scholarly journals The views of patients and carers in treatment decision making for chronic kidney disease: systematic review and thematic synthesis of qualitative studies

BMJ ◽  
2010 ◽  
Vol 340 (jan19 2) ◽  
pp. c112-c112 ◽  
Author(s):  
R L Morton ◽  
A Tong ◽  
K Howard ◽  
P Snelling ◽  
A C Webster
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Treatment Decision ◽  
Qualitative Studies ◽  
Thematic Synthesis ◽  
Treatment Decision Making

scholarly journals Person centred care provision and care planning in chronic kidney disease: which outcomes matter? A systematic review and thematic synthesis of qualitative studies

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ype de Jong ◽  
Esmee M. van der Willik ◽  
Jet Milders ◽  
Yvette Meuleman ◽  
Rachael L. Morton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Social Life ◽  
Healthcare Professionals ◽  
Financial Burden ◽  
Reporting Quality ◽  
Qualitative Studies ◽  
Care Planning ◽  
Thematic Synthesis

Abstract Rationale & Objective Explore priorities related to outcomes and barriers of adults with chronic kidney disease (CKD) regarding person centred care and care planning. Study design Systematic review of qualitative studies. Search Strategy & Sources In July 2018 six bibliographic databases, and reference lists of included articles were searched for qualitative studies that included adults with CKD stages 1–5, not on dialysis or conservative management, without a previous kidney transplantation. Analytical Approach Three independent reviewers extracted and inductively coded data using thematic synthesis. Reporting quality was assessed using the COREQ and the review reported according to PRISMA and ENTREQ statements. Results Forty-six studies involving 1493 participants were eligible. The period after diagnosis of CKD is characterized by feelings of uncertainty, social isolation, financial burden, resentment and fear of the unknown. Patients show interest in ways to return to normality and remain in control of their health in order to avoid further deterioration of kidney function. However, necessary information is often unavailable or incomprehensible. Although patients and healthcare professionals share the predominant interest of whether or not dialysis or transplantation is necessary, patients value many more outcomes that are often unrecognized by their healthcare professionals. We identified 4 themes with 6 subthemes that summarize these findings: ‘pursuing normality and control’ (‘pursuing normality’; ‘a search for knowledge’); ‘prioritizing outcomes’ (‘reaching kidney failure’; ‘experienced health’; ‘social life’; ‘work and economic productivity’); ‘predicting the future’; and ‘realising what matters’. Reporting quality was moderate for most included studies. Limitations Exclusion of non-English articles. Conclusions The realisation that patients’ priorities do not match those of the healthcare professionals, in combination with the prognostic ambiguity, confirms fatalistic perceptions of not being in control when living with CKD. These insights may contribute to greater understanding of patients’ perspectives and a more person-centred approach in healthcare prioritization and care planning within CKD care.

scholarly journals Self-referral of Chinese patients with advanced chronic kidney disease and treatment decision-making: A qualitative study

2020 ◽  
Author(s):  
Yajing Gao ◽  
Yan Shan ◽  
Tingting Jiang ◽  
Xue Li ◽  
Xinxin Jiang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Negative Emotion ◽  
Treatment Decision ◽  
Chinese Patients ◽  
Structured Interviews ◽  
Advanced Chronic Kidney Disease ◽  
Treatment Decision Making ◽  
Referral Decision

Abstract: Rationale, aims, and objectives: Chinese patients with advanced chronic kidney disease (CKD), especially rural patients possibly occur self-referral behavior and then treatment decisions followed. It is unclear the relationship between self-referral and treatment decision-making. Thus, the aim of this study was to explore the perceptions and views of self-referral and treatment decision making among patients with advanced chronic kidney disease. Methods: We conducted semi-structured interviews with 26 patients with advanced kidney disease and 12 nephrologists. Interviews were conducted and analyzed thematically until reaching thematic saturation. Results: We identified three themes reflected: 1) self-referral decision making (self-referral motive, barrier to self-referral, seeking for self-referral information); 2) the views and experience of self-referral care (facilitating shared decision making, imposing psychological pressure, feeling about self-referral communication, challenge to staff-patient relationship); 3) treatment decision making (decisional awareness and roles, cost-benefit trade-off and redicision). Conclusions: Our study identified that organizational and demographic factors, self-referral motives worked together at the self-referral decision-making and treatment decision-making when advanced CKD patients facing with healthcare facilities and treatment options. Those findings suggest stakeholders should accelerate the popularization of peritoneal dialysis technology and establish the CKD screening and management systems. For self-referral patients with advanced CKD, our results suggest specialized dialysis transition care to improve quality of communication and soothe patients’ negative emotion.

