title: The Experience of Older People in the Shared Decision-Making Process in Advanced Kidney Care.
abstract: Introduction. This qualitative descriptive study was designed to understand the experiences of older people (>70 years) when making a decision about renal replacement therapy. This was a coproduced study, whereby patients and carers were involved in all aspects of the research process.Methods. A Patient and Carer Group undertook volunteer and research training. The group developed the interview questions and interviewed 29 people who had commenced dialysis or made a decision not to have dialysis. Interview data were transcribed and analysed, and common themes were identified.Results. 22 men and 7 women (mean age 77.4 yrs) from two hospitals were interviewed. 18 had chosen haemodialysis, 6 peritoneal dialysis, and 5 supportive care. The majority of patients were involved in the dialysis decision. Most were satisfied with the amount of information that they received, although some identified that the quality of the information could be improved, especially how daily living can be affected by dialysis.Conclusion. Our findings show that overall older patients were involved in the dialysis decision along with their families. Our approach is innovative because it is the first time that patients and carers have been involved in a coproduced study about shared decision-making.
authors.affiliation: London South Bank University, 103 Borough Road, London SE1 0AA, UK.
authors.forename: Nicola
authors.identifier: 0000-0002-8311-7356
authors.initials: N
authors.lastname: Thomas
authors.affiliation: Kent Kidney Care Centre, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Jenkins
authors.affiliation: Barts Health NHS Trust, London, UK.
authors.forename: Breeda
authors.initials: B
authors.lastname: McManus
authors.affiliation: Patient and Carer Group, Barts Health NHS Trust, London, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Gracey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000523:psychology* / Q000628:therapy*; D008297:Male; D017060:Patient Satisfaction; D017582:Renal Replacement Therapy / Q000523:psychology*