患有肾衰竭的年轻人在肾脏替代疗法决策方面的生活经历。

IF 1.5 4区 医学 Q3 NURSING
Sarah Ofori-Ansah PhD, Michelle Evans PhD, Lesley Baillie PhD, Calvin Moorley PhD
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引用次数: 0

摘要

背景:患有肾衰竭的青壮年在与医护人员合作选择肾脏替代疗法时做出了决定。然而,人们对他们如何体验肾脏替代疗法的治疗决策以及这对他们福祉的影响知之甚少:目的:探讨患有肾衰竭的年轻人在治疗决策方面的经验。调查的治疗决策涉及透析和/或肾移植方案的选择:设计:定性诠释现象学研究:采用有目的的抽样方法,从社交媒体、电子媒体(如当地肾脏团体网站)和口碑中招募患有肾衰竭的年轻成年人。对 18-30 岁的参与者(n=18)进行了半结构化访谈:采用布劳恩和克拉克的主题分析框架对数据进行归纳分析:产生的五个主题是:(1)对未来肾脏替代治疗决定的认识和预期;(2)健康信息和教育;(3)参与决策、支持和选择;(4)实施肾脏替代治疗和过渡到新的正常生活;(5)决策和选择对幸福感的影响:结论:决策对青壮年的社会心理和精神健康有重大影响。青壮年在信息和决策方面的需求未得到满足,并且由于缺乏支持而难以应对。在现有的三会谈(团队会谈、选择会谈、决策会谈)共同决策模式中加入实施会谈阶段的四会谈模式,将促进对实施选择的关注,并支持从以前的生活过渡到长期依赖治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Young adults with kidney failure lived experiences of kidney replacement therapy decision-making

Young adults with kidney failure lived experiences of kidney replacement therapy decision-making

Background

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.

Objectives

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.

Design

A qualitative interpretive hermeneutic phenomenology study.

Participants

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.

Approach

Inductive analysis of the data were performed using Braun and Clarke's thematic analysis framework.

Findings

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.

Conclusions

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.

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来源期刊
Journal of renal care
Journal of renal care Nursing-Advanced and Specialized Nursing
CiteScore
3.50
自引率
5.30%
发文量
36
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.
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