Journal of renal care最新文献

{"title":"Self-efficacy and home dialysis: An integrative review.","authors":"Nicola A D'Souza, Ma'en Zaid Abu-Qamar, Lisa Whitehead","doi":"10.1111/jorc.12510","DOIUrl":"10.1111/jorc.12510","url":null,"abstract":"<p><strong>Background: </strong>Enhancing patient confidence in their ability (self-efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self-efficacy in patients managing home dialysis.</p><p><strong>Objectives: </strong>To identify self-reported levels of self-efficacy, the measurements used to assess self-efficacy and the effectiveness of interventions to enhance self-efficacy in patients undergoing home dialysis.</p><p><strong>Design: </strong>An integrative review approach was employed using Whittemore and Knafl's methodology.</p><p><strong>Methods: </strong>A comprehensive search was conducted to identify literature on self-efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and Scopus databases without a date limit. The included literature was critically appraised for methodological quality. Data extraction was conducted to report the study characteristics, measurement tools used and interventions conducted along with the synthesis of findings in a narrative format.</p><p><strong>Results: </strong>Fifteen studies were included in the review were predominantly quantitative examining training programmes promoting self-efficacy in adults conducting home dialysis. The finding that self-efficacy builds over time was structured into two themes; gaining skills to develop self-efficacy and building and maintaining knowledge of self-efficacy.</p><p><strong>Conclusion: </strong>The findings highlighted the importance of employing multifaceted strategies with support from health professionals including nurses, families and peer support to develop self-efficacy in patients undergoing home dialysis.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and enablers to exercise in kidney transplant recipients: Systematic review of qualitative studies.","authors":"Alexander Bates, Meg E Letton, Ria Arnold, Kelly Lambert","doi":"10.1111/jorc.12497","DOIUrl":"10.1111/jorc.12497","url":null,"abstract":"<p><strong>Background: </strong>Exercise has the potential to reduce the susceptibility to comorbidity and cardiovascular disease in kidney transplant recipients. However, kidney transplant recipients report lower levels of exercise compared to the general population, prompting an investigation into the barriers and enablers to exercise in this transplant cohort.</p><p><strong>Objectives: </strong>This systematic review aimed to explore and map the barriers and enablers to exercise in kidney transplant recipients.</p><p><strong>Methods: </strong>Seven electronic databases were systematically searched. Themes were synthesised and then deductively categorised using the Theoretical Domains Framework.</p><p><strong>Results: </strong>Eleven studies were included in the review. Commonly reported barriers to exercise were lack of exercise guidance (n = 9 studies), physical limitations (n = 5 studies) and a fear of harming the kidney (n = 7 studies). Enablers were a desire to return to normality (n = 5 studies), physical and mental benefits (n = 3 studies), goal setting and tracking improvements (n = 3 studies). At the local level, barriers identified by kidney transplant recipients were a lack of knowledge, fear of injuring the kidney, bad weather and physical limitations. Perceived enablers were already living an active lifestyle, mental benefits, exercise preferences and social support.</p><p><strong>Conclusion: </strong>Key findings of this research were an increased demand for specific/explicit exercise information regarding type and intensity, and personalised guidance and support for kidney transplant recipients after transplantation. These findings can be used to inform the development of exercise resources and interventions for kidney transplant recipients and their health care professionals within the local community and at a greater level.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-literacy, self-efficacy and health-outcomes of patients undergoing haemodialysis: Mediating role of self-management.","authors":"Shu-Hua Hsu, Yu-Li Lin, Malcolm Koo, Debra K Creedy, Ying Tsao","doi":"10.1111/jorc.12493","DOIUrl":"10.1111/jorc.12493","url":null,"abstract":"<p><strong>Background: </strong>Health literacy, self-efficacy and self-management are known to influence health-related well-being. However, the precise influence of self-management, health literacy and self-efficacy on health outcomes in Asian countries is under-researched.