Nursing support in the decision-making process regarding the choice of renal replacement therapy: A scoping review

Abstract

Context: Chronic kidney disease affects 7 to 10 percent of the French population. Entering the end stage of the disease requires a choice to be made between several options. The aim is to document the nursing practices used to support these patients in choosing their renal replacement therapy and to determine the elements that promote decision-making.

Method: This is a scoping review based on the methodology of Peters et al. of JBI.

Results: The nursing practices identified focus on empowerment, by intervening in: involvement, providing information, clarifying preferences, supporting deliberation, and assessing needs before, during, and after the decision-making process. The key factors identified are: an equal and trusting relationship, the personalization of the process, and emotional support, all provided by trained professionals.

Discussion: Several concepts shed light on decision support in a complementary and surprisingly paradoxical way: grief, adaptation, empowerment, and uncertainty.

Conclusion: This review shows nursing practices centered on helping the patient to take control of their life decisions. This experience causes a serious upheaval in patients’ lives, hence the importance of providing them with support in managing their emotions.