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. 2020 Dec;46(4):250-257.
doi: 10.1111/jorc.12327. Epub 2020 Apr 8.

Critical review of leaflets about conservative management used in uk renal services

Anna E Winterbottom  1 , Andrew Mooney  1 , Lynne Russon  2 , Vicki Hipkiss  3 , Richard Williams  1 , Lucy Ziegler  4 , Hilary L Bekker  5
Affiliations
Free article

Critical review of leaflets about conservative management used in uk renal services

Anna E Winterbottom et al. J Ren Care. 2020 Dec.
Free article

Abstract

Background: Written information supplements nurse-led education about treatment options. It is unclear if this information enhances patients' reasoning about conservative management (CM) and renal replacement therapy decisions.

Aim: This study describes a critical review of resources U.K. renal staff use when providing CM options to people with Established Kidney Disease (EKD) during usual pre-dialysis education.

Design: A survey using mixed methods identified and critically analysed leaflets about CM.

Participants & measurements: All 72 renal units in the United Kingdom received an 11-item questionnaire to elicit how CM education is delivered, satisfaction and/or needs with patient resources and staff training. Copies of leaflets were requested. A coding frame was utilised to produce a quality score for each leaflet.

Results: Fifty-four (75%) units participated. Patients discuss CM with a nephrologist (98%) or nurse (100%). Eighteen leaflets were reviewed, mean scores were 8.44 out of 12 (range 5-12, SD = 2.49) for information presentation; 3.50 out of 6 (range 0-6, SD = 1.58) for inclusion of information known to support shared decision-making and 2.28 out of 6 (range 1-4, SD = 0.96) for presenting non-biased information.

Conclusions: Nurses preferred communicating via face-to-face contact with patients and/or families because of the emotional consequences and complexity of planning treatment for the next stage of a person's worsening kidney disease. Conversations were supplemented with written information; 66% of which were produced locally. Staff perceived a need for using leaflets, and spend time and resources developing them to support their services. However, no leaflets included the components needed to help people reason about conservative care and renal replacement therapy options during EKD education consultations.

Keywords: Conservative management; Decision making; Patient leaflets; Pre-dialysis education; Shared decision making.

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References

REFERENCES

    1. Bekker H.L., Thornton J.G. Airey C.M. et al. (1999). Informed decision making: an annotated bibliography and systematic review. Health Technology Assessment, 3(1), 1-156.
    1. Bekker HL, Winterbottom A Gavaruzzi T et al. (2014). The Dialysis Decision Aid Booklet: Making The Right Choices for You. Peterborough, UK: Kidney Research UK. http://www.kidneyresearchuk.org/health-information
    1. Birmele B., Francois M., Pengloan J. et al. (2004). Death after withdrawal from dialysis: the most common cause of death in a French dialysis population. Nephrology, Dialysis, Transplantation, 19, 686-691.
    1. Bristowe K., Horsley H.L., Shepherd K. et al. (2015). Thinking ahead-the need for early advance care planning for people on haemodialysis: a qualitative interview study. Palliative Medicine, 29, 443-450.
    1. Brown E.A., Johansson L., Farrington K. et al. (2010). Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients. Nephrology, Dialysis, Transplantation, 25, 3755-3763.