenges and Aspirations to Improve End-Of-Life Care Provision

Ducharlet¹,

Weil²,

Gock³

et al. 2023

Kidney International Reports

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“…In this study we add that this hope is tinged with uncertainty. We also add a nuance related to waiting in the hope implicit in making decisions about kidney replacement therapy [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Having to visit the hospital three times a week for hemodialysis; having to change peritoneal fluid daily; being subject to significant dietary, social and leisure restrictions and the loss of independence significantly reduce people’s quality of life [ 15 , 16 ]. Therefore, when choosing a therapy, one of the main considerations of people in the final stages of CKD is maintaining the highest possible quality of life [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Living normally without being oneself: A qualitative study on the experience of living with advanced chronic kidney disease

de la Cuesta-Benjumea,

Hernádez-Ibarra,

Arredondo-González

2023

PLoS ONE

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The aim of the study was to describe and analyze the experience of people with advanced chronic kidney disease. Chronic kidney disease is a growing public health problem that is on the increase worldwideThe experience of living with this illness is paradoxical, as it can include feelings of dependent autonomy, distant connection, abnormal normalcy, and uncertain hope. Every chronic disease involves a biographical alteration from the onset. For those who suffer it, it implies a breaking down and reconstruction of their everyday life. Despite the prevalence of the disease and the increase in the number of qualitative research studies in recent decades, there has not been much research on the experience of people with Chronic kidney disease. This is a qualitative study that began in 2018 and concluded in 2021.Twenty-one people with advanced chronic kidney disease were interviewed. They participated voluntarily with informed consent Participants were selected by purposive sampling. Data analysis was guided by grounded theory procedures using the Nvivo 12 software. This study reveals that people with advanced chronic kidney disease do not feel the same as they used to because their control over their lives is limited; because they feel their health is in a continuous state of deterioration; and because of the changes in themselves and in their relationships with others. With chronic kidney disease, their identity is continually called into question. The normal lives of these people–their biographical constructions–are precarious and are continuously being remodelled by the effects of treatment and the inexorable course of this disease. This study contributes to an understanding of the experience of people with advanced chronic kidney disease. It can contribute to helping health care professionals effectively support these patients in their efforts to lead a normal life and in making decisions about their treatment.

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Developing a conceptual model of older patients’ decision‐making process in choosing dialysis or conservative care using meta‐ethnography

Cited by 4 publications

References 67 publications

Patient engagement during the transition from nondialysis‐dependent chronic kidney disease to dialysis: A meta‐ethnography

Patient engagement during the transition from nondialysis‐dependent chronic kidney disease to dialysis: A meta‐ethnography

Kidney Clinicians’ Perceptions of Challenges and Aspirations to Improve End-Of-Life Care Provision

Living normally without being oneself: A qualitative study on the experience of living with advanced chronic kidney disease

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