Show simple item record

dc.contributor.authorTonkin-Crine, Sarah
dc.contributor.authorOkamoto, Ikumi
dc.contributor.authorLeydon, Geraldine M
dc.contributor.authorMurtagh, Fliss E M
dc.contributor.authorFarrington, Ken
dc.contributor.authorCaskey, Fergus
dc.contributor.authorRayner, Hugh
dc.contributor.authorRoderick, Paul
dc.date.accessioned2018-02-13T17:15:31Z
dc.date.available2018-02-13T17:15:31Z
dc.date.issued2015-03-01
dc.identifier.citationTonkin-Crine , S , Okamoto , I , Leydon , G M , Murtagh , F E M , Farrington , K , Caskey , F , Rayner , H & Roderick , P 2015 , ' Understanding by older patients of dialysis and conservative management for chronic kidney failure ' , American Journal of Kidney Diseases , vol. 65 , no. 3 , pp. 443-50 . https://doi.org/10.1053/j.ajkd.2014.08.011
dc.identifier.issn0272-6386
dc.identifier.otherPURE: 13323473
dc.identifier.otherPURE UUID: 47010f8a-8bdb-4828-9d20-dfb4e492d5fa
dc.identifier.otherPubMed: 25304984
dc.identifier.otherPubMedCentral: PMC4339698
dc.identifier.otherScopus: 84924051111
dc.identifier.urihttp://hdl.handle.net/2299/19778
dc.descriptionThis is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License CC BY NC-ND 4.0 ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
dc.description.abstractBACKGROUND: Older adults with chronic kidney disease stage 5 may be offered a choice between dialysis and conservative management. Few studies have explored patients' reasons for choosing conservative management and none have compared the views of those who have chosen different treatments across renal units. STUDY DESIGN: Qualitative study with semistructured interviews. SETTINGS & PARTICIPANTS: Patients 75 years or older recruited from 9 renal units. Units were chosen to reflect variation in the scale of delivery of conservative management. METHODOLOGY: Semistructured interviews audiorecorded and transcribed verbatim. ANALYTICAL APPROACH: Data were analyzed using thematic analysis. RESULTS: 42 interviews were completed, 4 to 6 per renal unit. Patients were sampled from those receiving dialysis, those preparing for dialysis, and those choosing conservative management. 14 patients in each group were interviewed. Patients who had chosen different treatments held varying beliefs about what dialysis could offer. The information that patients reported receiving from clinical staff differed between units. Patients from units with a more established conservative management pathway were more aware of conservative management, less often believed that dialysis would guarantee longevity, and more often had discussed the future with staff. Some patients receiving conservative management reported that they would have dialysis if they became unwell in the future, indicating the conditional nature of their decision. LIMITATIONS: Recruitment of older adults with frailty and comorbid conditions was difficult and therefore transferability of findings to this population is limited. CONCLUSIONS: Older adults with chronic kidney disease stage 5 who have chosen different treatment options have contrasting beliefs about the likely outcomes of dialysis for those who are influenced by information provided by renal units. Supporting renal staff in discussing conservative management as a valid alternative to dialysis for a subset of patients will aid informed decision making. There is a need for better evidence about conservative management to support shared decision making for older people with chronic kidney failure.en
dc.format.extent8
dc.language.isoeng
dc.relation.ispartofAmerican Journal of Kidney Diseases
dc.rightsOpen
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectChoice Behavior
dc.subjectComprehension
dc.subjectDisease Management
dc.subjectFemale
dc.subjectHumans
dc.subjectKidney Failure, Chronic
dc.subjectMale
dc.subjectPatient Education as Topic
dc.subjectRenal Dialysis
dc.subjectSurveys and Questionnaires
dc.subjectJournal Article
dc.subjectMulticenter Study
dc.subjectResearch Support, Non-U.S. Gov't
dc.titleUnderstanding by older patients of dialysis and conservative management for chronic kidney failureen
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Pharmacy, Pharmacology and Postgraduate Medicine
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2015-03-01
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1053/j.ajkd.2014.08.011
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record