Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology
Abstract Background Given the complexity and variety in treatment options for advanced chronic kidney disease (CKD), shared decision-making (SDM) can be a challenge. SDM is needed for making decisions that best suit patients’ needs and their medical and living situations. SDM might be experienced di...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12882-022-02887-4 |
| _version_ | 1829101903914467328 |
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| author | Sandra van Dulmen Ruud Roodbeen Lotte Schulze Karen Prantl Maarten Rookmaaker Brigit van Jaarsveld Janneke Noordman Alferso Abrahams |
| author_facet | Sandra van Dulmen Ruud Roodbeen Lotte Schulze Karen Prantl Maarten Rookmaaker Brigit van Jaarsveld Janneke Noordman Alferso Abrahams |
| author_sort | Sandra van Dulmen |
| collection | DOAJ |
| description | Abstract Background Given the complexity and variety in treatment options for advanced chronic kidney disease (CKD), shared decision-making (SDM) can be a challenge. SDM is needed for making decisions that best suit patients’ needs and their medical and living situations. SDM might be experienced differently by different stakeholders. This study aimed to explore clinical practice and perspectives on SDM in nephrology from three angles: observers, patients and healthcare professionals (HCPs). Methods An explanatory sequential mixed methods design was used. First, in the quantitative part of the study, outpatient consultations with patients with advanced chronic kidney disease (eGFR < 20 ml/min) were video recorded and SDM was assessed using the OPTION5 instrument. Subsequently, in the qualitative part, patients and HCPs reflected on their own SDM behaviour during individual stimulated recall interviews which were analysed using deductive thematic content analysis. Results Twenty nine consultations were recorded and observed in seven hospitals. The mean SDM score was 51 (range 25–80), indicating that SDM was applied to a moderate extent. The stimulated recall interviews with patients showed that they rely on the information provision and opinion of HCPs, expect consistency and support, and desire a proactive role. They also expect to be questioned by the HCP about their SDM preferences. HCPs said they were willing to incorporate patients’ preferences in SDM, as long as there are no medical contraindications. They also prefer patients to take a prominent role in SDM. HCPs ascribe various roles to themselves in supporting patients’ decision-making. Conclusions Although SDM was applied by HCPs to a moderate extent, improvement is needed, especially in helping patients get the information they need and in making sure that every patient is involved in SDM. This is even more important given the complex nature of the disease and the relatively high prevalence of limited health literacy among patients with chronic kidney disease. |
| first_indexed | 2024-12-10T22:52:31Z |
| format | Article |
| id | doaj.art-5b7124fb55114fd6947c2e738671f9ec |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-10T22:52:31Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-5b7124fb55114fd6947c2e738671f9ec2022-12-22T01:30:22ZengBMCBMC Nephrology1471-23692022-07-0123111310.1186/s12882-022-02887-4Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrologySandra van Dulmen0Ruud Roodbeen1Lotte Schulze2Karen Prantl3Maarten Rookmaaker4Brigit van Jaarsveld5Janneke Noordman6Alferso Abrahams7Nivel (Netherlands institute for health services research)Breuer&Intraval, Research and ConsultancyNivel (Netherlands institute for health services research)Dutch Kidney Patients AssociationDepartment of Nephrology and Hypertension, University Medical Center UtrechtDepartment of NephrologyAmsterdam UMC, Vrije Universiteit Amsterdam locationNivel (Netherlands institute for health services research)Department of Nephrology and Hypertension, University Medical Center UtrechtAbstract Background Given the complexity and variety in treatment options for advanced chronic kidney disease (CKD), shared decision-making (SDM) can be a challenge. SDM is needed for making decisions that best suit patients’ needs and their medical and living situations. SDM might be experienced differently by different stakeholders. This study aimed to explore clinical practice and perspectives on SDM in nephrology from three angles: observers, patients and healthcare professionals (HCPs). Methods An explanatory sequential mixed methods design was used. First, in the quantitative part of the study, outpatient consultations with patients with advanced chronic kidney disease (eGFR < 20 ml/min) were video recorded and SDM was assessed using the OPTION5 instrument. Subsequently, in the qualitative part, patients and HCPs reflected on their own SDM behaviour during individual stimulated recall interviews which were analysed using deductive thematic content analysis. Results Twenty nine consultations were recorded and observed in seven hospitals. The mean SDM score was 51 (range 25–80), indicating that SDM was applied to a moderate extent. The stimulated recall interviews with patients showed that they rely on the information provision and opinion of HCPs, expect consistency and support, and desire a proactive role. They also expect to be questioned by the HCP about their SDM preferences. HCPs said they were willing to incorporate patients’ preferences in SDM, as long as there are no medical contraindications. They also prefer patients to take a prominent role in SDM. HCPs ascribe various roles to themselves in supporting patients’ decision-making. Conclusions Although SDM was applied by HCPs to a moderate extent, improvement is needed, especially in helping patients get the information they need and in making sure that every patient is involved in SDM. This is even more important given the complex nature of the disease and the relatively high prevalence of limited health literacy among patients with chronic kidney disease.https://doi.org/10.1186/s12882-022-02887-4CommunicationShared decision-makingNephrologyObservational studyVideo-recordingStimulated recall interviews |
| spellingShingle | Sandra van Dulmen Ruud Roodbeen Lotte Schulze Karen Prantl Maarten Rookmaaker Brigit van Jaarsveld Janneke Noordman Alferso Abrahams Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology BMC Nephrology Communication Shared decision-making Nephrology Observational study Video-recording Stimulated recall interviews |
| title | Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology |
| title_full | Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology |
| title_fullStr | Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology |
| title_full_unstemmed | Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology |
| title_short | Practices and perspectives of patients and healthcare professionals on shared decision-making in nephrology |
| title_sort | practices and perspectives of patients and healthcare professionals on shared decision making in nephrology |
| topic | Communication Shared decision-making Nephrology Observational study Video-recording Stimulated recall interviews |
| url | https://doi.org/10.1186/s12882-022-02887-4 |
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