Nien-Hsin Chen1, Yu-Ping Lin2, Shu-Yuan Liang3, Heng-Hsin Tung3, Shiow-Luan Tsay4, Tsae-Jyy Wang3. 1. Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Shalunhu, Houlong Township, Miaoli County, Taiwan. 2. Department of Nursing, Oriental Institute of Technology, Taipei, Taiwan. 3. School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan. 4. Department of Nursing, Dayeh University, Changhua, Taiwan.
Abstract
AIMS AND OBJECTIVES: To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. BACKGROUND: Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. DESIGN: A predictive correlational cross-sectional study design was used. METHODS: Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. RESULTS: The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. CONCLUSIONS: Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. RELEVANCE TO CLINICAL PRACTICE: When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis predialysis education, increase dialysis knowledge and provide professional support.
AIMS AND OBJECTIVES: To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. BACKGROUND: Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. DESIGN: A predictive correlational cross-sectional study design was used. METHODS: Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. RESULTS: The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. CONCLUSIONS: Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. RELEVANCE TO CLINICAL PRACTICE: When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis predialysis education, increase dialysis knowledge and provide professional support.
Authors: Miriam Vélez-Bermúdez; Jenna L Adamowicz; Natoshia M Askelson; Susan K Lutgendorf; Mony Fraer; Alan J Christensen Journal: BMC Nephrol Date: 2022-08-05 Impact factor: 2.585
Authors: Nicole DePasquale; Jamie A Green; Patti L Ephraim; Sarah Morton; Sarah B Peskoe; Clemontina A Davenport; Dinushika Mohottige; Lisa McElroy; Tara S Strigo; Felicia Hill-Briggs; Teri Browne; Jonathan Wilson; LaPricia Lewis-Boyer; Ashley N Cabacungan; L Ebony Boulware Journal: Kidney Med Date: 2022-08-04