A randomized controlled trial protocol testing a decision support intervention for older patients with advanced kidney disease.

Autor:	Brown, Leanne, Gardner, Glenn, Bonner, Ann
Předmět:	TREATMENT of chronic kidney failure ELDER care CHI-squared test CLUSTER analysis (Statistics) CONFIDENCE intervals STATISTICAL correlation DECISION making HEMODIALYSIS HOSPITAL wards RESEARCH methodology MEDICAL cooperation NEPHROLOGY NURSING NURSING assessment PATIENT education PUBLIC hospitals QUALITY of life RESEARCH RESEARCH funding STATISTICAL hypothesis testing STATISTICS T-test (Statistics) TEACHING aids UNCERTAINTY LOGISTIC regression analysis STATISTICAL power analysis DATA analysis EFFECT sizes (Statistics) RANDOMIZED controlled trials REPEATED measures design BLIND experiment HEALTH literacy DESCRIPTIVE statistics MANN Whitney U Test PATIENT decision making OLD age
Zdroj:	Journal of Advanced Nursing (John Wiley & Sons, Inc.); May2016, Vol. 72 Issue 5, p1191-1202, 12p, 2 Diagrams, 1 Chart
Abstrakt:	Aim To assess the effectiveness of a decision support intervention using a pragmatic single blind Randomized Controlled Trial. Background Worldwide the proportion of older people (aged 65 years and over) is rising. This population is known to have a higher prevalence of chronic diseases including chronic kidney disease. The resultant effect of the changing health landscape is seen in the increase in older patients (aged ≥65 years) commencing on dialysis. Emerging evidence suggests that for some older patients dialysis may provide minimal benefit. In a majority of renal units non-dialysis management is offered as an alternative to undertaking dialysis. Research regarding decision-making support that is required to assist this population in choosing between dialysis or non-dialysis management is limited. Design A multisite single blinded pragmatic randomized controlled trial is proposed. Methods Patients will be recruited from four Queensland public hospitals and randomizd into either the control or intervention group. The decision support intervention is multimodal and includes counselling provided by a trained nurse. The comparator is standard decision-making support. The primary outcomes are decisional regret and decisional conflict. Secondary outcomes are improved knowledge and quality of life. Ethics approval obtained November 2014. Conclusion This is one of the first randomized controlled trials assessing a decision support intervention in older people with advance chronic kidney disease. The results may provide guidance for clinicians in future approaches to assist this population in decision-making to ensure reduced decisional regret and decisional conflict. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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