Determinants of regret in elderly dialysis patients.

Published

Journal Article

AIMS:In Singapore, most elderly end-stage renal disease (ESRD) patients choose dialysis over palliative management. However, dialysis may not be the optimal treatment option given only moderate survival benefits and high costs and treatment burden compared to non-dialysis management. Elderly patients may therefore come to regret this decision. This study investigated: (i) extent of patients' decision regret after starting dialysis, and (ii) potentially modifiable predictors of regret: satisfaction with chronic kidney disease education, decisional conflict, and decision-making involvement. METHODS:The present study was a cross-sectional study of 103 dialysis patients above 70 years of age, surveyed at Singapore General Hospital's renal medicine clinics between March and June 2017. Participants reported their levels of decision regret on the Decision Regret Scale (DRS), retrospective decisional conflict on the Decisional Conflict Scale, information satisfaction, and decision-making involvement. RESULTS:In total, 81% of participants reported no decision regret (DRS score < 50), 11% ambivalence (DRS = 50), and 8% regret (DRS >50). In individual DRS items, 19% felt dialysis had done them harm and 16% would not make the same decision again. In multivariable analyses, lower information satisfaction [b = -0.07 (95% CI: -0.13, -0.01)] and decisional conflict [b = 0.004 (95% CI: 0.002, 0.006)] were significantly associated with decision regret. CONCLUSION:Although the majority of elderly dialysis patients were comfortable with their decision to start dialysis, a proportion was ambivalent or regretted this choice. Regret was more likely among those who experienced decisional conflict and/or expressed poorer information satisfaction. Healthcare professionals should recognize these risk factors and take steps to minimize chances of regret among this population subset.

Full Text

Duke Authors

Cited Authors

  • Tan, EGF; Teo, I; Finkelstein, EA; Meng, CC

Published Date

  • June 2019

Published In

Volume / Issue

  • 24 / 6

Start / End Page

  • 622 - 629

PubMed ID

  • 29736929

Pubmed Central ID

  • 29736929

Electronic International Standard Serial Number (EISSN)

  • 1440-1797

International Standard Serial Number (ISSN)

  • 1320-5358

Digital Object Identifier (DOI)

  • 10.1111/nep.13400

Language

  • eng