Nephrologists' experiences with patient participation when long-term dialysis is required

BackgroundFor individuals in need of dialysis, patient participation is important when determining care goals and in decision making regarding dialysis modality. Nephrologists hold a key role in delivering evidence-based healthcare that integrates patient preferences and values throughout the trajec...

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Veröffentlicht in:BMC nephrology 2021-02, Vol.22 (1), p.58-58, Article 58
Hauptverfasser: Andersen-Hollekim, Tone, Landstad, Bodil J., Solbjor, Marit, Kvangarsnes, Marit, Hole, Torstein
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container_end_page 58
container_issue 1
container_start_page 58
container_title BMC nephrology
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creator Andersen-Hollekim, Tone
Landstad, Bodil J.
Solbjor, Marit
Kvangarsnes, Marit
Hole, Torstein
description BackgroundFor individuals in need of dialysis, patient participation is important when determining care goals and in decision making regarding dialysis modality. Nephrologists hold a key role in delivering evidence-based healthcare that integrates patient preferences and values throughout the trajectory, and their experiences with patient participation are important for improving health care. The aim of this study was to explore nephrologists' experiences with patient participation in different phases of the end-stage renal disease trajectory for working-age individuals who require dialysis.MethodsThis explorative study comprised interviews with ten nephrologists from four different dialysis units in Central Norway. We analysed the interviews by applying an interpretive phenomenological approach.ResultsNephrologists had varied experiences with patient participation throughout the different phases of the treatment trajectory. During decision making on the dialysis modality, nephrologists emphasised patients' choices in two approaches. In the first approach, they expected patients to choose the modality based on the provided information, which could be actively steered. In the second approach, they recognised the patients' values and lifestyle preferences through shared decision-making. Within hospital haemodialysis, nephrologists considered patients' self-care activities equivalent to patient participation, seeing self-care as a source of patient empowerment. They identified divergent patient-professional values and organisational structures as barriers to patient participation.ConclusionOur study shows that nephrologists have different approaches to patient participation in different phases of the end-stage renal disease trajectory. Individual understanding as well as organisational structures are important factors to address to increase patient participation in end-stage renal disease care. Shared decision making, in which patient values are balanced against biomedical treatment targets, allows for mutual agreement between patients and healthcare professionals concerning medical plans and minimises the potential for patient-professional tensions.
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Nephrologists hold a key role in delivering evidence-based healthcare that integrates patient preferences and values throughout the trajectory, and their experiences with patient participation are important for improving health care. The aim of this study was to explore nephrologists' experiences with patient participation in different phases of the end-stage renal disease trajectory for working-age individuals who require dialysis.MethodsThis explorative study comprised interviews with ten nephrologists from four different dialysis units in Central Norway. We analysed the interviews by applying an interpretive phenomenological approach.ResultsNephrologists had varied experiences with patient participation throughout the different phases of the treatment trajectory. During decision making on the dialysis modality, nephrologists emphasised patients' choices in two approaches. In the first approach, they expected patients to choose the modality based on the provided information, which could be actively steered. In the second approach, they recognised the patients' values and lifestyle preferences through shared decision-making. Within hospital haemodialysis, nephrologists considered patients' self-care activities equivalent to patient participation, seeing self-care as a source of patient empowerment. They identified divergent patient-professional values and organisational structures as barriers to patient participation.ConclusionOur study shows that nephrologists have different approaches to patient participation in different phases of the end-stage renal disease trajectory. Individual understanding as well as organisational structures are important factors to address to increase patient participation in end-stage renal disease care. 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Nephrologists hold a key role in delivering evidence-based healthcare that integrates patient preferences and values throughout the trajectory, and their experiences with patient participation are important for improving health care. The aim of this study was to explore nephrologists' experiences with patient participation in different phases of the end-stage renal disease trajectory for working-age individuals who require dialysis.MethodsThis explorative study comprised interviews with ten nephrologists from four different dialysis units in Central Norway. We analysed the interviews by applying an interpretive phenomenological approach.ResultsNephrologists had varied experiences with patient participation throughout the different phases of the treatment trajectory. During decision making on the dialysis modality, nephrologists emphasised patients' choices in two approaches. In the first approach, they expected patients to choose the modality based on the provided information, which could be actively steered. In the second approach, they recognised the patients' values and lifestyle preferences through shared decision-making. Within hospital haemodialysis, nephrologists considered patients' self-care activities equivalent to patient participation, seeing self-care as a source of patient empowerment. They identified divergent patient-professional values and organisational structures as barriers to patient participation.ConclusionOur study shows that nephrologists have different approaches to patient participation in different phases of the end-stage renal disease trajectory. Individual understanding as well as organisational structures are important factors to address to increase patient participation in end-stage renal disease care. 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Nephrologists hold a key role in delivering evidence-based healthcare that integrates patient preferences and values throughout the trajectory, and their experiences with patient participation are important for improving health care. The aim of this study was to explore nephrologists' experiences with patient participation in different phases of the end-stage renal disease trajectory for working-age individuals who require dialysis.MethodsThis explorative study comprised interviews with ten nephrologists from four different dialysis units in Central Norway. We analysed the interviews by applying an interpretive phenomenological approach.ResultsNephrologists had varied experiences with patient participation throughout the different phases of the treatment trajectory. During decision making on the dialysis modality, nephrologists emphasised patients' choices in two approaches. In the first approach, they expected patients to choose the modality based on the provided information, which could be actively steered. In the second approach, they recognised the patients' values and lifestyle preferences through shared decision-making. Within hospital haemodialysis, nephrologists considered patients' self-care activities equivalent to patient participation, seeing self-care as a source of patient empowerment. They identified divergent patient-professional values and organisational structures as barriers to patient participation.ConclusionOur study shows that nephrologists have different approaches to patient participation in different phases of the end-stage renal disease trajectory. Individual understanding as well as organisational structures are important factors to address to increase patient participation in end-stage renal disease care. Shared decision making, in which patient values are balanced against biomedical treatment targets, allows for mutual agreement between patients and healthcare professionals concerning medical plans and minimises the potential for patient-professional tensions.</abstract><cop>LONDON</cop><pub>Springer Nature</pub><pmid>33593314</pmid><doi>10.1186/s12882-021-02261-w</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-2394-7160</orcidid><oa>free_for_read</oa></addata></record>
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subjects Age
Analysis
Beliefs, opinions and attitudes
Care and treatment
Chronic illnesses
Chronic kidney failure
Collaboration
Decision making
Dialysis care
End-stage renal disease
Hemodialysis
Interviews
Kidney diseases
Life Sciences & Biomedicine
Nephrologists
Nephrology
Participation
Patient compliance
Patient participation
Patients
Physician and patient
Physicians
Science & Technology
Social aspects
Urology & Nephrology
title Nephrologists' experiences with patient participation when long-term dialysis is required
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