African American and non-African American patients' and families' decision making about renal replacement therapies.
We conducted focus group meetings of African American and non-African American patients with end-stage renal disease (six groups) and their family members (six groups), stratified by race/ethnicity and treatment. We elicited differences in participants' experiences with shared decision making about initiating renal replacement therapy (RRT; that is, hemodialysis, peritoneal dialysis, or a kidney transplant). Patients were often very sick when initiating RRT, and had little, if any, time to make a decision about what type of RRT to initiate. They also lacked sufficient information about alternative treatment options prior to initiation. Family members played supportive roles and shared in decision making when possible. Reports were similar for African American and non-African American participants. Our findings suggest that a greater emphasis on the improved engagement of patients and their families in shared decision making about RRT initiation is needed for both ethnic/racial minorities and nonminorities.
Johns Hopkins University, Baltimore, Maryland, USA.
Johanna
J
Sheu
Patti L
PL
Ephraim
Neil R
NR
Powe
Hamid
H
Rabb
Mikiko
M
Senga
Kira E
KE
Evans
Bernard G
BG
Jaar
Deidra C
DC
Crews
Raquel C
RC
Greer
L Ebony
LE
Boulware
D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D003142:Communication; D054521:Cultural Competency; D003657:Decision Making; D005195:Family Relations; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D036301:Qualitative Research; D017582:Renal Replacement Therapy / Q000379:methods / Q000523:psychology*; D014481:United States