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Related Concept Videos

Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Dialysis01:15

Dialysis

Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Peritoneal Dialysis III: Nursing Management01:25

Peritoneal Dialysis III: Nursing Management

Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...

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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
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Patient perspectives on informed decision-making surrounding dialysis initiation.

Mi-Kyung Song1, Feng-Chang Lin, Constance A Gilet

  • 1University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 1, 2013
PubMed
Summary

Most dialysis patients feel unprepared and ill-informed about starting treatment. Improving shared decision-making for dialysis initiation is crucial for better patient preparation and perceptions.

Keywords:
chronic kidney diseasedecision-makingdialysis

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Area of Science:

  • Nephrology
  • Medical Ethics
  • Patient-Centered Care

Background:

  • Shared decision-making (SDM) in dialysis initiation is encouraged, but patient experiences regarding information provision and decision processes are understudied.
  • Limited research exists on how patients perceive the information they receive before starting dialysis and the dynamics of the decision-making process.

Purpose of the Study:

  • To explore patient perspectives on information provision and communication during the decision-making process for initiating maintenance dialysis.
  • To assess the extent of informed decision-making (IDM) among patients starting dialysis and identify factors associated with IDM scores.

Main Methods:

  • Ninety-nine maintenance dialysis patients from 15 centers in North Carolina participated in semistructured interviews.
  • Content analysis was used to examine interview data on information and communication about dialysis initiation.
  • Informed decision-making (IDM) scores were calculated based on patient responses to 10 questions regarding the decision process.

Main Results:

  • The average IDM score was 4.4 out of 10, with 67% of patients scoring 5 or below.
  • Factors significantly associated with IDM scores included age at decision-making, years of education, and prior warning about end-stage kidney disease progression.
  • Nearly 70% of patients reported that dialysis risks and burdens were not discussed, and most felt they had no choice in starting dialysis or choosing a modality.

Conclusions:

  • A significant majority of patients initiating dialysis feel unprepared and lack adequate information.
  • Enhancing the scope of informed decision-making in dialysis initiation can improve patient preparedness and their overall perception of the decision-making journey.