Golsorkhi Mohadese, Ebrahimi Niloufar, Vakhshoori Mehrbod, Norouzi Sayna, Abdipour Amir
Psychiatry Department, Brookdale Medical Center, Brooklyn, NY, USA.
Department of Medicine, Division of Nephrology, Loma Linda University Medical Center, Loma Linda, CA, USA.
J Nephrol. 2025 Jan 14. doi: 10.1007/s40620-024-02176-3.
The increasing prevalence of kidney failure highlights the crucial need for effective patient-physician communication to improve health-related quality of life and ensure adherence to treatment plans. This narrative review evaluates communication practices in the context of advanced kidney disease, focusing on the frameworks of shared decision-making, advanced care planning, and communication skills training among nephrologists. The findings highlight the significant gaps in patient-physician communication, particularly in the domains of advanced care planning, shared decision-making, and dialysis withdrawal. When communication in such situations falls short, it affects patient satisfaction and outcomes. Effective communication is essential for managing advanced kidney disease, requiring a patient-centered approach that includes patients, families, and healthcare providers in care planning. This review advocates for a more integrated, empathic approach to healthcare interactions, emphasizing the importance of including patients, their families, and healthcare providers in a collaborative model based on goals of care. Moreover, it highlights the role of patient-reported outcome measures and patient experience of care in assessing the quality of care in dialysis settings. Here, we call for enhanced training programs regarding communication skills for physicians and emphasize the need for systemic changes to foster patient-centered communication.
肾衰竭患病率的不断上升凸显了有效医患沟通的迫切需求，以提高与健康相关的生活质量并确保患者坚持治疗方案。本叙述性综述评估了晚期肾病背景下的沟通实践，重点关注共同决策、临终关怀规划以及肾科医生沟通技能培训等框架。研究结果凸显了医患沟通中存在的重大差距，尤其是在临终关怀规划、共同决策和透析撤减等领域。当此类情况下的沟通不足时，会影响患者满意度和治疗效果。有效沟通对于管理晚期肾病至关重要，需要一种以患者为中心的方法，在护理规划中纳入患者、家属和医疗服务提供者。本综述倡导采用更综合、更具同理心的医疗互动方法，强调在基于护理目标的协作模式中纳入患者及其家属和医疗服务提供者的重要性。此外，它还强调了患者报告结局指标和患者护理体验在评估透析环境中护理质量方面的作用。在此，我们呼吁加强针对医生的沟通技能培训项目，并强调进行系统性变革以促进以患者为中心的沟通的必要性。