</p><p><strong>Objectives: </strong>To examine the impact of health literacy and self-efficacy (independent variables) and self-management (mediator) on patients' health outcomes (dependent variable).</p><p><strong>Design: </strong>An observational, cross-sectional design was conducted between 1 March 2022 and 31 August 2022.</p><p><strong>Participants: </strong>Outpatients receiving haemodialysis (n = 200) at a Taiwanese medical centre were assessed.</p><p><strong>Measurements: </strong>The survey included demographic questions and standardised scales: the 3-item Brief Health Literacy Screen, the 8-item Perceived Kidney/Dialysis Self-Management Scale as a measure of self-efficacy, and the 20-item Haemodialyses Self-Management Instrument. Health outcomes were responses on the 12-item Short-Form Health Survey version 2 and clinical blood results from the past 3 months.</p><p><strong>Results: </strong>Participants aged over 60 exhibited common comorbidities, with 34% showing low health literacy. Biochemical markers (e.g., haemoglobin and albumin) significantly correlated with physical and mental health scores. Mediating coefficients revealed that self-management significantly influenced associations between health outcomes, health literacy (β = 0.31; p < 0.01), and self-efficacy (β = 0.19; p < 0.01).</p><p><strong>Implications for practice: </strong>Self-management can modify the overall influence of health literacy and self-efficacy on patients' quality of physical and emotional health. When managing a chronic condition, 'knowing' how to self-manage does not always result in 'doing so' by the patient. Continuous monitoring and promoting self-management behaviours and support by nurses are crucial to enhance health outcomes.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140193962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The futility of post-haemodialysis blood glucose levels: A retrospective cohort study.","authors":"Jing Zhang, Richard K Le Leu, Qunyan Xu, Paul Bennett","doi":"10.1111/jorc.12492","DOIUrl":"10.1111/jorc.12492","url":null,"abstract":"<p><strong>Background: </strong>Frequent blood glucose tests are performed for people with diabetes receiving haemodialysis.</p><p><strong>Objectives: </strong>To determine the rate of out-of-range post-haemodialysis blood glucose levels that are clinically acted upon, the intervention and outcome of each intervention, and the associations between post-haemodialysis blood glucose levels and relevant clinical predictors.</p><p><strong>Design: </strong>12-month retrospective cohort medical record review in one Australian haemodialysis centre. Post-haemodialysis blood glucose levels, prehaemodialysis blood glucose levels, time of treatment, diabetes medications, intradialytic fluid removal, dialysate dextrose concentration, clinical actions, interventions, and outcomes on out-of-range blood glucose levels were retrieved.</p><p><strong>Participants: </strong>22 participants with a median time receiving dialysis 3.1 years (interquartile range 2.3-4.7).</p><p><strong>Measurements and results: </strong>The proportion of out-of-range post-haemodialysis blood glucose levels was 87.3% (95% confidence interval, 86.1%-88.5%). No out-of-range post-haemodialysis blood glucose levels were clinically acted upon. Out-of-range post-haemodialysis blood glucose levels were 4.6 times more likely if a higher dextrose bath was used (95% confidence interval: 3.3; 6.3. p < 0.001). The odds of the post-haemodialysis blood glucose levels increased by each 1 mmol/L. Intradialytic fluid removal, dialysate dextrose concentration, sex, dialysis time, anti-hyperglycaemic agents were also associated with out-of-range post-haemodialysis blood glucose levels.</p><p><strong>Conclusion: </strong>Routine post-haemodialysis blood glucose levels testing has limited clinical utility in care for people with diabetes receiving maintenance haemodialysis. Higher dextrose dialysate may require individual titration depending on prehaemodialysis blood glucose levels.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an ice roller on chronic kidney disease-associated pruritus in patients receiving haemodialysis.","authors":"Jong-Ni Lin, Chiu-Feng Chen, Chih-Yuan Huang, Feng-Min Lai, Chi-Jane Wang","doi":"10.1111/jorc.12491","DOIUrl":"10.1111/jorc.12491","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease-associated pruritus is a distressing symptom and has a far-reaching impact on patients' sleep and quality of life for most patients receiving haemodialysis. Traditional therapies have limited effectiveness.