Loiselle Marie-Chantal, Michaud Cécile, O'Connor Annette
Professor and Doctoral Student, School of Nursing Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Canada.
Full Professor, School of Nursing Sciences, Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Canada.
Nephrol Nurs J. 2016 Nov-Dec;43(6):463-493.
Patients with advanced chronic kidney disease (CKD) face many choices regarding future dialysis modalities. Decision-making is difficult for patients. The objective of this study was to describe the decision-making needs from the perspectives of patients with advanced CKD, professionals, and others involved in the decision. Guided by a shared decision-making model, this qualitative study was conducted using interviews with key informants (17 patients, two peer helpers, and eight health professionals) and a focus group (five nurses). The results revealed evolving decisional needs in five-stage through the decision making journey: 1) Progress toward acceptance of dialysis, 2) Receive information, 3) Take some time for personal reflection, 4) Seek opinion and support of other, and 5) Re-evaluate one's choice. As we anticipate decisional needs, we will be able to develop decision support interventions that are stage-matched.
晚期慢性肾脏病（CKD）患者在未来透析方式方面面临诸多选择。对患者来说，决策很困难。本研究的目的是从晚期CKD患者、专业人员及其他参与决策的人员的角度描述决策需求。在共享决策模型的指导下，本定性研究通过对关键信息提供者（17名患者、2名同伴协助者和8名健康专业人员）进行访谈以及开展一个焦点小组（5名护士）来进行。结果揭示了在决策过程中五个阶段不断演变的决策需求：1）朝着接受透析的方向进展，2）接收信息，3）花些时间进行个人思考，4）寻求他人的意见和支持，5）重新评估自己的选择。当我们预测决策需求时，我们将能够制定与之阶段匹配的决策支持干预措施。
