ESRD treatment modality selection: which factors are important in the decision?

The purpose of this study was to determine which factors are most important in choosing between ESRD treatments and to assess if patients, R.N.'s and M.D.'s agree or differ as to the level of importance of different factors.

22 patients, 11 R.N.'s and 10 M.D.'s were interviewed to determine which factors should be considered. Forty-three factors were identified relevant to CAPD and hemodialysis. Then 14 patients, 8 R.N.'s and M.D.'s were asked to rate each of these factors on a scale of 1-10 (10 being most important) and the average score for each was computed. The factors were then ranked in order of importance (1 being most important). The results revealed that peritonitis ranked as overall the most important factor in determining treatment modality choice. In general, life style considerations ranked higher than medical consequences of a specific therapy. There was concordance amongst the three groups in some areas but there were also differences between patients, R.N.'s and M.D.'s. This raises important issues with regards to the adequacy of patient counselling.