</p><p><strong>Objectives: </strong>This study aimed to invent a self-operated ice roller and evaluate its efficacy in relieving pruritus, sleep quality, and quality of life.</p><p><strong>Design: </strong>This study was experimental with a two-arm parallel group design.</p><p><strong>Participants: </strong>A convenient sampling method was used to recruit 60 patients receiving haemodialysis who reported pruritus (5D-Itch Scale score >5) lasting over 4 weeks in Taiwan. The participants were randomly assigned to one of two groups: the intervention group used an ice roller for 7 days, while the control group received no anti-pruritus treatment.</p><p><strong>Measurements: </strong>This study was experimental with a two-arm parallel group design. The measurement instruments included the 5D-Itch Scale, Pittsburgh Sleep Quality Index and WHOQOL-BREF-Taiwan Version. The analysis of covariance, chi-square, Independent t tests, and partial Eta² (η²p) were used to analyse the data.</p><p><strong>Results: </strong>The participants' mean age was 62.77 years. Application of the ice roller significantly decreased overall pruritus (p < .05; η²p = .09) and distribution of pruritus-associated bodily parts (p = .03; η²p = .08). There were no statistically significant differences in sleep quality and related indicators between the experimental and control groups at the study endpoint. Regarding quality of life, only the social relationship domain significantly differed between the two groups (p = .02; η²p = .08).</p><p><strong>Conclusions: </strong>The ice roller can decrease pruritus and its distribution in patients receiving haemodialysis, serving as an adjunct therapy alongside conventional anti-pruritus treatments.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting the most out of remote care: Co-developing a Toolkit to improve the delivery of remote kidney care appointments for underserved groups.","authors":"Patricia Tum, Fez Awan, Jyoti Baharani, Emma Coyne, Gavin Dreyer, Catriona Ewart, Chipiliro Kalebe-Nyamomgo, Udita Mitra, Martin Wilkie, Nicola Thomas","doi":"10.1111/jorc.12504","DOIUrl":"10.1111/jorc.12504","url":null,"abstract":"<p><strong>Background: </strong>Telephone and video appointments are still common post-pandemic, with an estimated 25%-50% of kidney appointments in the United Kingdom still conducted remotely. This is important as remote consultations may exacerbate pre-existing inequalities in those from underserved groups. Those from underserved groups are often not represented in health research and include those with learning disability, mental health needs, hearing/sight problems, young/older people, those from ethnic minority groups.</p><p><strong>Objectives: </strong>The aim was to develop a Toolkit to improve the quality of remote kidney care appointments for people from different underserved groups.</p><p><strong>Design: </strong>A parallel mixed methods approach with semistructured interviews/focus groups and survey. We also conducted workshops to develop and validate the Toolkit.</p><p><strong>Participants: </strong>Seventy-five renal staff members completed the survey and 21 patients participated in the interviews and focus groups. Patients (n = 11) and staff (n = 10) took part in the Toolkit development workshop, and patients (n = 13) took part in the Toolkit validation workshop.</p><p><strong>Results: </strong>Four themes from interviews/focus groups suggested areas in which remote appointments could be improved. Themes were quality of appointment, patient empowerment, patient-practitioner relationship and unique needs for underserved groups. Staff reported difficulty building rapport, confidentiality issues, confidence about diagnosis/advice given, technical difficulties and shared decision making.</p><p><strong>Conclusion: </strong>This study is the first to explore experiences of remote appointments among both staff and those from underserved groups living with kidney disease in the United Kingdom. While remote appointments can be beneficial, our findings indicate that remote consultations need optimisation to meet the needs of patients. The project findings informed the development of a Toolkit which will be widely promoted and accessible in the United Kingdom during 2024.