Decisional Needs Assessment to Help Patients with Advanced Chronic Kidney Disease Make Better Dialysis Choices

Patients with advanced chronic kidney disease (CKD) face many choices regarding future dialysis modalities. Decision-making is difficult for patients. The objective of this study was to describe the decision-making needs from the perspectives of patients with advanced CKD, professionals, and others involved in the decision. Guided by a shared decision-making model, this qualitative study was conducted using interviews with key informants (17 patients, two peer helpers, and eight health professionals) and a focus group (five nurses). The results revealed evolving decisional needs in five-stage through the decision making journey: 1) Progress toward acceptance of dialysis, 2) Receive information, 3) Take some time for personal reflection, 4) Seek opinion and support of other, and 5) Re-evaluate one's choice. As we anticipate decisional needs, we will be able to develop decision support interventions that are stage-matched.