Ho Ya-Fang, Hsu Pei-Ti, Yang Kai-Ling
School of Nursing, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist, 406040, Taichung City, Taiwan, ROC.
Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan, ROC.
BMC Nurs. 2022 Sep 30;21(1):268. doi: 10.1186/s12912-022-01043-5.
The current health policy in Taiwan favors peritoneal dialysis (PD) at home. Policy objectives may make healthcare providers give more consideration to the introduction of PD treatment. This study aimed to explore the process of information acquisition and consideration during shared decision-making (SDM) for patients undergoing PD and compare their quality of life expectations before and after PD at home.
In this qualitative study, 15 patients undergoing PD for < 12 months were purposively recruited from one large PD unit in Taichung, Taiwan. Data were collected between August 2020 and December 2020 using a semi-structured interview. All transcripts were evaluated using thematic analysis.
Three themes and seven subthemes were identified following data analysis: 1. sources for information on dialysis treatment, including (a) effect of others' experiences and (b) incomplete information from healthcare providers (HCPs); 2. considerations for choosing PD, including (a) trusting physicians, and (b) maintaining pre-dialysis life; and 3. disparity between pre-and post-PD reality and expectation, including (a) limitation by time and place, (b) discrepancies in expected freedom and convenience, and (c) regret versus need to continue.
HCPs played an important role in SDM, providing key information that influenced the process. Patients undergoing initial PD at home exhibited a disparity between expectation and reality, which was exacerbated by incomplete information.
台湾目前的卫生政策倾向于居家腹膜透析（PD）。政策目标可能使医疗服务提供者在引入PD治疗时给予更多考虑。本研究旨在探讨PD患者共同决策（SDM）过程中的信息获取和考虑过程，并比较他们居家PD前后的生活质量期望。
在这项定性研究中，从台湾台中的一个大型PD中心有目的地招募了15名接受PD治疗<12个月的患者。2020年8月至2020年12月期间使用半结构化访谈收集数据。所有转录本均采用主题分析进行评估。
数据分析后确定了三个主题和七个子主题：1.透析治疗信息来源，包括（a）他人经验的影响和（b）医疗服务提供者（HCP）提供的不完整信息；2.选择PD的考虑因素，包括（a）信任医生和（b）维持透析前的生活；3.PD前后现实与期望的差异，包括（a）时间和地点的限制、（b）预期自由和便利方面的差异以及（c）后悔与继续的必要性。
HCP在SDM中发挥了重要作用，提供了影响该过程的关键信息。首次居家接受PD的患者期望与现实存在差异，不完整信息加剧了这种差异。
