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透析选择中的共同决策有可能改善肾病患者的自我管理:一项定性随访研究。

Shared decision-making in dialysis choice has potential to improve self-management in people with kidney disease: A qualitative follow-up study.

机构信息

Department of Renal Medicine, Aarhus University Hospital, Aarhus N, Denmark.

Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.

出版信息

J Adv Nurs. 2021 Apr;77(4):1878-1887. doi: 10.1111/jan.14726. Epub 2020 Dec 17.

Abstract

AIMS

To explore how patients remained involved in their treatment and care of their own health following a shared decision-making intervention for dialysis choice.

DESIGN

A follow-up study using semi-structured interviews.

METHODS

Individual interviews with 13 patients were conducted immediately following their participation in a shared decision-making intervention for dialysis choice and again 3 months after initiating dialysis. This study reports findings from the follow-up interviews 3 month after dialysis initiation. Data were collected from August 2017-February 2019 and analysed using systematic text condensation.

RESULTS

The analysis revealed five main findings, which indicated differing levels of: (a) involvement in the decision-making process; (b) involvement in treatment; (c) involvement in care of own health; (d) involvement of a relative; and (e) support from healthcare professionals.

CONCLUSIONS

Following the shared decision-making intervention, patients who chose home-based treatment had become more involved in their treatment and care of their own health. The involvement of relatives and support from healthcare professionals contributed positively to this. In contrast, patients who had chosen hospital-based treatment were less involved in their treatment.

IMPACT

Shared decision-making in dialysis choice has potential to improve self-management in people with kidney disease. However, support from healthcare professionals for patients and their relatives should be prioritized in an effort to increase all patients' involvement in their treatment and care of their own health.

摘要

目的

探讨在透析选择的共享决策干预后,患者如何继续参与自身的治疗和健康护理。

设计

采用半结构式访谈的随访研究。

方法

13 名患者在参与透析选择的共享决策干预后立即进行了个体访谈,并在开始透析后 3 个月再次进行了访谈。本研究报告了在开始透析后 3 个月的随访访谈结果。数据收集于 2017 年 8 月至 2019 年 2 月,采用系统文本凝结进行分析。

结果

分析揭示了五个主要发现,这些发现表明了患者在以下方面的参与程度存在差异:(a)决策过程的参与度;(b)治疗的参与度;(c)自身健康护理的参与度;(d)亲属的参与度;以及(e)医疗保健专业人员的支持度。

结论

在共享决策干预后,选择家庭治疗的患者在治疗和自身健康护理方面的参与度有所提高。亲属的参与和医疗保健专业人员的支持对此起到了积极的作用。相比之下,选择医院治疗的患者在治疗方面的参与度较低。

影响

在透析选择中的共享决策有可能改善肾病患者的自我管理。然而,应优先考虑为患者及其亲属提供医疗保健专业人员的支持,以增加所有患者在治疗和自身健康护理方面的参与度。

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