scholarly journals Self-referral of Chinese patients with advanced chronic kidney disease and treatment decision-making: A qualitative study

2020 ◽  
Author(s):  
Ya jing Gao ◽  
Yan Shan ◽  
Yue Zhou ◽  
Ting ting Jiang ◽  
Xue Li ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Health Care Professionals ◽  
Negative Emotion ◽  
Treatment Decision ◽  
Chinese Patients ◽  
Advanced Chronic Kidney Disease ◽  
Treatment Decision Making ◽  
Referral Decision

Abstract Background: Chinese patients with advanced chronic kidney disease, especially rural patients possibly occur self-referral behavior and then treatment decisions followed. It is unclear the relationship between self-referral and treatment decision-making. Thus, the aim of this study was to explore HCPs and patient with advanced CKD perceptions of self-referral and treatment decision making. Methods: We conducted semi-structured interviews with 22 patients with advanced kidney disease and 8 health care professionals. Interviews were conducted and analyzed thematically until reaching thematic saturation. Results: We identified three themes reflected: 1) self-referral decision making (self-referral motive, barrier to self-referral, seeking for self-referral information); 2) the views and experience of self-referral care (facilitating shared decision making, imposing psychological pressure, feeling about self-referral communication, challenge to staff-patient relationship); 3) treatment decision making (decisional awareness and roles, cost-benefit trade-off and redicision). Conclusions: Our study identified that organizational and demographic factors, self-referral motives worked together at the self-referral decision-making and treatment decision-making when advanced CKD patients facing with healthcare facilities and treatment options. Those findings suggest stakeholders should accelerate the popularization of peritoneal dialysis technology and establish the CKD screening and management systems. For self-referral patients with advanced CKD, our results suggest specialized dialysis transition care to improve quality of communication and soothe patients’ negative emotion.

A systematic review of factors influencing decision-making in adults living with chronic kidney disease

2009 ◽  
Vol 76 (2) ◽  
pp. 149-158 ◽  
Author(s):  
Mary Ann Murray ◽  
Gillian Brunier ◽  
Jenny Oey Chung ◽  
Lee Ann Craig ◽  
Cynthia Mills ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Factors Influencing

scholarly journals Consideration of comorbidity in treatment decision making in multidisciplinary cancer team meetings: a systematic review

2015 ◽  
Vol 26 (7) ◽  
pp. 1325-1332 ◽  
Author(s):  
J. Stairmand ◽  
L. Signal ◽  
D. Sarfati ◽  
C. Jackson ◽  
L. Batten ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Treatment Decision ◽  
Team Meetings ◽  
Treatment Decision Making

scholarly journals Systematic review and meta-analysis of factors that help or hinder treatment decision-making capacity in psychosis

2017 ◽  
Vol 211 (4) ◽  
pp. 205-215 ◽  
Author(s):  
Amanda Larkin ◽  
Paul Hutton
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Current Knowledge ◽  
Meta Analysis ◽  
Treatment Decision ◽  
Psychotic Symptoms ◽  
Related Factors ◽  
Treatment Decision Making ◽  
Effective Strategies ◽  
Decision Making Capacity

BackgroundThe evidence on factors that may influence treatment decisional capacity (‘capacity’) in psychosis has yet to be comprehensively synthesised, which limits the development of effective strategies to improve or support it.AimsTo determine the direction, magnitude and reliability of the relationship between capacity in psychosis and a range of clinical, demographic and treatment-related factors, thus providing a thorough synthesis of current knowledge.MethodWe conducted a systematic review, meta-analytical and narrative synthesis of factors that help or hinder treatment decision-making capacity in psychosis, assessing the direction, magnitude, significance and reliability of reported associations.ResultsWe identified 23 relevant studies (n= 1823). Psychotic symptoms had small, moderate and strong associations with appreciation, understanding and reasoning respectively. Both verbal cognitive functioning and duration of education had small to moderate correlations with understanding and reasoning. Better capacity was also associated with better insight, better metacognitive ability, higher anxiety and lower perceived coercion. No linear relationship with depression was observed. Interventions linked to improved capacity over time were in-patient care, information simplification, shared decision-making and metacognitive training.ConclusionsAlthough much is known about the role of symptoms and other clinical variables, effective and acceptable psychological interventions to support capacity in this group are lacking.

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