title: The Communication and Bioethical Training (CoBiT) Program for assisting dialysis decision-making in Spanish ACKD units.
abstract: Healthcare professionals currently working in Advanced Chronic Kidney Disease (ACKD) units must cope with difficult situations regarding assisting patients with the dialysis decision-making process, and they are often untrained for these conversations. Although we have evidence from the literature that these skills can be learned, few professionals feel confident in this area. A Communication and Bioethical Training (CoBiT) Program for ACKD staff (physicians, nurses and allied health professionals) was developed to improve their ability and self-confidence in conducting these conversations. A four-stage study was conducted: (1) development of the CoBiT program, beginning with the creation of an interdisciplinary focus group (N = 10); (2) design of a questionnaire to assess self-confidence based on the areas identified by the focus group. The face validity of the instrument was tested using an inter-judge methodology (N = 6); (3) design of the format and contents of the program; (4) piloting the program. Thirty-six health professionals took an 8-h workshop based on role-playing methodology. Participants assessed their self-confidence in their communication skills before and after the program using self-report measures. The results show that after the program, participants reported significantly higher levels of self-confidence measured with a five-point Likert scale (p < 0.001). Participants felt that communication with colleagues of other professions significantly increased after the workshop (p = 0.004). The CoBiT program improves ACKD Unit healthcare professionals' self-confidence in their ability to perform a specific communication task.
authors.affiliation: a Nephrology Department , University Hospital La Paz, IdiPAZ , Madrid , Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: García-Llana
authors.affiliation: b Nephrology Department , University Hospital La Paz, Autonomous University of Madrid, IdiPAZ, FRIAT-IRSIN, REDinREN , Madrid , Spain.
authors.forename: Maria-Auxiliadora
authors.initials: MA
authors.lastname: Bajo
authors.affiliation: c Hematology Department , University Hospital La Paz Madrid , Madrid , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Barbero
authors.affiliation: b Nephrology Department , University Hospital La Paz, Autonomous University of Madrid, IdiPAZ, FRIAT-IRSIN, REDinREN , Madrid , Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Selgas
authors.affiliation: d Nephrology Department , University Hospital La Paz, IdiPAZ, FRIAT-IRSIN, REDinREN , Madrid , Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Del Peso
mesh_terms: D000328:Adult; D001675:Bioethics / Q000193:education*; D003657:Decision Making / Q000941:ethics; D005260:Female; D006282:Health Personnel / Q000193:education* / Q000941:ethics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations / Q000941:ethics; D016730:Program Development; D015397:Program Evaluation; D006435:Renal Dialysis / Q000592:standards*; D013030:Spain
keywords: ACKD units; Communication; bioethics; training program