دورية أكاديمية
أعرض في EDS

Shared decision-making in end-of-life care for end-stage renal disease patients: nephrologists' views and attitudes.

التفاصيل البيبلوغرافية
العنوان: Shared decision-making in end-of-life care for end-stage renal disease patients: nephrologists' views and attitudes.
المؤلفون: Hatoum WBA; Faculty of Social Welfare and Health Sciences, Department of Nursing, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, Israel. wassiem_hatoum@hotmail.com.; Department of Nephrology and hypertension, Haemek Medical Center, Afula, Israel, Yitshak Rabin Boulevard , 1834111. wassiem_hatoum@hotmail.com., Sperling D; Faculty of Social Welfare and Health Sciences, Department of Nursing, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa, Israel.
المصدر: Israel journal of health policy research [Isr J Health Policy Res] 2024 Sep 10; Vol. 13 (1), pp. 45. Date of Electronic Publication: 2024 Sep 10.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101584158 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-4015 (Electronic) Linking ISSN: 20454015 NLM ISO Abbreviation: Isr J Health Policy Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central
مواضيع طبية MeSH: Kidney Failure, Chronic*/therapy , Kidney Failure, Chronic*/psychology , Terminal Care*/methods , Terminal Care*/psychology , Nephrologists*/psychology , Decision Making, Shared*, Humans ; Male ; Female ; Surveys and Questionnaires ; Israel ; Middle Aged ; Adult ; Attitude of Health Personnel ; Decision Making
مستخلص: Background: The term end-stage renal disease (ESRD) refers to the final stage of chronic kidney disease. Not all ESRD patients are suitable for dialysis treatment, which despite its advantages, is not without risks. Shared nephrologist-patient decision-making could be beneficial at this stage, yet little is known about such practices in Israel. This study aimed at examining the practice of shared decision-making (SDM) between nephrologists and ESRD patients in Israel, while exploring related conflicts, ethical dilemmas, and considerations.
Methods: The descriptive-quantitative approach applied in this study included a validated questionnaire for nephrologists, based on Emanual and Emanual (1992). The survey, which was distributed via social-media platforms and snowball sampling, was completed by 169 nephrologists. Data analysis included t-tests for independent samples, f-tests for analysis of variance, and t-tests and f-tests for independence. Descriptive analysis examined attitudes towards SDM in end-of-life care for ESRD patients.
Results: The findings show that the research sample did not include nephrologists who typically act according to the paternalistic decision-making style. Rather, 53% of the respondents were found to act in line with the informative decision-making style, while 47% act according to the interpretive decision-making style. Almost 70% of all respondents reported their discussing quality-of-life with patients; 63.4% provide prognostic assessments; 61.5% inquire about the patient's desired place of death; 58.6% ask about advance directives or power-of-attorney; and 57.4% inquire about cultural and religious beliefs in end-of-life treatment. Additionally, informative nephrologists tend to promote the patients' autonomy over their health (P < 0.001); they are also in favor of conservative treatment, compared to paternalistic and interpretive nephrologists, and use less invasive methods than other nephrologists (P = 0.02).
Conclusions: Nephrologists in Israel only partially pursue an SDM model, which has the potential to improve quality-of-care for ESRD patients and their families. SDM programs should be developed and implemented for increasing such practices among nephrologists, thereby expanding the possibilities for providing conservative care at end-of-life.
(© 2024. The Author(s).)
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معلومات مُعتمدة: Minerva Foundation Minerva Foundation
فهرسة مساهمة: Keywords: End-of-life; End-stage renal disease; Ethics; Nephrologists; Shared decision-making
تواريخ الأحداث: Date Created: 20240910 Date Completed: 20240911 Latest Revision: 20240914
رمز التحديث: 20240914
مُعرف محوري في PubMed: PMC11385125
DOI: 10.1186/s13584-024-00632-w
PMID: 39256820
قاعدة البيانات: MEDLINE
الوصف
تدمد:2045-4015
DOI:10.1186/s13584-024-00632-w