Comparing Nephrologists' Self-Reported Decision-Making Skills and Treatment Attitudes With Their Patients' Experiences of Making Kidney Therapy Decisions and Receiving Nephrology Care.
Areeba Jawed, Brook Batch, Rebecca Allen and 4 others
PMID 39207953WHAT IT FOUND
Nephrologists reported high comfort with shared decision-making and prioritizing quality of life, but older patients rarely recalled discussions about prognosis, conservative management, or emotional well-being.
There is a significant gap between clinicians' self-assessed skills and patients' actual experiences.
Key findings
01Nephrologists reported high comfort with shared decision-making (92.8%) and prioritizing quality of life over longevity (78.6%).
02Patients rarely recalled discussions on key informed decision-making topics: life expectancy (26.1%), conservative kidney management (38.3%), and quality of life (39.1%).
03There is a disparity between nephrologists' stated values and patients' reported experiences, with patients noting less emphasis on pain, emotions, and quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is a small, single-center pilot analysis with only 58 patients and 28 nephrologists. It was not powered for inferential statistical analysis. Data relies on self-report from nephrologists and recall from patients, which introduces social desirability and recall bias. Researchers did not directly observe clinical encounters, so they could not verify if discussions occurred but were forgotten, or if they never happened.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not interpret the high self-reported comfort of nephrologists as evidence that patients are receiving adequate information. The study shows a clear disconnect where clinicians feel they are communicating well, but patients rarely recall essential discussions about prognosis and treatment options.