ArticleClinical journal of the American Society of Nephrology : CJASN2015
Behavioral stage of change and dialysis decision-making.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient Perspectives to Inform a Health Literacy Educational Program: A Systematic Review and Thematic Synthesis of Qualitative Studies.International journal of environmental research and public health · 2019Pooled it
- Use of a Supportive Kidney Care Video Decision Aid in Older Patients: A Randomized Controlled Trial.American journal of nephrology · 2020Trial
- Article
- Impact of pre-dialysis nephrology care engagement and decision-making on provider and patient action toward permanent vascular access.BMC nephrology · 2021Article
- Barriers to Education and Shared Decision Making in the Chronic Kidney Disease Population: A Narrative Review.Canadian journal of kidney health and disease · 2018Review
- Educational Support Around Dialysis Modality Decision Making in Patients With Chronic Kidney Disease: Qualitative Study.Canadian journal of kidney health and disease · 2018Article
- Educating Prospective Kidney Transplant Recipients and Living Donors about Living Donation: Practical and Theoretical Recommendations for Increasing Living Donation Rates.Current transplantation reports · 2016Article
- Factors Associated with the Choice of Peritoneal Dialysis in Patients with End-Stage Renal Disease.BioMed research international · 2016Article
- Barriers to effective communication between veterans with chronic kidney disease and their healthcare providers.Clinical kidney journal · 2015Article
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Authors and funding
7 authors.
Funding
Abstract
BACKGROUND AND
objectivesBehavioral stage of change (SoC) algorithms classify patients' readiness for medical treatment decision-making. In the precontemplation stage, patients have no intention to take action within 6 months. In the contemplation stage, action is intended within 6 months. In the preparation stage, patients intend to take action within 30 days. In the action stage, the change has been made. This study examines the influence of SoC on dialysis modality decision-making. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: SoC and relevant covariates were measured, and associations with dialysis decision-making were determined. In-depth interviews were conducted with 16 patients on dialysis to elicit experiences. Qualitative interview data informed the survey design. Surveys were administered to adults with CKD (eGFR≤25 ml/min/1.73 m(2)) from August, 2012 to June, 2013. Multivariable logistic regression modeled dialysis decision-making with predictors: SoC, provider connection, and dialysis knowledge score.
resultsFifty-five patients completed the survey (71% women, 39% white, and 59% black), and median annual income was $17,500. In total, 65% of patients were in the precontemplation/contemplation (thinking) and 35% of patients were in the preparation/maintenance (acting) SoC; 62% of patients had made dialysis modality decisions. Doctors explaining modality options, higher dialysis knowledge scores, and fewer lifestyle barriers were associated with acting versus thinking SoC (all P<0.02). Patients making modality decisions had doctors who explained dialysis options (76% versus 43%), were in the acting versus the thinking SoC (50% versus 10%), had higher dialysis knowledge scores (1.4 versus 0.5), and had lower eGFR (13.9 versus 16.8 ml/min/1.73 m(2); all P<0.05). In adjusted analyses, dialysis knowledge was significantly associated with decision-making (odds ratio, 4.2; 95% confidence interval, 1.4 to 12.9; P=0.01), and SoC was of borderline significance (odds ratio, 5.8; 95% confidence interval, 1.0 to 32.6; P=0.05). The model C statistic was 0.87.
conclusionsDialysis decision-making was associated with SoC, dialysis knowledge, and physicians discussing treatment options. Future studies determining ways to assist patients with CKD in making satisfying modality decisions are warranted.
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