比较行血液透析和腹膜透析的患者在选择透析方式方面的共同决策。
Comparison of shared decision making in patients undergoing hemodialysis and peritoneal dialysis for choosing a dialysis modality.
机构信息
Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
BMC Nephrol. 2021 Feb 23;22(1):67. doi: 10.1186/s12882-021-02269-2.
BACKGROUND
Shared decision making (SDM) is recognized as the gold standard for patient-centered care. This study aimed to assess and compare the SDM among patients undergoing hemodialysis and peritoneal dialysis for choosing a dialysis modality.
METHODS
This is a cross-sectional study that was performed on 300 dialysis patients (218 HD and 82 PD) referred to two Dialysis Centers. Data were collected using demographic information and a 9-item Shared Decision Making Questionnaire (SDM-Q-9). The data were analyzed using ANOVA and independent t-test by SPSS software.
RESULTS
The mean SDM-Q-9 score in all samples (PD and HD) was 21.94 ± 15.08 (in a possible range of 0 to 45). Results of the independent t-test showed that the mean SDM-Q-9 score in PD patients (33.11 ± 10.08) was higher than HD patients (17.14 ± 74.24) (p < 0.001). The results showed a statistically significant difference in mean SDM-Q-9 score based on patients' age, educational level, and income (p < 0.05).
CONCLUSION
Implementing shared decision making and providing information on RRT should be started in the early stage of CKD. The health care providers should involve patients with CKD and their families in dialysis-related decisions and it should be started in the early stage of CKD.
背景
共同决策（SDM）被认为是以患者为中心的护理的金标准。本研究旨在评估和比较接受血液透析和腹膜透析的患者在选择透析方式方面的 SDM。
方法
这是一项横断面研究，对 300 名透析患者（218 名血液透析和 82 名腹膜透析）进行了研究，这些患者被转介到两个透析中心。使用人口统计学信息和 9 项共享决策问卷（SDM-Q-9）收集数据。使用 SPSS 软件进行方差分析和独立 t 检验对数据进行分析。
结果
所有样本（PD 和 HD）的 SDM-Q-9 评分平均值为 21.94±15.08（可能范围为 0 至 45）。独立 t 检验的结果表明，PD 患者的 SDM-Q-9 评分平均值（33.11±10.08）高于 HD 患者（17.14±74.24）（p<0.001）。结果表明，患者的年龄、教育水平和收入对 SDM-Q-9 评分平均值有统计学上的显著差异（p<0.05）。
结论
应在 CKD 的早期阶段实施共同决策，并提供 RRT 相关信息。医疗保健提供者应让 CKD 患者及其家属参与与透析相关的决策，应在 CKD 的早期阶段进行。
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