Advance care planning intervention in chronic kidney care: A qualitative evaluation

IF 1.5 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2025-01-28 DOI:10.1111/jorc.70000

Christina Egmose Frandsen RN, MSc(Nursing), PhD, Hans Dieperink MD, PhD, Bettina Trettin RN, MSc(Nursing), PhD, Hanne Agerskov RN, MSc(health), PhD

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引用次数: 0

Abstract

Background

Patients with chronic kidney disease and their families request early and continuous advance care planning. Based on user involvement, an advance care planning intervention was developed to support patients, family members and healthcare professionals (HCPs) in advance care planning conversations in a nephrology outpatient setting.

Objective

To explore the experiences and perceptions of an advance care planning intervention among patients with chronic kidney disease, family members and healthcare professionals.

Design

An exploratory qualitative study with a phenomenological-hermeneutic approach.

Participants

Six patients with chronic kidney disease, four family members and four healthcare professionals.

Approach

Semistructured interviews with patients and family members and a focus group interview with healthcare professionals were conducted. Data were analysed using Ricoeur's interpretation theory.

Findings

Patients and their families were impacted in various ways when the patient received the diagnose of chronic kidney disease. The need for an advance care planning intervention was based on a range of individual needs. The intervention supported patients, their family members, and healthcare professionals through open dialogues and reflections about thoughts and concerns. Healthcare professionals' reflected that it might be too early to deliver an increased amount of care.

Conclusion

When the disease challenged family and everyday life, the advance care planning intervention was useable and facilitated an open dialogue and reflections. The advance care planning conversations developed awareness among the patients and family members about their values, preferences, and needs, and supported them in sharing them. There is a need for training in initiating and conducting advance care planning conversations among healthcare professionals.

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背景：慢性肾脏病患者及其家属要求尽早、持续地制定预先护理计划。在用户参与的基础上，我们开发了一种预先医疗规划干预措施，以支持患者、家属和医疗保健专业人员（HCPs）在肾脏科门诊环境中进行预先医疗规划对话：探讨慢性肾病患者、家属和医护人员对预先医疗规划干预的体验和看法：设计：一项探索性定性研究，采用现象学-医学方法：六名慢性肾病患者、四名家庭成员和四名医护人员：方法：对患者和家属进行半结构化访谈，对医护人员进行焦点小组访谈。采用呂科爾的詮釋理論分析資料：当患者被诊断出患有慢性肾病时，患者及其家属受到了不同程度的影响。对预先护理规划干预的需求是基于一系列个人需求。干预措施通过开放式对话以及对想法和担忧的反思，为患者、其家人和医护人员提供了支持。医护人员认为，现在就增加护理服务可能为时过早：结论：当疾病对家庭和日常生活构成挑战时，预先护理规划干预措施是可行的，并促进了公开对话和反思。预先护理规划对话提高了患者和家属对其价值观、偏好和需求的认识，并支持他们分享这些价值观、偏好和需求。有必要对医护人员进行启动和开展预先护理规划对话的培训。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.