scholarly journals Family dynamics in a multi-ethnic Asian society: comparison of elderly CKD patients and their family caregivers experience with medical decision making for managing end stage kidney disease

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Semra Ozdemir ◽  
Tazeen H. Jafar ◽  
Lina Hui Lin Choong ◽  
Eric Andrew Finkelstein
Keyword(s):  
Decision Making ◽  
Kidney Disease ◽  
Family Caregivers ◽  
Family Dynamics ◽  
Medical Decision Making ◽  
Medical Decision ◽  
End Stage Kidney Disease ◽  
Asian Society ◽  
End Stage

scholarly journals The Need for Accurate Risk Prediction Models for Road Mapping, Shared Decision Making and Care Planning for the Elderly with Advanced Chronic Kidney Disease

PRILOZI ◽  
2016 ◽  
Vol 37 (2-3) ◽  
pp. 33-42 ◽  
Author(s):  
Marijke Stryckers ◽  
Evi V Nagler ◽  
Wim Van Biesen
Keyword(s):  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Shared Decision Making ◽  
Risk Prediction ◽  
Prediction Models ◽  
Shared Decision ◽  
End Stage Kidney Disease ◽  
Risk Prediction Models ◽  
End Stage

AbstractAs people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual’s values and preferences. Accurate estimations of one’s risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective. Formal risk prediction models can help, provided they are externally validated, well-calibrated and discriminative; include unambiguous and measureable variables; and come with readily applicable equations or scores. Reliable, externally validated risk prediction models for progression of chronic kidney disease to end-stage kidney disease or mortality in frail elderly with or without chronic kidney disease are scant. Within this paper, we discuss a number of promising models, highlighting both the strengths and limitations physicians should understand for using them judiciously, and emphasize the need for external validation over new development for further advancing the field.

scholarly journals Considerations of healthcare professionals in medical decision-making about treatment for clinical end-stage cancer patients

2004 ◽  
Vol 28 (4) ◽  
pp. 351-355 ◽  
Author(s):  
Anna F. van Leeuwen ◽  
Elsbeth Voogt ◽  
Adriaan Visser ◽  
Carin C.D. van der Rijt ◽  
Agnes van der Heide
Keyword(s):  
Decision Making ◽  
Cancer Patients ◽  
Medical Decision Making ◽  
Healthcare Professionals ◽  
Medical Decision ◽  
End Stage

scholarly journals Factors promoting shared decision-making in renal replacement therapy for patients with end-stage kidney disease: systematic review and qualitative meta-synthesis

2021 ◽  
Author(s):  
Yu Shi ◽  
Wang Li ◽  
Fangjian Duan ◽  
Shi Pu ◽  
Hongmei Peng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Shared Decision Making ◽  
Shared Decision ◽  
End Stage Kidney Disease ◽  
Related Factors ◽  
End Stage

Abstract Purpose Shared decision-making (SDM) about the type of renal replacement therapy to use is a matter of great importance involving patients, their families, and health treatment teams. This review aims to synthesize the volume of qualitative work explaining the factors influencing SDM regarding renal replacement therapy. Methods A systematic review and qualitative meta-synthesis approach recommended by JBI was used, six databases were searched. Studies were qualitative or mixed research published since 2000, with a primary focus on patient experiences, perceptions and practices regarding which method to choose for renal replacement therapy in End-Stage Kidney Disease (ESKD) patients. All themes were analyzed and compared to the established connectedness. Results A total of 1313 patients were enrolled in 32 studies focusing on factors associated with SDM regarding renal replacement therapy were included. All quality evaluations of the literature were medium to high. Four common themes were identified in our synthesis: (1) patient personal reasons, (2) family-related factors, (3) health care professional-related factors, and (4) social factors influence. Conclusion The model proposes pathways that could be explored further in future qualitative and quantitative studies and suggests that patients’ beliefs, emotions, and awareness should be targeted alongside patients’ decision-making practices to increase the efficacy of interventions. The majority of studies included in this review focus on older patients, and all report patients’ perspectives. Further research is required to understand the family member perspectives on SMD of renal replacement therapy.

