Decisions regarding dialysis treatment modality: a holistic perspective

Area of Science:

• Neuman Systems Model
• Renal Disease Management
• Qualitative Research

Background:

• End-stage renal disease (ESRD) necessitates treatment modality decisions, primarily hemodialysis (HD) or peritoneal dialysis (PD).
• Understanding client perspectives is crucial for informed decision-making in dialysis selection.
• Previous research highlighted the complexity of choosing between HD and PD.

Purpose of the Study:

• To identify factors influencing clients' choices between hemodialysis and continuous ambulatory peritoneal dialysis.
• To explore the 'why,' 'how,' and 'by whom' of dialysis treatment modality decisions from the client's perspective.
• To analyze these factors through the lens of the Neuman Systems Model.

Main Methods:

• Secondary analysis of an existing qualitative study.
• In-depth interviews with clients undergoing end-stage renal disease treatment.
• Thematic analysis of qualitative data to identify decision-making factors.

Main Results:

• Client decisions regarding dialysis modality were influenced by five key areas: physiologic, psychologic, sociocultural, developmental, and spiritual.
• These factors align with the Neuman Systems Model's framework.
• The interplay of these variables provides a comprehensive understanding of patient choices.

Conclusions:

• The Neuman Systems Model offers a valuable framework for understanding the multifaceted factors influencing dialysis modality selection in ESRD patients.
• Recognizing these diverse influences can aid healthcare providers in supporting clients through the decision-making process.
• Further research can explore interventions based on these identified factors to improve patient outcomes and satisfaction with dialysis treatment.