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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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. |
doi_str_mv | 10.1186/s12882-021-02261-w |
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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.</description><identifier>ISSN: 1471-2369</identifier><identifier>EISSN: 1471-2369</identifier><identifier>DOI: 10.1186/s12882-021-02261-w</identifier><identifier>PMID: 33593314</identifier><language>eng</language><publisher>LONDON: Springer Nature</publisher><subject>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</subject><ispartof>BMC nephrology, 2021-02, Vol.22 (1), p.58-58, Article 58</ispartof><rights>COPYRIGHT 2021 BioMed Central Ltd.</rights><rights>2021. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>10</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000620618900001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c601t-a035960f083bb988b64198e6c150c14524b3f30cbf6786e45ea6d12139d8f2163</citedby><cites>FETCH-LOGICAL-c601t-a035960f083bb988b64198e6c150c14524b3f30cbf6786e45ea6d12139d8f2163</cites><orcidid>0000-0003-2394-7160</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885613/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885613/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,554,729,782,786,866,887,2104,2116,27931,27932,39265,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33593314$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-41319$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Andersen-Hollekim, Tone</creatorcontrib><creatorcontrib>Landstad, Bodil J.</creatorcontrib><creatorcontrib>Solbjor, Marit</creatorcontrib><creatorcontrib>Kvangarsnes, Marit</creatorcontrib><creatorcontrib>Hole, Torstein</creatorcontrib><title>Nephrologists' experiences with patient participation when long-term dialysis is required</title><title>BMC nephrology</title><addtitle>BMC NEPHROL</addtitle><addtitle>BMC Nephrol</addtitle><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.</description><subject>Age</subject><subject>Analysis</subject><subject>Beliefs, opinions and attitudes</subject><subject>Care and treatment</subject><subject>Chronic illnesses</subject><subject>Chronic kidney failure</subject><subject>Collaboration</subject><subject>Decision making</subject><subject>Dialysis care</subject><subject>End-stage renal disease</subject><subject>Hemodialysis</subject><subject>Interviews</subject><subject>Kidney diseases</subject><subject>Life Sciences & Biomedicine</subject><subject>Nephrologists</subject><subject>Nephrology</subject><subject>Participation</subject><subject>Patient compliance</subject><subject>Patient participation</subject><subject>Patients</subject><subject>Physician and patient</subject><subject>Physicians</subject><subject>Science & Technology</subject><subject>Social aspects</subject><subject>Urology & Nephrology</subject><issn>1471-2369</issn><issn>1471-2369</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>D8T</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl2L1DAUhoso7rr6B7yQghcK0jUnSTPJjTCMXwuL3qjgVUjT05ksnWY2aa37702n67gjXkhb8tHnfXNyeLPsKZBzACleR6BS0oJQSB8VUIz3slPgCygoE-r-nflJ9ijGK0JgITl5mJ0wVirGgJ9m3z_hbhN869cu9vFFjj93GBx2FmM-un6T70yfln0aQ--sm5a-y8cNdnnru3XRY9jmtTPtTXQxT2_A68EFrB9nDxrTRnxyO55lX9-_-7L6WFx-_nCxWl4WVhDoC0NSLYI0RLKqUlJWgoOSKCyUxAIvKa9Yw4itGrGQAnmJRtRAgalaNhQEO8suZt_amyu9C25rwo32xun9hg9rvS-9RU2gJpKaulGGc8upZLSWSA0rZVnSEpJXMXvFEXdDdeT21n1b7t22bug0BwYq8W9mPsFbrG1qVDDtkez4T-c2eu1_6IWUpQCWDF7eGgR_PWDsk3u02LamQz9ETbkigijKp9qe_4Ve-SF0qbUTBYyTkvE_1NqkC7uu8elcO5nqpSiZIAulpmPP_0Glp8ats77DxqX9IwGdBTb4GAM2hzsC0VMY9RxGncKo92HUYxI9u9udg-R3-hLwagZGrHwT7T53B4wQIigRIFWakakB8v_plev3SV35oevZL50p-fA</recordid><startdate>20210216</startdate><enddate>20210216</enddate><creator>Andersen-Hollekim, Tone</creator><creator>Landstad, Bodil J.</creator><creator>Solbjor, Marit</creator><creator>Kvangarsnes, Marit</creator><creator>Hole, Torstein</creator><general>Springer Nature</general><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AKRZP</scope><scope>AOWAS</scope><scope>D8T</scope><scope>DG5</scope><scope>ZZAVC</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2394-7160</orcidid></search><sort><creationdate>20210216</creationdate><title>Nephrologists' experiences with patient participation when long-term dialysis is required</title><author>Andersen-Hollekim, Tone ; Landstad, Bodil J. ; Solbjor, Marit ; Kvangarsnes, Marit ; Hole, Torstein</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c601t-a035960f083bb988b64198e6c150c14524b3f30cbf6786e45ea6d12139d8f2163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Analysis</topic><topic>Beliefs, opinions and attitudes</topic><topic>Care and treatment</topic><topic>Chronic illnesses</topic><topic>Chronic kidney failure</topic><topic>Collaboration</topic><topic>Decision making</topic><topic>Dialysis care</topic><topic>End-stage renal disease</topic><topic>Hemodialysis</topic><topic>Interviews</topic><topic>Kidney diseases</topic><topic>Life Sciences & Biomedicine</topic><topic>Nephrologists</topic><topic>Nephrology</topic><topic>Participation</topic><topic>Patient compliance</topic><topic>Patient participation</topic><topic>Patients</topic><topic>Physician and patient</topic><topic>Physicians</topic><topic>Science & Technology</topic><topic>Social aspects</topic><topic>Urology & Nephrology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andersen-Hollekim, Tone</creatorcontrib><creatorcontrib>Landstad, Bodil J.</creatorcontrib><creatorcontrib>Solbjor, Marit</creatorcontrib><creatorcontrib>Kvangarsnes, Marit</creatorcontrib><creatorcontrib>Hole, Torstein</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SWEPUB Mittuniversitetet full text</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Mittuniversitetet</collection><collection>SwePub Articles full text</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andersen-Hollekim, Tone</au><au>Landstad, Bodil J.</au><au>Solbjor, Marit</au><au>Kvangarsnes, Marit</au><au>Hole, Torstein</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nephrologists' experiences with patient participation when long-term dialysis is required</atitle><jtitle>BMC nephrology</jtitle><stitle>BMC NEPHROL</stitle><addtitle>BMC Nephrol</addtitle><date>2021-02-16</date><risdate>2021</risdate><volume>22</volume><issue>1</issue><spage>58</spage><epage>58</epage><pages>58-58</pages><artnum>58</artnum><issn>1471-2369</issn><eissn>1471-2369</eissn><abstract>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.</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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