日本患者在脏替代疗法中对共享决策的看法
Yugo Shibagaki1, Tadashi Sofue2, Hiroo Kawarazaki3
1Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-city, Kanagawa, Japan.
Kidney international reports
|August 15, 2025
概括
日本慢性病患者在替代疗法 (RRT) 选择时认可共享决策 (SDM). 改善的系统对于及时,重复的SDM讨论,涉及多学科团队至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
背景情况:
- 共享决策 (SDM) 是选择置换疗法 (RRT) 的组成部分.
- 了解患者的感知和影响RRT选择的因素对于有效的SDM至关重要.
研究的目的:
- 分析在接受RRT选择的日本慢性病 (CKD) 患者中SDM的看法和偏好.
- 确定与SDM认知相关的患者和设施级因素.
主要方法:
- 在49个医疗机构对475名成年CKD患者进行了横截面调查.
- 评估SDM意识,认可,时间,频率,内容和专业参与.
- 多变量分析用于评估与SDM感知相关的因素.
主要成果:
- 81.2%的人在选择RRT时回忆起SDM,但只有4.7%的人事先知道SDM.
- 患者优先讨论日常生活的影响,财务状况和家庭问题.
- 多次门诊访问,护士参与和延长的咨询与更好的SDM感知有关.
结论:
- 日本的CKD患者往往会回顾RRT选择视为SDM,尽管之前的认识有限.
- 建立反复,及时进行SDM讨论的系统是必不可少的.
- 讨论应该集中在生活影响上,并涉及一个多学科的团队.
相关概念视频
Chronic Kidney Disease III: Interprofessional Care
80
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...
80
Kidney Transplant III: Nursing Management
81
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
81
Continuous Renal Replacement Therapy
143
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
143
Kidney Transplant II: Surgical Procedure
75
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
75
Dialysis
478
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...
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...
478
Hemodialysis III: Nursing Management
187
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...
187


