Shared Decision-Making In Dialysis Choice Has Potential To Improve Self-Management In People With Kidney Disease: A Qualitative Follow-Up Study

Aims To explore how patients remained involved in their treatment and care of their own health following a shared decision-making intervention for dialysis choice.Design A follow-up study using semi-structured interviews.Methods 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.Results 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.Conclusions 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.Impact 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.