Cassidy Brendan P, Harwood Lori, Getchell Leah E, Smith Michael, Sibbald Shannon L, Moist Louise M
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Renal Services, London Health Sciences Centre, London, ON, Canada.
Can J Kidney Health Dis. 2018 Oct 8;5:2054358118803323. doi: 10.1177/2054358118803323. eCollection 2018.
Patients with chronic kidney disease (CKD) are asked to choose a renal replacement therapy or conservative management. Education and knowledge transfer play key roles in this decision-making process, yet they remain a partially met need.
We sought to understand the dialysis modality decision-making process through exploration of the predialysis patient experience to better inform the educational process.
Qualitative descriptive study.
Kidney Care Centre of London Health Sciences Centre in London, Ontario, Canada.
Twelve patients with CKD, with 4 patients on in-center hemodialysis, home hemodialysis, and peritoneal dialysis, respectively.
Not applicable.
We conducted semistructured interviews with each participant, along with any family members who were present. Interviews were transcribed verbatim. Conventional content analysis was used to analyze the transcripts for common themes. Representative quotes were decided via team consensus. A patient collaborator was part of the research team.
Three themes influenced dialysis modality decision making: (i) Patient Factors: individualization, autonomy, and emotions; (ii) Educational Factors: tailored education, time and preparation, and available resources; and (iii) Support Systems: partnership with health care team, and family and friends.
Sample not representative of wider CKD population. Limited number of eligible patients. Poor recall may affect findings.
Modality decision making is a complex process, influenced by the patient's health literacy, willingness to accept information, predialysis lifestyle, support systems, and values. Patient education requires the flexibility to individualize the delivery of a standardized CKD curriculum in partnership with a patient-health care team, to fulfill the goal of informed, shared decision making.
慢性肾脏病（CKD）患者需要选择肾脏替代治疗或保守治疗。教育和知识传授在这一决策过程中起着关键作用，但这方面的需求仍未得到充分满足。
我们试图通过探索透析前患者的经历来了解透析方式的决策过程，以便更好地为教育过程提供信息。
定性描述性研究。
加拿大安大略省伦敦市伦敦健康科学中心肾脏护理中心。
12例CKD患者，其中4例分别接受中心血液透析、家庭血液透析和腹膜透析。
不适用。
我们对每位参与者及其在场的家庭成员进行了半结构化访谈。访谈内容逐字记录。采用常规内容分析法分析转录本中的共同主题。通过团队共识确定代表性引语。一名患者合作者是研究团队的一员。
三个主题影响透析方式的决策：（i）患者因素：个体化、自主性和情绪；（ii）教育因素：量身定制的教育、时间和准备以及可用资源；（iii）支持系统：与医疗团队、家人和朋友的合作关系。
样本不代表更广泛的CKD人群。符合条件的患者数量有限。回忆不佳可能影响研究结果。
透析方式的决策是一个复杂的过程，受患者的健康素养、接受信息的意愿、透析前生活方式、支持系统和价值观影响。患者教育需要灵活性，以便与患者-医疗团队合作，根据标准化的CKD课程进行个性化授课，以实现知情、共同决策的目标。
