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Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions.

Publication ,  Journal Article
Vandenberg, AE; Bowling, CB; Adisa, O; Sahlie, A; Nadel, L; Lea, J; Plantinga, LC
Published in: Patient Educ Couns
July 2019

OBJECTIVE: To examine concordance and tensions in values among stakeholder groups across the shared decision making process for end-stage renal disease patients treated with hemodialysis. METHODS: A thematic analysis of transcripts from three stakeholder groups: hemodialysis patients (2 groups, n = 17), nephrologists (1 group, n = 9), and non-physician providers (dietitians, social workers, and registered nurses) (1 group, n = 8). A framework of decision-making components (communication, information, decision, behavior, and outcome) guided analysis of values within and across groups. RESULTS: Shared values included communication that informed patients and involved family; information about function, trajectory, life context, and patient experience; behavior to manage diet; and outcomes of function, safety, and survival. Identified thematic tensions in patient-provider values were: personalized vs. routinized communication; shared vs. separate information; managed vs. adherent behavior; and participating vs. protected outcome. Patient behavior emerged as a contested area of control. CONCLUSION: Emphasizing shared values and bridging values conflicts may ease tensions surrounding self-care behavior by facilitating discussions about diet, medications, and consistent dialyzing. PRACTICE IMPLICATIONS: More individualized information needs to be delivered to patients in a personalized communication approach that can still be achieved within a busy dialysis clinic setting.

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Published In

Patient Educ Couns

DOI

EISSN

1873-5134

Publication Date

July 2019

Volume

102

Issue

7

Start / End Page

1280 / 1287

Location

Ireland

Related Subject Headings

  • Social Values
  • Social Participation
  • Renal Dialysis
  • Public Health
  • Prognosis
  • Professional-Patient Relations
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Humans
 

Citation

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Chicago
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Vandenberg, A. E., Bowling, C. B., Adisa, O., Sahlie, A., Nadel, L., Lea, J., & Plantinga, L. C. (2019). Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions. Patient Educ Couns, 102(7), 1280–1287. https://doi.org/10.1016/j.pec.2019.02.012
Vandenberg, Ann E., C Barrett Bowling, Olufunmilola Adisa, Abyalew Sahlie, Leigh Nadel, Janice Lea, and Laura C. Plantinga. “Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions.Patient Educ Couns 102, no. 7 (July 2019): 1280–87. https://doi.org/10.1016/j.pec.2019.02.012.
Vandenberg AE, Bowling CB, Adisa O, Sahlie A, Nadel L, Lea J, et al. Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions. Patient Educ Couns. 2019 Jul;102(7):1280–7.
Vandenberg, Ann E., et al. “Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions.Patient Educ Couns, vol. 102, no. 7, July 2019, pp. 1280–87. Pubmed, doi:10.1016/j.pec.2019.02.012.
Vandenberg AE, Bowling CB, Adisa O, Sahlie A, Nadel L, Lea J, Plantinga LC. Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions. Patient Educ Couns. 2019 Jul;102(7):1280–1287.

Published In

Patient Educ Couns

DOI

EISSN

1873-5134

Publication Date

July 2019

Volume

102

Issue

7

Start / End Page

1280 / 1287

Location

Ireland

Related Subject Headings

  • Social Values
  • Social Participation
  • Renal Dialysis
  • Public Health
  • Prognosis
  • Professional-Patient Relations
  • Middle Aged
  • Male
  • Kidney Failure, Chronic
  • Humans