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Reasons renal patients give for deciding not to dialyse: prospective qualitative interview study

Reasons renal patients give for deciding not to dialyse: prospective qualitative interview study
Reasons renal patients give for deciding not to dialyse: prospective qualitative interview study
Background: as the population ages, sicker patients often with multiple comorbidities are presenting in renal clinics. Some are deciding not to embark on dialysis. The objective of this study was to gain an understanding of the decision that some patients make not to embark on dialysis.

Methods: naturally occurring qualitative interviews were conducted with 30 patients and 17 caregivers managed within a Renal Supportive Care Service in an acute NHS Trust in London

Results: several patients believed they had made an informed and autonomous decision, either on or against the advice of their doctor (n 5 17); some felt that they had no option but to refuse dialysis treatment, as it would not have been of benefit and might ultimately cause their death (n 5 7); some stated they had decided to opt for medication rather than dialysis 3 times a week and seemed to believe that either option would lead to the same outcome (n 5 2), and some felt there had been no decision to be made (n 5 4).

Conclusions: prior to this study, little was known about those who decide not to embark on dialysis and how they make this decision. It cannot be presumed that decisions made by patients are fully understood and free from inappropriate professional or family influence, and the decision needs to be regularly revisited to check patients' and caregivers' understanding and to allow for reversal of the decision if fitting. There is a need to understand how service providers can help to ensure that such decisions are informed and supported by the best available supportive care thereafter
0090-2934
82-89
Noble, Helen
65485329-4bed-4f9b-96c1-26e7f91e531f
Meyer, Julienne
c4fc2052-b132-4749-9df3-41f012d7e90f
Bridges, Jackie
8352b54c-c34f-430b-b9fb-107a1f2f4e28
Kelly, Daniel
10b0a4eb-fd29-4110-81da-92700153149e
Johnson, Barbara
4fb4f990-a256-402d-8ca2-53182692dc0a
Noble, Helen
65485329-4bed-4f9b-96c1-26e7f91e531f
Meyer, Julienne
c4fc2052-b132-4749-9df3-41f012d7e90f
Bridges, Jackie
8352b54c-c34f-430b-b9fb-107a1f2f4e28
Kelly, Daniel
10b0a4eb-fd29-4110-81da-92700153149e
Johnson, Barbara
4fb4f990-a256-402d-8ca2-53182692dc0a

Noble, Helen, Meyer, Julienne, Bridges, Jackie, Kelly, Daniel and Johnson, Barbara (2008) Reasons renal patients give for deciding not to dialyse: prospective qualitative interview study. Dialysis & Transplantation, 38 (3), 82-89. (doi:10.1002/dat.20288).

Record type: Article

Abstract

Background: as the population ages, sicker patients often with multiple comorbidities are presenting in renal clinics. Some are deciding not to embark on dialysis. The objective of this study was to gain an understanding of the decision that some patients make not to embark on dialysis.

Methods: naturally occurring qualitative interviews were conducted with 30 patients and 17 caregivers managed within a Renal Supportive Care Service in an acute NHS Trust in London

Results: several patients believed they had made an informed and autonomous decision, either on or against the advice of their doctor (n 5 17); some felt that they had no option but to refuse dialysis treatment, as it would not have been of benefit and might ultimately cause their death (n 5 7); some stated they had decided to opt for medication rather than dialysis 3 times a week and seemed to believe that either option would lead to the same outcome (n 5 2), and some felt there had been no decision to be made (n 5 4).

Conclusions: prior to this study, little was known about those who decide not to embark on dialysis and how they make this decision. It cannot be presumed that decisions made by patients are fully understood and free from inappropriate professional or family influence, and the decision needs to be regularly revisited to check patients' and caregivers' understanding and to allow for reversal of the decision if fitting. There is a need to understand how service providers can help to ensure that such decisions are informed and supported by the best available supportive care thereafter

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More information

Published date: March 2008

Identifiers

Local EPrints ID: 175639
URI: https://eprints.soton.ac.uk/id/eprint/175639
ISSN: 0090-2934
PURE UUID: 7b81f6e0-f37c-4619-8026-ea36238581ac

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Date deposited: 25 Feb 2011 10:25
Last modified: 18 Jul 2017 12:09

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