How to Integrate Predictions in Outcomes in Planning Clinical Care

Germain, Michael J.

doi:10.1159/000368946

Cited by 4 publications

(1 citation statement)

References 40 publications

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“…Disease severity was measured using the HD Mortality Predictor, a validated, prognostic tool. This takes into consideration five variables: age, dementia, peripheral vascular disease, albumin and the Surprise Question (‘would I be surprised if this patient died within the next 6 months?’) This is one of the tools suggested for use in end‐stage renal disease for predicting prognosis and used to help guide shared decision‐making (Germain, 2015). The c‐statistic (measure of model accuracy) for the prognostic model prediction of 6‐month mortality was 0.8 (95% CI 0.73–0.88) indicating good performance (Cohen et al, 2010).…”

Section: Methodsmentioning

confidence: 99%

Interest and perceived capability of self‐care in haemodialysis units

Kurtz

Geron

Shadmi

2020

Journal of Clinical Nursing

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Aims To (a) assess patients' interest and perceived capability of participating in haemodialysis; (b) assess nurses' perceptions of patients’ interest and perceived capability of participating in haemodialysis; and (c) examine associations between patient characteristics and interest and perceived capability of performing haemodialysis self‐care. Design Cross‐sectional, questionnaire‐based study. Methods Data were collected from dialysis patients and their nurses between October 2018–May 2019. Patients’ interest and perceived capability of participation were assessed by a 10‐item Likert‐type scale developed and tested for this study, with responses ranging from 1 (not interested/no perceived capability) to 5 (already doing task independently). Multivariate linear regression was used to assess the relationship between patient characteristics, including age, sex, education level and severity of illness to ratings of activation level and haemodialysis self‐care scale scores. The STROBE checklist was used as a guideline for this study. Results Ninety‐one patients and 31 nurses participated. Overall, patients expressed interest (2.43 ± 0.93) and perceived themselves capable (2.34 ± 0.9) of participating in various haemodialysis‐related tasks. Nurses assessed lower interest (2.19 ± 0.77) than patients, but similar average capability (2.31 ± 0.8). Both greater interest and perceived capability were correlated with more years of education and higher patient activation; additionally, interest was associated with disease severity and perceived capability was associated with age. Conclusion Haemodialysis patients are interested and perceive themselves capable of participating in the tasks involved in dialysis care. Nurses underestimate patient interest in participation. Relevance to clinical practice Self‐care behaviours among haemodialysis patients are important, as they may affect quality of life and survival. Determining interest and perceived capability of participation is a first step towards evaluating the feasibility of self‐care in a supervised haemodialysis setting.

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Section: Methodsmentioning

confidence: 99%

Interest and perceived capability of self‐care in haemodialysis units

Kurtz

Geron

Shadmi

2020

Journal of Clinical Nursing

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Ethical Challenges and the Role of Palliative Care in Kidney Disease

Germain¹,

Cohen²

2019

Chronic Kidney Disease, Dialysis, and Transplantation

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Development of a risk stratification algorithm to improve patient-centered care and decision making for incident elderly patients with end-stage renal disease

Couchoud

Beuscart

Aldigier

et al. 2015

Kidney International

128

109

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A significant number of elderly patients die during their first 3 months of dialysis. Because dialysis can impair the quality of both life and death, a personalized care plan based on both early prognosis and patient choices is required. We developed a prognostic screening tool to identify older patients in need of specific care based on a multidisciplinary approach. Our study included 24,348 patients aged 75 years and older from the French national renal epidemiology and information network (REIN) registry who began dialysis between 1 January 2005 and 30 September 2012. Our primary outcome was overall mortality during the first 3 months of renal replacement therapy. Multivariate logistic regression was used to construct a scoring system in a random half of the cohort (training set). This score, which included age, gender, specific comorbidities, albumin levels, and mobility, was then applied to the other half (validation set). In all, 2548 patients died during the first 3 months after dialysis initiation, 22% after dialysis withdrawal. Three risk groups were identified: low risk (score under 12 points, 3-month expected mortality under 20%), intermediate risk (score from 12 to 16, mortality between 20 and 40%, 9.5% of patients) and high risk (score 17 or more, mortality over 40%, 2.5% of patients). We developed a decision-making process that classifies patients according to their risk of early death in view of their potentially imminent need for supportive care or treatment.

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How to Integrate Predictions in Outcomes in Planning Clinical Care

Cited by 4 publications

References 40 publications

Interest and perceived capability of self‐care in haemodialysis units

Interest and perceived capability of self‐care in haemodialysis units

Ethical Challenges and the Role of Palliative Care in Kidney Disease

Development of a risk stratification algorithm to improve patient-centered care and decision making for incident elderly patients with end-stage renal disease

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