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experiences of people starting haemodialysis: A qualitative study.","authors":"Kshama Mehta, Wael F Hussein, Kerstin K Leuther, Alexandra Fegler, Brigitte Schiller, Paul N Bennett","doi":"10.1111/jorc.12496","DOIUrl":"10.1111/jorc.12496","url":null,"abstract":"<p><strong>Background and objective: </strong>Starting dialysis is a life-changing transition for people living with kidney disease. People feel overwhelmed with diet changes, medications and surgical interventions, and often experience high levels of anxiety, depression and hospital admissions. The objective of this study was to explore and describe the experiences and perspectives of people starting dialysis.</p><p><strong>Study design: </strong>Observational qualitative study using audio-recorded, individual, semi-structured interviews.</p><p><strong>Participants: </strong>We conducted 20 semi-structured interviews with English-speaking adults who were within 90 days of starting in-centre haemodialysis at centres of a nonprofit dialysis provider in Northern California.</p><p><strong>Approach: </strong>Trained qualitative researchers conducted interviews that were deidentified and transcribed verbatim before being inductively coded into codes, categories, and themes.</p><p><strong>Results: </strong>Three overarching themes emerged from the interviews. Being overwhelmed when starting dialysis, realises the emotional unpreparedness of patients starting dialysis and how the centre's environment (waiting and treatment areas) and staff behaviour impact the dialysis start experience. Making sense of it all, covers how the patient's symptoms, behaviour, and dialysis-related experiences impact the dialysis start. Moving forward, describes how education informed optimal decision-making, and can provide hope for a longer and better life.</p><p><strong>Limitations: </strong>Predominantly college-educated participants were recruited from a single dialysis organisation which may limit the transferability of results.</p><p><strong>Conclusion: </strong>Understanding the life-changing experiences that patients encounter when starting dialysis assist dialysis clinicians to help patients adjust and develop long-term coping strategies.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Once-per-week haemodialysis in a financial crisis: Predictors of interdialytic weight gain.","authors":"Hemamali M H Jagodage, Charrlotte Seib, Amanda McGuire, Ann Bonner","doi":"10.1111/jorc.12498","DOIUrl":"10.1111/jorc.12498","url":null,"abstract":"<p><strong>Background: </strong>Several countries are experiencing challenges in maintaining standard haemodialysis services for people with kidney failure.</p><p><strong>Objective: </strong>This study aimed to investigate the health profile of people receiving haemodialysis and to identify factors associated with interdialytic weight gain.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Participants: </strong>A total of 166 adults with kidney failure and receiving haemodialysis for at least 3 months were included.</p><p><strong>Measurements: </strong>A structured chart audit form collected, demographic and haemodialysis treatment characteristics, recent biochemical and haematological results, and prescribed treatment regimens from clinical records. Data were analysed descriptively. Odds ratios (OR) were calculated to identify independent risk factors for interdialytic weight gain.</p><p><strong>Results: </strong>Mean age was 52 years (SD = 12.5), over half were male (60.2%, n = 100), and most were receiving 4 h of haemodialysis once per week (87.3%, n = 145). Approximately half (51.8%, n = 86) had an interdialytic weight gain >2%. Being female (OR = 3.39; 95% CI, 1.51-7.61), increased comorbidities (OR = 1.50; 95% CI, 1.22-1.84) and having BMI outside of the normal range (overweight/obese [OR = 8.49; 95% CI, 3.58-20.13] or underweight [OR = 4.61; 95% CI, 1.39-15.31]) were independent risk factors for increased interdialytic weight gain.</p><p><strong>Conclusion: </strong>Most patients were receiving 4 h of haemodialysis once per week although only modest alterations in potassium, phosphate, and fluid status were observed. Understanding the patient profile and predictors of interdialytic weight gain will inform the development of self-management interventions to optimise clinician support.