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

Finderup, Jeanette; Jensen, Jens K. D.; Lomborg, Kirsten

doi:10.1111/jorc.12241

Cited by 31 publications

(50 citation statements)

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“…A detailed description of the SDM-DC intervention can be found in the online supplementary material. The pilot test confirmed that SDM-DC was useful in encounters between individual patients and a dialysis coordinator at a Danish university hospital, but that further research was needed to gain insight into patients’ experiences of involvement and the implications for their choice of dialysis mode 10…”

Section: Introductionmentioning

confidence: 79%

“…The decision was experienced as being their own was a significant finding, which demonstrates that the patients experienced SDM-DC as involving them in the decision-making process. The SDM-DC pilot test predicted this finding, because some of the patients did not experience the decision as a shared decision, but their own decision 10. Due to the age of the patient group, this finding was surprising when compared with a study focusing on the involvement of the over-65 age group 39.…”

Section: Discussionmentioning

confidence: 95%

“…Based on SDM for dialysis choice, we developed and pilot-tested an intervention called ‘Shared Decision-making and Dialysis Choice’ (SDM-DC) with the purpose of involving patients and their relatives in the decision-making process 10. In this article, we document patients’ perspectives on using the SDM-DC intervention at four different hospitals in Denmark.…”

Section: Introductionmentioning

confidence: 99%

“…The SDM-DC intervention was developed in 2015 and then described and pilot-tested 10. It includes a PDA, named ‘Dialysis Choice’, and is designed for patients with kidney failure who must make a decision regarding their future dialysis mode: haemodialysis or peritoneal dialysis.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a shared decision-making intervention for dialysis choice at four Danish hospitals: a qualitative study of patient perspective

2019

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ObjectiveTo evaluate the ‘Shared Decision-making and Dialysis Choice’ (SDM-DC) intervention with regard to patients’ experience and involvement.DesignSemistructured individual interviews and systematic text condensation for data analysis.SettingThe SDM-DC intervention was implemented and evaluated at four different hospitals in Denmark.ParticipantsA total of 348 patients had received the SDM-DC intervention, and of these 29 patients were interviewed.InterventionsSDM-DC was designed for patients facing a choice of dialysis modality. The available modalities were haemodialysis and peritoneal dialysis, either performed by patients on their own or with help from a healthcare professional. The intervention was tailored to individual patients and consisted of three meetings with a dialysis coordinator who introduced a patient decision aid named ‘Dialysis Choice’ to the patient.FindingsThe following were the four main findings: the decision was experienced as being the patient’s own; the meetings contributed to the decision process; ‘Dialysis Choice’ contributed to the decision process; and the decision process was experienced as being iterative.ConclusionsThe patients experienced SDM-DC as involving them in their choice of dialysis modality. Due to the iterative properties of the decision-making process, a shared decision-making intervention for dialysis choice has to be adapted to the needs of individual patients. The active mechanisms of the meetings with the dialysis coordinator were (1) questions to and from the patient, and (2) the dialysis coordinator providing accurate information about the options. The overview of options and the value clarification tool in the decision aid were particularly helpful in establishing a decision-making process based on informed preferences.

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Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of a shared decision-making intervention for dialysis choice at four Danish hospitals: a qualitative study of patient perspective

2019

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“…In 2018, nine studies evaluating interventions based on SDM in dialysis choice were identified [7], but few had been rigorously evaluated in clinical practice. In fact, none of these studies evaluated the SDM process or the decisional outcomes.…”

Section: Introductionmentioning

confidence: 99%

Choice of dialysis modality: patients’ experiences and quality of decision after shared decision-making

et al. 2020

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Background: Patients with kidney failure experience a complex decision on dialysis modality performed either at home or in hospital. The options have different levels of impact on their physical and psychological condition and social life. The purpose of this study was to evaluate the implementation of an intervention designed to achieve shared decision-making for dialysis choice. Specific objectives were: 1) to measure decision quality as indicated by patients' knowledge, readiness and achieved preferences; and 2) to determine if patients experienced shared decision-making. Method: A mixed methods descriptive study was conducted using both questionnaires and semi-structured interviews. Eligible participants were adults with kidney failure considering dialysis modality. The intervention, based on the Three-Talk model, consisted of a patient decision aid and decision coaching meetings provided by trained dialysis coordinators. The intervention was delivered to 349 patients as part of their clinical pathway of care. After the intervention, 148 participants completed the Shared Decision-Making Questionnaire and the Decision Quality Measurement, and 29 participants were interviewed. Concordance between knowledge, decision and preference was calculated to measure decision quality. Interview transcripts were analysed qualitatively. Results: The participants obtained a mean score for shared decision-making of 86 out of 100. There was no significant difference between those choosing home-or hospital-based treatment (97 versus 83; p = 0.627). The participants obtained a knowledge score of 82% and a readiness score of 86%. Those choosing home-based treatment had higher knowledge score than those choosing hospital-based treatment (84% versus 75%; p = 0.006) but no significant difference on the readiness score (87% versus 84%; p = 0.908). Considering the chosen option and the knowledge score, 83% of the participants achieved a high-quality decision. No significant difference was found for decision quality between those choosing home-or hospital-based treatment (83% versus 83%; p = 0.935). Interview data informed the interpretation of these results. Conclusions: Although there was no control group, over 80% of participants exposed to the intervention and responded to the surveys experienced shared decision-making and reached a high-quality decision. Both participants who chose homeand hospital-based treatment experienced the intervention as shared decision-making and made a high-quality decision. Qualitative findings supported the quantitative results.

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Evidence-Based Clinical Practice

Finderup

Lomborg

2019

Leadership in Nursing: Experiences From the European Nordic Countries

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

Cited by 31 publications

References 31 publications

Evaluation of a shared decision-making intervention for dialysis choice at four Danish hospitals: a qualitative study of patient perspective

Evaluation of a shared decision-making intervention for dialysis choice at four Danish hospitals: a qualitative study of patient perspective

Choice of dialysis modality: patients’ experiences and quality of decision after shared decision-making

Evidence-Based Clinical Practice

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