Patients' transition experience and care from predialysis to dialysis: a theory-guided integrative review.

Abstract

Background: A smooth transition to dialysis is essential for survival and quality of life in patients with advanced chronic kidney disease (CKD).

Objective: To develop a transition framework for patients with advanced CKD based on the existing research and transition theory, which aims to illuminate patients' transition experience and provide potential intervention strategies.

Methods: An integrative review methodology was employed, with searches conducted in ten Chinese and English databases (PubMed, Web of Science, CINAHL, Embase, etc.). Articles were screened and selected based on predefined criteria independently by two authors, with reference lists of included studies reviewed for further studies. Data analysis followed the approach proposed by Whittemore and Knafl.

Results: 13 qualitative, 7 quantitative and 1 mixed methods articles were extracted and evaluated. This review develops the transition framework for patients with advanced CKD, including the concepts of transition nature, conditions, intervention strategies, and response patterns. It provides a comprehensive understanding of how personal, dialysis-related, interpersonal, community, and societal factors shape patients' transition experiences and identifies actionable strategies to enhance transitional care.

Conclusion: The transition of patients with advanced CKD from predialysis to dialysis is multiple and dynamic. Healthcare professionals should take into account diverse factors influencing this process and formulate tailored strategies to support patients in achieving a smooth and healthy transition.

Clinical trial number: Not applicable.