Guppy Michelle, Bowles Esther Joy, Glasziou Paul, Doust Jenny
Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
School of Rural Medicine, University of New England, Armidale, Australia.
BJGP Open. 2025 Apr 24;9(1). doi: 10.3399/BJGPO.2024.0031. Print 2025 Apr.
Guidelines for terminology defining chronic kidney disease (CKD) have been in use for 20 years. Age is not currently considered in the guideline definition of CKD. In previous studies, GPs have been reluctant to give older patients the label of CKD.
To determine what language GPs are using to describe or label CKD with their older patients, and to explore the reasons for their use of alternative language.
DESIGN & SETTING: This was a descriptive qualitative interview study of Australian GPs.
Twenty-seven GPs were recruited via email and interviewed regarding their management of CKD. GPs were asked what language and terminology they used when discussing a diagnosis of CKD with their older patients.
'Labelling of CKD', the language that GPs use when talking about CKD with their patients, emerged as a major theme from the initial GP interviews. Sub-themes emerged, including types of alternative labels and rationale for alternative labels. GPs used descriptions of 'reduced kidney function' to explain CKD to their patients, either in parallel with the diagnosis of CKD or instead of it. GPs had concerns about the words 'chronic' and 'disease', and used different terminology to explain these words to patients when diagnosing them with CKD.
GPs use alternative descriptions to explain mild decrease in kidney function with older patients. Alternative labels that denote level of risk to older patients, without creating unnecessary concern about normal age-related kidney function, need to be explored.
定义慢性肾脏病（CKD）的术语指南已使用20年。目前CKD的指南定义中未考虑年龄因素。在先前的研究中，全科医生（GPs）一直不愿给老年患者贴上CKD的标签。
确定全科医生在与老年患者描述或标记CKD时使用的语言，并探究他们使用替代语言的原因。
这是一项对澳大利亚全科医生的描述性定性访谈研究。
通过电子邮件招募了27名全科医生，并就他们对CKD的管理进行了访谈。询问全科医生在与老年患者讨论CKD诊断时使用的语言和术语。
“CKD的标记”，即全科医生在与患者谈论CKD时使用的语言，是最初对全科医生访谈中出现的一个主要主题。出现了一些子主题，包括替代标签的类型和替代标签的理由。全科医生使用“肾功能减退”的描述向患者解释CKD，要么与CKD诊断同时使用，要么取而代之。全科医生对“慢性”和“疾病”这两个词有所顾虑，并在诊断患者患有CKD时使用不同的术语向患者解释这些词。
全科医生使用替代描述向老年患者解释肾功能的轻度下降。需要探索能够向老年患者表明风险程度，同时又不会引起对正常年龄相关肾功能不必要担忧的替代标签。
