title: The Choice of Renal Replacement Therapy (CORETH) project: dialysis patients' psychosocial characteristics and treatment satisfaction.
abstract: Until today, research has underestimated the role of psychosocial conditions as contributing factors to dialysis modality choice. The novelty within the Choice of Renal Replacement Therapy (CORETH) project (German Clinical Trials Register #DRKS00006350) is its focus on the multivariate associations between these aspects and their consecutive significance regarding treatment satisfaction (TS) in peritoneal dialysis (PD) versus haemodialysis (HD) patients. In this article, we present the baseline results of a multicentre study, which is supported by a grant from the German Ministry for Education and Research.
  
  
  
  Six to 24 months after initiation of dialysis, 780 patients from 55 dialysis centres all over Germany were surveyed. The questionnaire addressed psychosocial, physical, socio-demographic and shared decision-making (SDM) aspects. Furthermore, cognitive functioning was tested. After indexing the measures, two propensity score-matched groups (n = 482) were compared in a first step, after having chosen PD or HD. In a second step, a moderated multiple regression (n = 445) was conducted to initially investigate the multivariate impact of patient characteristics on TS.
  
  
  
  In comparison with HD patients, PD patients were more satisfied with their treatment (P < 0.001), had a more autonomy-seeking personality (P = 0.04), had better cognitive functioning (P = 0.001), indicated more satisfying SDM (P < 0.001) and had a larger living space (P < 0.001). All patients were more satisfied when they had a good psychological state and received SDM. Especially in HD patients, TS was higher when the patient had a less autonomous personality, lower cognitive functioning, more social support, a poorer physical state and poorer socio-demographic conditions (R2 = 0.26).
  
  
  
  Psychosocial characteristics play a major role in TS in dialysis patients. Within a multivariate approach, these factors are even more important than physical or environment-related factors. In practice, focusing on SDM and screening patient characteristics at an early stage can foster patients’ TS. Changes will be examined in a 1-year follow-up.
authors.affiliation: Institute for Rehabilitation Medicine, Medical Faculty of the Martin Luther University Halle-Wittenberg, C/o Institute of Rehabilitation Medicine, Halle (Saale), Germany.|Centre for Health Sciences of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Maxi
authors.initials: M
authors.lastname: Robinski
authors.affiliation: Institute for Rehabilitation Medicine, Medical Faculty of the Martin Luther University Halle-Wittenberg, C/o Institute of Rehabilitation Medicine, Halle (Saale), Germany.|Centre for Health Sciences of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Mau
authors.affiliation: Centre for Health Sciences of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.|Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wienke
authors.affiliation: Centre for Health Sciences of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.|Department of Internal Medicine II, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Girndt
mesh_terms: D000368:Aged; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D005858:Germany; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D006435:Renal Dialysis; D017582:Renal Replacement Therapy / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: haemodialysis; kidney failure chronic; peritoneal dialysis; psychosocial factors; shared decision-making