Shared decision‐making in dialysis choice has potential to improve self‐management in people with kidney disease: A qualitative follow‐up study

To explore how patients remained involved in their treatment and care of their own health following a shared decision-making intervention for dialysis choice.A follow-up study using semi-structured interviews.Individual interviews with 13 patients were conducted immediately following their participation in a shared decision-making intervention for dialysis choice and again 3 months after initiating dialysis. This study reports findings from the follow-up interviews 3 month after dialysis initiation. Data were collected from August 2017-February 2019 and analysed using systematic text condensation.The analysis revealed five main findings, which indicated differing levels of: (a) involvement in the decision-making process; (b) involvement in treatment; (c) involvement in care of own health; (d) involvement of a relative; and (e) support from healthcare professionals.Following the shared decision-making intervention, patients who chose home-based treatment had become more involved in their treatment and care of their own health. The involvement of relatives and support from healthcare professionals contributed positively to this. In contrast, patients who had chosen hospital-based treatment were less involved in their treatment.Shared decision-making in dialysis choice has potential to improve self-management in people with kidney disease. However, support from healthcare professionals for patients and their relatives should be prioritized in an effort to increase all patients' involvement in their treatment and care of their own health.目的: 探讨在对透析选择进行共同决策干预后, 患者如何保持对自身健康的参与治疗和护理。 设计: 采用半结构式访谈进行随访研究。 方法: 在13名患者参与透析选择的共同决策干预后, 立即对他们进行了单独访谈, 并在他们开始接受透析3个月后再次对他们进行了访谈。本研究报告了透析开始3个月后的随访结果。于2017年8月至2019年2月收集数据, 并采用系统性文本压缩方式进行分析。 结果: 该分析显示了五项主要的调查结果, 这些结果表明了不同程度的参与: (a) 参与决策过程; (b) 参与治疗; (c) 参与照顾自己的健康; (d) 亲属的参与; 以及 (e) 医疗保健专业人士的支持。 结论: 在共同决策干预后, 选择在家治疗的患者在自身健康的治疗和护理工作中参与度更高。亲属的参与和医疗保健专业人士的支持对此起到了积极作用。相比之下, 选择住院治疗的患者在治疗工作方面参与度较低。 影响: 选择透析的共同决策有可能改善肾病患者的自我管理状况。不过, 应该优先考虑医疗保健专业人士对患者及其亲属的支持, 努力提高所有患者对自身健康治疗和护理工作的参与度。.