Medical decision-making and information needs in end-stage renal disease patients

2003 ◽  
Vol 25 (5) ◽  
pp. 324-331 ◽  
Author(s):  
Angela Orsino ◽  
Jill I Cameron ◽  
Maja Seidl ◽  
David Mendelssohn ◽  
Donna E Stewart
Keyword(s):  
Decision Making ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Information Needs ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Components of quality of life in hemodialysis patients from family caregivers’ perspective: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sima Sadat Hejazi ◽  
Meimanat Hosseini ◽  
Abbas Ebadi ◽  
Hamid Alavi Majd
Keyword(s):  
Quality Of Life ◽  
Content Analysis ◽  
Kidney Disease ◽  
Family Caregivers ◽  
Hemodialysis Patients ◽  
End Stage Kidney Disease ◽  
The Family ◽  
End Stage ◽  
The Impact

Abstract Background Patients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients’ quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients’ disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers’ perspective. Methods In this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas’ method. Results A total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs). Conclusion Family caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients’ quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients’ quality of life and even reduce the caregivers’ burden.

Processes toward the end of life and dialysis withdrawal Physicians’ and nurses’ perspectives

2019 ◽  
Vol 27 (2) ◽  
pp. 419-432
Author(s):  
Lena Axelsson ◽  
Eva Benzein ◽  
Jenny Lindberg ◽  
Carina Persson
Keyword(s):  
Decision Making ◽  
Kidney Disease ◽  
End Of Life ◽  
Healthcare Professionals ◽  
Moral Distress ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Research Approach ◽  
End Stage Kidney Disease ◽  
End Stage

Background: Nurses and physicians in nephrology settings provide care for patients with end-stage kidney disease receiving hemodialysis treatment along a complex illness trajectory. Aim: The aim was to explore physicians’ and nurses’ perspectives on the trajectories toward the end of life involving decisions regarding hemodialysis withdrawal for patients with end-stage kidney disease. Research design and participants: A qualitative research approach was used. Four mixed focus group interviews were conducted with renal physicians (5) and nurses (17) in Sweden. Qualitative content analysis was used to analyse data. Ethical considerations: Ethical approval was obtained (Dnr 2014/304-31). Findings and discussion: Findings illuminated multi-faceted, intertwined processes encompassing healthcare professionals, patients, and family members. The analysis resulted in four themes: Complexities of initiating end-of-life conversations, Genuine attentiveness to the patient’s decision-making process, The challenge awaiting the family members’ processes, and Negotiating different professional responsibilities. Findings showed complexities and challenges when striving to provide good, ethical care which are related to beneficence, nonmaleficence, and self-determination, and which can give rise to moral distress. Conclusion: There are ethical challenges and strains in the dialysis context that healthcare professionals may not always be prepared for. Supporting healthcare professionals in not allowing complexities to hinder the patient’s possibilities for shared decision-making seems important. An open and continual communication, including family meetings, from dialysis initiation could serve to make conversations involving decisions about hemodialysis withdrawal a more natural routine, as well as build up a relationship of trust necessary for the advance care planning about the end of life. Healthcare professionals should also receive support in ethical reasoning to meet these challenges and handle potential moral distress in the dialysis context.

scholarly journals “It's a lot easier to say yes than no” - decision making in end stage kidney disease

2014 ◽  
Vol 4 (Suppl 1) ◽  
pp. A3.1-A3
Author(s):  
Jamilla Hussain ◽  
Kate Flemming ◽  
Miriam Johnson
Keyword(s):  
Decision Making ◽  
Kidney Disease ◽  
End Stage Kidney Disease ◽  
End Stage

Decision Making in Intestinal Transplantation

2005 ◽  
Vol 15 (1) ◽  
pp. 65-68
Author(s):  
Sander Florman ◽  
Stuart S. Kaufman ◽  
Thomas Fishbein
Keyword(s):  
Decision Making ◽  
Gastrointestinal Tract ◽  
Medical Decision Making ◽  
Intestinal Failure ◽  
Intestinal Transplantation ◽  
Venous Drainage ◽  
Medical Decision ◽  
Individualized Approach ◽  
End Stage

Intestinal transplantation is an accepted lifesaving option to treat appropriately selected patients with end-stage failure of the gastrointestinal tract. The evaluation of each candidate involves complex judgments. When to perform an isolated intestinal transplantation versus a combined transplantation with the liver and/or other organs often requires thoughtful considerations and an individualized approach. In addition, performing venous drainage of the isolated graft is potentially complex. We discuss the significant advances in surgical and medical decision making in the evaluation and management of patients with intestinal failure.

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