TY - JOUR
T1 - Evaluation of a shared decision-making intervention for dialysis choice at four Danish hospitals
T2 - a qualitative study of patient perspective
AU - Finderup, Jeanette
AU - Dam Jensen, Jens
AU - Lomborg, Kirsten
N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/10/18
Y1 - 2019/10/18
N2 - Objective To evaluate the â € Shared Decision-making and Dialysis Choice' (SDM-DC) intervention with regard to patients' experience and involvement. Design Semistructured individual interviews and systematic text condensation for data analysis. Setting The SDM-DC intervention was implemented and evaluated at four different hospitals in Denmark. Participants A total of 348 patients had received the SDM-DC intervention, and of these 29 patients were interviewed. Interventions SDM-DC was designed for patients facing a choice of dialysis modality. The available modalities were haemodialysis and peritoneal dialysis, either performed by patients on their own or with help from a healthcare professional. The intervention was tailored to individual patients and consisted of three meetings with a dialysis coordinator who introduced a patient decision aid named â € Dialysis Choice' to the patient. Findings The following were the four main findings: the decision was experienced as being the patient's own; the meetings contributed to the decision process; â € Dialysis Choice' contributed to the decision process; and the decision process was experienced as being iterative. Conclusions The patients experienced SDM-DC as involving them in their choice of dialysis modality. Due to the iterative properties of the decision-making process, a shared decision-making intervention for dialysis choice has to be adapted to the needs of individual patients. The active mechanisms of the meetings with the dialysis coordinator were (1) questions to and from the patient, and (2) the dialysis coordinator providing accurate information about the options. The overview of options and the value clarification tool in the decision aid were particularly helpful in establishing a decision-making process based on informed preferences.
AB - Objective To evaluate the â € Shared Decision-making and Dialysis Choice' (SDM-DC) intervention with regard to patients' experience and involvement. Design Semistructured individual interviews and systematic text condensation for data analysis. Setting The SDM-DC intervention was implemented and evaluated at four different hospitals in Denmark. Participants A total of 348 patients had received the SDM-DC intervention, and of these 29 patients were interviewed. Interventions SDM-DC was designed for patients facing a choice of dialysis modality. The available modalities were haemodialysis and peritoneal dialysis, either performed by patients on their own or with help from a healthcare professional. The intervention was tailored to individual patients and consisted of three meetings with a dialysis coordinator who introduced a patient decision aid named â € Dialysis Choice' to the patient. Findings The following were the four main findings: the decision was experienced as being the patient's own; the meetings contributed to the decision process; â € Dialysis Choice' contributed to the decision process; and the decision process was experienced as being iterative. Conclusions The patients experienced SDM-DC as involving them in their choice of dialysis modality. Due to the iterative properties of the decision-making process, a shared decision-making intervention for dialysis choice has to be adapted to the needs of individual patients. The active mechanisms of the meetings with the dialysis coordinator were (1) questions to and from the patient, and (2) the dialysis coordinator providing accurate information about the options. The overview of options and the value clarification tool in the decision aid were particularly helpful in establishing a decision-making process based on informed preferences.
KW - complex intervention
KW - patient decision aid
KW - qualitative evaluation
KW - shared decision-making
UR - http://www.scopus.com/inward/record.url?scp=85073625805&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2019-029090
DO - 10.1136/bmjopen-2019-029090
M3 - Review
C2 - 31630101
AN - SCOPUS:85073625805
SN - 2399-9772
VL - 9
SP - e029090
JO - BMJ Paediatrics Open
JF - BMJ Paediatrics Open
IS - 10
M1 - e029090
ER -