A qualitative study on shared decision-making of patients with chronic kidney disease.
Ya-Fang Ho, Yu-Chi Chen, I-Chuan Li
PMID 33942567WHAT IT FOUND
Patients with kidney disease often first refused dialysis, then accepted it only when symptoms or kidney function decline made it unavoidable.
Nurse listening, clear information, and family discussion were described as helping them move from fear to choosing treatment.
Key findings
01Participants usually avoided or refused dialysis at first and accepted it only when worsening symptoms or declining kidney function made it unavoidable.
02Participants often formed ideas about dialysis from media, books, friends, or others' experiences, and repeated discussions helped clarify misunderstandings.
03Family discussion was central to decisions, with participants weighing work, freedom, family burden, and personal values, and many said they would not decide alone.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All participants were from one hospital, and the study says there was minimal diversity in the areas participants came from, so the themes may not transfer to other CKD groups. Some patients refused interviews because they did not want to talk about dialysis, so the findings may represent patients who were more open to discussing decision-making. The nurse who interviewed participants also had regular care responsibilities for them and had established trust relationships, which may shape what participants said. This is a qualitative study of experiences, so it cannot show that nurse support, family discussion, or the interview process improved decisions or outcomes.
Declared interests
The authors declared no conflict of interest. The supplied publication types include non-U.S. government research support, but the article text does not name a funder.
The easy way to misread this
Do not read this as evidence that nurse listening or family discussion improves dialysis decisions. It reports patients' experiences in one hospital, and no intervention was tested against a comparison group.