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to vascular access point-of-care ultrasound in haemodialysis: An international survey of haemodialysis clinicians.","authors":"Monica Schoch, Catherine Fielding, Rosa M Marticorena, George E Smith, Peter M Sinclair, Ruben Iglesias, Paul N Bennett","doi":"10.1111/jorc.12503","DOIUrl":"10.1111/jorc.12503","url":null,"abstract":"<p><strong>Background: </strong>Utilising point-of-care ultrasound for assessment and cannulation of vascular access in people receiving haemodialysis has shown positive clinical results. Nonetheless, there is variation in how renal health care professionals worldwide embrace this method, and there's a lack of research on the factors that promote or hinder its adoption.</p><p><strong>Objectives: </strong>To explore regional differences, and barriers and facilitators, to the use of point-of-care ultrasound for assessment and cannulation of vascular access in haemodialysis.</p><p><strong>Design: </strong>Exploratory descriptive cross-sectional web-based survey.</p><p><strong>Participants: </strong>Healthcare clinicians working in haemodialysis responsible for cannulation of arteriovenous fistula or grafts.</p><p><strong>Results: </strong>The survey was completed by 645 health care clinicians from 38 countries. 75% to 93% of respondents from Australia/New Zealand, Canada, Europe and United Kingdom/Ireland reported access to ultrasound, compared to 26% (n = 43/167) from the United States. United States respondent's reported lower levels of ultrasound training than other regions. Facilitators for using ultrasound were: the availability of ultrasound training (87%, n = 558), to reduce miscannulations (76%, n = 255/336) and to improve patient outcomes (73%, n = 246/336). Point-of-care ultrasound barriers were lack of access to ultrasound education (82%, n = 196/239), lack of ultrasound machines (33%, n = 212/645) or believing that ultrasound was someone else's role (38%, n = 29/86).</p><p><strong>Conclusions: </strong>This study revealed national and regional differences related to haemodialysis point-of-care ultrasound. Understanding the regions requiring more education and implementation of ultrasound and what motivates staff, or deters from using ultrasound, is crucial for effectiveness of future implementation and workplace change initiatives.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young adults with kidney failure lived experiences of kidney replacement therapy decision-making.","authors":"Sarah Ofori-Ansah, Michelle Evans, Lesley Baillie, Calvin Moorley","doi":"10.1111/jorc.12508","DOIUrl":"10.1111/jorc.12508","url":null,"abstract":"<p><strong>Background: </strong>Young adults living with kidney failure make decisions to select a kidney replacement therapy choice in partnership with healthcare professionals. However, little is known about how they experience kidney replacement therapy treatment decision-making and the impact this has on their well-being.</p><p><strong>Objectives: </strong>To explore young adults living with kidney failure experiences of treatment decision-making. The treatment decision-making investigated is about the choice of dialysis and/or kidney transplant options.</p><p><strong>Design: </strong>A qualitative interpretive hermeneutic phenomenology study.</p><p><strong>Participants: </strong>Purposeful sampling was used to recruit young adults with kidney failure from social media, electronic media such as local kidney group websites and word of mouth. Semistructured interviews were conducted with (n = 18) participants aged 18-30 years.</p><p><strong>Approach: </strong>Inductive analysis of the data were performed using Braun and Clarke's thematic analysis framework.</p><p><strong>Findings: </strong>The five themes generated were (1) awareness and anticipation of future kidney replacement therapy decision; (2) health information and education; (3) engaging in decision-making, support and choices; (4) implementation of kidney replacement therapy and transitioning into the new normal life and (5) the impact of decision-making and choice on well-being.</p><p><strong>Conclusions: </strong>Decision-making significantly affected young adults' psychosocial and mental well-being. Young adults had unmet informational and decisional needs and struggled to cope due to lack of support. A four-talk model, with an implement talk phase added to the existing three-talk (team talk, option talk, decision talk) shared decision-making model, would promote a focus on the implementation of choice and support the transitioning from previous life to long-term dependence on treatment.</p>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}