Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates

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Jayanti , A , Neuvonen , M , Wearden , A , Morris , J , Foden , P , Brenchley , P , Mitra , S & BASIC-HHD Study Grp 2015 , ' Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates ' , BMC Nephrology , vol. 16 , 189 .

Title: Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates
Author: Jayanti, Anuradha; Neuvonen, Markus; Wearden, Alison; Morris, Julie; Foden, Philip; Brenchley, Paul; Mitra, Sandip; BASIC-HHD Study Grp
Contributor organization: Department of Political and Economic Studies (2010-2017)
Date: 2015-11-14
Language: eng
Number of pages: 17
Belongs to series: BMC Nephrology
ISSN: 1471-2369
Abstract: Background: Medical decision-making is critical to patient survival and well-being. Patients with end stage renal disease (ESRD) are faced with incrementally complex decision-making throughout their treatment journey. The extent to which patients seek involvement in the decision-making process and factors which influence these in ESRD need to be understood. Methods: 535 ESRD patients were enrolled into the cross-sectional study arm and 30 patients who started dialysis were prospectively evaluated. Patients were enrolled into 3 groups-'predialysis' (group A), 'in-centre' haemodialysis (HD) (group B) and self-care HD (93 % at home-group C) from across five tertiary UK renal centres. The Autonomy Preference Index (API) has been employed to study patient preferences for information-seeking (IS) and decision-making (DM). Demographic, psychosocial and neuropsychometric assessments are considered for analyses. Results: 458 complete responses were available. API items have high internal consistency in the study population (Cronbach's alpha > 0.70). Overall and across individual study groups, the scores for information-seeking and decision-making are significantly different indicating that although patients had a strong preference to be well informed, they were more neutral in their preference to participate in DM (p <0.05). In the age, education and study group adjusted multiple linear regression analysis, lower age, female gender, marital status; higher API IS scores and white ethnicity background were significant predictors of preference for decision-making. DM scores were subdivided into tertiles to identify variables associated with high (DM > 70: and low DM ( Conclusion: ESRD patients prefer to receive information, but this does not always imply active involvement in decision-making. By understanding modifiable and non-modifiable factors which affect patient preferences for involvement in healthcare decision-making, health professionals may acknowledge the need to accommodate individual patient preferences to the extent determined by the individual patient factors.
Subject: Haemodialysis
3142 Public health care science, environmental and occupational health
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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