Shared Decision-Making in the Choice of Renal Replacement Therapy: A Comparative Text Mining Analysis of Physicians and Nurses.

Abstract

Objective: This study aimed to compare factors facilitating shared decision-making (SDM) in renal replacement therapy decision support between physicians and nurses using text mining analysis. Methods: A web-based survey was conducted among 250 physicians and 299 nurses between December 2024 and March 2025. Free-text responses regarding factors facilitating SDM were collected and analyzed using quantitative text analysis. Results: Valid responses were obtained from 103 physicians and 122 nurses. Both groups identified six factors, with three shared conceptual domains across physicians and nurses, reflected in three physician factors and four nurse factors. Common domains included "promoting patient and family understanding", "enhancing staff education", and "strengthening multidisciplinary collaboration". Physicians emphasized structural and environmental factors, such as "establishing clinical systems", "inter-institutional collaboration", and "securing sufficient time". In contrast, nurses highlighted practical and interpersonal aspects, including "understanding patients' values and lifestyles", "supporting patient-centered decision-making", and "promoting team-based information sharing". Conclusions: Factors that facilitate SDM in renal replacement therapy include perspectives common to both physicians and nurses, as well as profession-specific perspectives. These findings suggest that integrating organizational support and clinical skills development is crucial for promoting SDM in clinical settings.