Dialysis-dependency: The reformulated or remnant person

Martin-McDonald, Kristine

doi:10.5172/conu.16.1-2.151

Cited by 6 publications

(10 citation statements)

References 16 publications

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“…2 Not only do patients have to come to terms with the knowledge they have an advanced illness that will curtail their life, 3 they have to decide on future treatment options and will require input from healthcare practitioners for the rest of their shortened lives. As the population ages, sicker patients, often with multiple comorbidities, are presenting in renal clinics.…”

Section: T He Incorporation Of Non-dialysis Care Into Counseling For mentioning

confidence: 99%

Reasons Renal Patients Give for Deciding Not to Dialyze: A Prospective Qualitative Interview Study

Noble¹,

Meyer²,

Bridges³

et al. 2009

Dialysis & Transplantation

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BACKGROUNDAs the population ages, sicker patients often with multiple comorbidities are presenting in renal clinics. Some are deciding not to embark on dialysis. The objective of this study was to gain an understanding of the decision that some patients make not to embark on dialysis.METHODSNaturally occurring qualitative interviews were conducted with 30 patients and 17 caregivers managed within a Renal Supportive Care Service in an acute NHS Trust in London.RESULTSSeveral patients believed they had made an informed and autonomous decision, either on or against the advice of their doctor (n 5 17); some felt that they had no option but to refuse dialysis treatment, as it would not have been of benefit and might ultimately cause their death (n 5 7); some stated they had decided to opt for medication rather than dialysis 3 times a week and seemed to believe that either option would lead to the same outcome (n 5 2), and some felt there had been no decision to be made (n 5 4).CONCLUSIONSPrior to this study, little was known about those who decide not to embark on dialysis and how they make this decision. It cannot be presumed that decisions made by patients are fully understood and free from inappropriate professional or family influence, and the decision needs to be regularly revisited to check patients' and caregivers' understanding and to allow for reversal of the decision if fitting. There is a need to understand how service providers can help to ensure that such decisions are informed and supported by the best available supportive care thereafter.

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Section: T He Incorporation Of Non-dialysis Care Into Counseling For mentioning

confidence: 99%

Reasons Renal Patients Give for Deciding Not to Dialyze: A Prospective Qualitative Interview Study

Noble¹,

Meyer²,

Bridges³

et al. 2009

Dialysis & Transplantation

View full text Add to dashboard Cite

show abstract

“…2001; Hagren et al . 2001; Smith & Soliday 2001; Curtin et al 2002; Giles 2003; Martin‐McDonald 2003, 2004; Polaschek 2003; Al‐Arabi 2006; Kaba et al . 2007; Lee et al .…”

Section: Relationshipsmentioning

confidence: 99%

“…2007; Tanyi & Werner 2008; Mitchell et al 2009; Tong et al 2009). Patients indicated that their friends found it difficult to be around someone who was chronically ill (Martin‐McDonald 2004) and that they were unable to develop new relationships (Polaschek 2003). Sustaining relationships, especially intimate partnerships, was difficult partly because of the strains and limitations their disease imposed on their partners (Polaschek 2003).…”

Section: Relationshipsmentioning

confidence: 99%

“…Family members did not understand that the patient, generally the mother of the family, was sicker and therefore could not carry out her everyday activities in the role of mother or parent (Lee et al 2007). Parents, especially mothers, indicated they were unable to care for their children in the way they wanted to (Smith & Soliday 2001; Martin‐McDonald 2004). They were too tired to ‘be a good mother’ (Lee et al 2007, p. 411).…”

Section: Relationshipsmentioning

confidence: 99%

“…This theme incorporated the features of adaptation and acceptance, remodelled self (self adjustment), normality and constructive non‐compliance. The adjustment process extended from being able to reformulate oneself by finding new meaning in his/her situation to being filled with despair and facing an unacceptable future (Martin‐McDonald 2004). Patients emphasised the importance of education to the adjustment process (Mitchell et al 2009).…”

Section: Adjustmentmentioning

confidence: 99%

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