Date
Summer 2024
Document Type
Scholarly Project
Department
College of Nursing
First Advisor
Brooke Patterson
Abstract
Problem Statement: A notable phenomenon in nephrology is indecision regarding treatment for End Stage Renal Disease (ESRD). Indecision regarding treatment for ESRD can lead to suboptimal dialysis starts, creating poorer health outcomes, decreased quality of life, and higher healthcare costs. Purpose: This project aimed to determine if participation in a shared decision-making (SDM) program decreases decisional conflict in patients with advancing renal disease deciding between ESRD treatment options. Methods: A pretest-posttest design was used. Participants were recruited from a private nephrology practice. Inclusion Criteria: English-speaking patients, over the age of 20, with Chronic Kidney Disease Stages 4 or 5 (estimated glomerular filtration rate <30), who participated in an ESRD treatment options course offered through a private nephrology practice. The intervention consisted of introducing a SDM program facilitated by a renal care coordinator over three months. All participants were asked to complete the Decisional Conflict Scale (DCS)-Low Literacy pre and post-intervention. Analysis: The Wilcoxon two sample test was used to evaluate whether the participants experienced significant reduction in decisional conflict after participating in the SDM program when compared to participants receiving usual care. Results: A total of 33 participants were included in the results, 21 in the usual care group and 12 in the intervention group. No significant difference (p=0.9847) was found between the two groups when assessing the change in pre and post DCS scores. Implications for Practice: Reducing decisional conflict regarding ESRD treatment options may lead to increased numbers of optimal dialysis starts, improved health outcomes, increased quality of life, and lower healthcare costs but more research is needed to determine the best approach to lessen decisional conflict in patients with advancing chronic kidney disease.
Recommended Citation
Sorkin, Margaret McAnnar, "Implementation of Shared Decision Making to Impact Decisional Conflict in Advancing Chronic Kidney Disease" (2024). Doctor of Nursing Practice Scholarly Projects. 64.
https://scholarcommons.sc.edu/dnp_projects/64
Rights
© 2024, Margaret McAnnar Sorkin