Shared Decision-Making in Choosing Dialysis Modalities for Patients With Chronic Kidney Disease: An Evolutionary Concept Analysis.
Youn-Jung Son, Jeehee Han, Eun Young Kim
PMID 40228796WHAT IT FOUND
When patients choose hemodialysis or peritoneal dialysis, readiness, clear information, trust, family partnership, and time were identified as key elements.
The analysis did not test whether using them improves outcomes.
Key findings
01The analysis identified conditions that should come before shared decision-making: readiness, awareness of chronic kidney disease, understanding of dialysis advantages and disadvantages, and enough time and resources.
02The core elements of shared decision-making were goal setting, trust, collaborative partnership, effective communication, choosing the right dialysis option, informed decision-making, and voluntary participation.
03The analysis listed potential consequences: patient-family centered care, quality of life, reduced decisional conflict, safety in dialysis, and family harmony.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No patients, families, or clinicians were studied; the paper analyzed published literature and concepts. It did not test whether using the proposed shared decision-making elements changes dialysis choice, quality of life, safety, or other outcomes. The search included only English articles, so views from other languages and cultures may be missing. The review focused on recent literature, so older definitions of shared decision-making were not included. Most included studies reflected healthcare professional perspectives rather than patients and family caregivers. Dialysis modality choices differ by country, culture, and healthcare system, so the framework may not fit every setting.
Declared interests
The authors declared no conflicts of interest. The work was funded by Soonchunhyang University.
The easy way to misread this
Do not read this as evidence that shared decision-making improves dialysis outcomes. The paper analyzed concepts from published literature and did not test an intervention or measure patient outcomes.