The development and piloting of the REnal specific Advanced Communication Training (REACT) programme to improve Advance Care Planning for renal patients

Bristowe, Katherine; Shepherd, Kate; Bryan, Liz; Brown, Heather; Carey, Ivana; Matthews, Beverley; O’Donoghue, Dónal; Vinen, Katie; Murtagh, Fliss E.M.

doi:10.1177/0269216313510342

Cited by 36 publications

(61 citation statements)

References 19 publications

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“…The other two studies did report an increase in post-intervention confidence scores; however the findings were non-significant (Bristowe et al, 2014;Krimshtein et al, 2011). These findings suggest that communication skills training does have some effect on participants' confidence; however effectiveness can be varied, and therefore we cannot conclusively argue that training will significantly improve health professionals' confidence in communicating about EoL issues with patients and families.…”

Section: Discussionmentioning

confidence: 95%

“…Seven studies were conducted in the United States of America (Betcher, 2010;Kelley et al, 2012;Kerai & Wheeler, 2013;Krimshtein et al, 2011;Schell et al, 2013;Smith et al, 2013;Zapka et al, 2006); one study in the Netherlands (Mulder et al, 2009); one study in Australia (Clayton et al, 2012); and one study in the United Kingdom (Bristowe et al, 2014). Only four studies reported sex of participants (Clayton et al, 2012;Mulder et al, 2009;Schell et al, 2013;Smith et al, 2013).…”

Section: Participantsmentioning

confidence: 99%

“…Five studies reported how many of the participants were in either their first, second, third or beyond, year of training (for medical trainees) (Bristowe et al, 2014;Clayton et al, 2012;Kelley et al, 2012;Kerai & Wheeler, 2013;Schell et al, 2013). For these studies the majority of participants were in their first year (ranging from 38% to 100% of participants).…”

Section: Participantsmentioning

confidence: 99%

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The effectiveness of communication-skills training interventions in end-of-life noncancer care in acute hospital-based services: A systematic review

2015

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A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP URL' above for details on accessing the published version and note that access may require a subscription For more information, please contact the WRAP Team at: wrap@warwick.ac.uk Significance of ResultsFurther research is needed to fully explore the effectiveness of existing training interventions in this population, and evidence using objective measures in particular is needed. Ideally, randomised controlled trials, or studies using control groups and longer follow ups are needed to test the effectiveness of interventions. There has been no recent review that has focused on non-cancer services and patients, and with evidence highlighting gaps in effective communication between staff and patients about EoL care in acute hospitals (e.g. Hewison et al., 2014), it is timely to focus on communication skills training in non-cancer acute services. Therefore this review seeks to establish, through the available literature, the effectiveness of communication skills training in non-cancer EoL care in acute hospital based services.

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Section: Discussionmentioning

confidence: 95%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

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The effectiveness of communication-skills training interventions in end-of-life noncancer care in acute hospital-based services: A systematic review

2015

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“…Although the need for ACP for dialysis patients is becoming more widely recognized (7,(24)(25)(26), and interventions to improve ACP have begun (27,28), this study begins to address the important question of how to develop and test broadly applicable strategies for implementing patient-centered ACP for all dialysis patients and their families. This study also raises questions about the role of both patient-family/friend interaction styles and patient-provider relationships in ACP.…”

Section: Discussionmentioning

confidence: 99%

Advance Care Planning

Goff

Eneanya

Feinberg

et al. 2015

Clinical Journal of the American Society of Nephrology

102

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Background and objectives More than 90,000 patients with ESRD die annually in the United States, yet advance care planning (ACP) is underutilized. Understanding patients' and families' diverse needs can strengthen systematic efforts to improve ACP.Design, setting, participants, & measurements In-depth interviews were conducted with a purposive sample of patients and family/friends from dialysis units at two study sites. Applying grounded theory, interviews were audiotaped, professionally transcribed, and analyzed in an iterative process. Emergent themes were identified, discussed, and organized into major themes and subthemes.Results Thirteen patients and nine family/friends participated in interviews. The mean patient age was 63 years (SD 14) and five patients were women. Participants identified as black (n=1), Hispanic (n=4), Native American (n=4), Pacific Islander (n=1), white (n=11), and mixed (n=1). Three major themes with associated subthemes were identified. The first theme, "Prior experiences with ACP," revealed that these discussions rarely occur, yet most patients desire them. A potential role for the primary care physician was broached. The second theme, "Factors that may affect perspectives on ACP," included a desire for more of a connection with the nephrologist, positive and negative experiences with the dialysis team, disenfranchisement, life experiences, personality traits, patient-family/friend relationships, and power differentials. The third theme, "Recommendations for discussing ACP," included thoughts on who should lead discussions, where and when discussions should take place, what should be discussed and how.Conclusions Many participants desired better communication with their nephrologist and/or their dialysis team. A number expressed feelings of disenfranchisement that could negatively impact ACP discussions through diminished trust. Life experiences, personality traits, and relationships with family and friends may affect patient perspectives regarding ACP. This study's findings may inform clinical practice and will be useful in designing prospective intervention studies to improve patient and family experiences at the end of life.

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“…Because of the very specific challenges entailed, renal-specific training may be useful, such as the training in advanced communication skills tailored to advanced kidney disease developed by Bristowe et al (25).…”

Section: Discussionmentioning

confidence: 99%

Conservative Care for ESRD in the United Kingdom

Okamoto

Tonkin‐Crine

Rayner

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Conservative kidney management (CKM) has been developed in the United Kingdom (UK) as an alternative to dialysis for older patients with stage 5 CKD (CKD5) and multiple comorbidities. This national survey sought to describe the current scale and pattern of delivery of conservative care in UK renal units and identify their priorities for its future development.Design, setting, participants, & measurements A survey on practice patterns of CKM for patients age 75 and older with CKD5 was sent to clinical directors of all 71 adult renal units in the UK in March 2013.Results Sixty-seven units (94%) responded. All but one unit reported providing CKM for some patients. Terminology varied, although "conservative management" was the most frequently used term (46%). Lack of an agreed-upon definition of when a patient is receiving CKM made it difficult to obtain meaningful data on the numbers of such patients. Fifty-two percent provided the number of CKM patients age $75 years in 2012; the median was 45 per unit (interquartile range [IQR], 20-83). The median number of symptomatic CKM patients who would otherwise have started dialysis was eight (IQR,. CKM practice patterns varied: 35% had a written guideline, 23% had dedicated CKM clinics, 45% had dedicated staff, and 50% provided staff training on CKM. Most units (88%) provided primary care clinicians with information/advice regarding CKM. Eighty percent identified a need for better evidence comparing outcomes on CKM versus dialysis, and 65% considered it appropriate to enter patients into a randomized trial.Conclusions CKM is provided in almost all UK renal units, but scale and organization vary widely. Lack of common terminology and definitions hinders the development and assessment of CKM. Many survey respondents expressed support for further research comparing outcomes with conservative care versus dialysis.

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The development and piloting of the REnal specific Advanced Communication Training (REACT) programme to improve Advance Care Planning for renal patients

Abstract: There is a need to improve end-of-life care for End-Stage Kidney Disease patients, to enable them to make informed decisions about future care. Challenges include prioritising communication training among service providers.

Cited by 36 publications

References 19 publications

The effectiveness of communication-skills training interventions in end-of-life noncancer care in acute hospital-based services: A systematic review

The effectiveness of communication-skills training interventions in end-of-life noncancer care in acute hospital-based services: A systematic review

Advance Care Planning

Conservative Care for ESRD in the United Kingdom

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