title: End-stage kidney disease patient evaluation of the Australian 'My Kidneys, My Choice' decision aid.
abstract: BACKGROUND
  A multidisciplinary team in Australia and New Zealand utilized a current decision-making theory to develop the 'My Kidneys, My Choice' decision aid (MKDA) to support end-stage kidney disease (ESKD) treatment options in decision-making. Assessment of the MKDA was deemed critical to practice integration.
  
  
  METHODS
  A multisite pre-test, post-test study design was used. Routine ESKD education was supported by the MKDA. Knowledge levels, worries and priorities were assessed pre- and post-education with Likert-scale questions. MKDA usability and treatment option preferences were surveyed post-test. Data were analysed in SPSS.
  
  
  RESULTS
  Ninety-seven participants completed the pre-survey and 72 (70%) the post-survey. Mean pre-test knowledge scores ranged from: 0.88 (SD 1.5) for conservative care to 1.32 (SD 1.3) for centre-based dialysis. Post-decision-making knowledge levels increased significantly (P < 0.001). Worry and flexibility scores all increased significantly (P < 0.05) from pre- to post-test; about future pre- 4.15 (SD 1.3), post- 4.61 (SD 0.76); change to lifestyle 4.23 (SD 1.05), 4.59 (SD 0.8); ability to work/do leisure activities 3.67 (SD 1.56) 4.27 (SD 1.17) and desire for flexibility 4.51 (SD 0.86), 4.76 (SD 0.66). MKDA usability scores were high: easy to understand 4.64, (SD 0.77), easy to follow 4.65, (SD 0.66) and supporting decision-making 4.76 (SD 0.61). MKDA section scores ranged from 4.21 (SD 0.75) for writing treatment choices to 4.90 (SD 0.41) for the use of the treatment option comparison grid.
  
  
  CONCLUSIONS
  Preliminary MKDA assessment revealed high patient acceptance and usability. Patients had equitable knowledge of all treatment options but experienced higher post-worries levels than anticipated.
authors.affiliation: Kidney Health Australia , Perth , Australia.
authors.forename: Debbie
authors.initials: D
authors.lastname: Fortnum
authors.affiliation: Kidney Health Australia , Sydney , Australia.
authors.forename: Kirren
authors.initials: K
authors.lastname: Grennan
authors.affiliation: Westmead Hospital , Sydney , Australia.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Smolonogov
keywords: ESRD; decision aid; dialysis; education; shared decision-making