1. African American and Non-African American Patients’ and Families’ Decision Making About Renal Replacement Therapies
- Author
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Sheu, Johanna, Ephraim, Patti L, Powe, Neil R, Rabb, Hamid, Senga, Mikiko, Evans, Kira E, Jaar, Bernard G, Crews, Deidra C, Greer, Raquel C, and Boulware, L Ebony
- Subjects
Health Sciences ,Human Society ,Kidney Disease ,Transplantation ,Clinical Research ,7.3 Management and decision making ,Management of diseases and conditions ,Renal and urogenital ,Adult ,Black or African American ,Aged ,Communication ,Cultural Competency ,Decision Making ,Family Relations ,Female ,Focus Groups ,Health Knowledge ,Attitudes ,Practice ,Humans ,Male ,Middle Aged ,Patient Education as Topic ,Qualitative Research ,Renal Replacement Therapy ,United States ,African Americans ,communication ,medical ,decision making ,illness and disease ,chronic ,illness and disease ,experiences ,minorities ,nephrology ,Medical and Health Sciences ,Studies in Human Society ,Psychology and Cognitive Sciences ,Nursing ,Health sciences ,Human society - Abstract
We conducted focus group meetings of African American and non-African American patients with end-stage renal disease (six groups) and their family members (six groups), stratified by race/ethnicity and treatment. We elicited differences in participants' experiences with shared decision making about initiating renal replacement therapy (RRT; that is, hemodialysis, peritoneal dialysis, or a kidney transplant). Patients were often very sick when initiating RRT, and had little, if any, time to make a decision about what type of RRT to initiate. They also lacked sufficient information about alternative treatment options prior to initiation. Family members played supportive roles and shared in decision making when possible. Reports were similar for African American and non-African American participants. Our findings suggest that a greater emphasis on the improved engagement of patients and their families in shared decision making about RRT initiation is needed for both ethnic/racial minorities and nonminorities.
- Published
- 2012