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Abstract
Introduction: Involving people with advanced chronic kidney disease in decision-making about their treatment promotes their autonomy and guarantees their free choice of treatment. This educational process culminates in selecting a treatment modality that should be consistent with their values, preferences, and lifestyle. However, little is known about their satisfaction with their choice once treatment has begun.
Objective: To determine the degree of satisfaction of the renal patient with the renal replacement therapy chosen.
Material and Method: A quantitative, cross-sectional, descriptive observational study was conducted in the Dialysis Unit of the Complejo Asistencial Universitario de León in 2024. We included chronic dialysis patients who had visited the Advanced Chronic Kidney Disease Unit for information on treatment options and had been on treatment for more than one month. Demographic and clinical variables and satisfaction with the choice were studied.
Results: Fifty-eight patients were studied. 67.24% were men. Mean age 67.1±13.98 years and median 69.5 years. The mean time on treatment was 30.64±31.67 months, 74.14% were on haemodialysis, and 98.3% were satisfied with their choice. We found no statistically significant differences in patient satisfaction between the dialysis options (p=0.551).
Conclusions: The percentage of regret was low, only 1.7%. Assessing patient satisfaction with their dialysis treatment can help to verify whether they are satisfied and/or wish to change the modality.
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Copyright (c) 2024 Ana Isabel Aguilera-Flórez, María de los Ángeles Morán-Centeno, Cristina Bandera-Álvarez, María Jesús Cordero-Guerrero, Israel Robles-del Río, Raquel Fernández-Iban
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References
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- Arenas MD, Collado S, Fernández-Chamarro M. Pautas de derivación a la Unidad de Enfermedad Renal Crónica Avanzada (ERCA). En: Lorenzo V, López Gómez JM (Eds). Nefrología al día. 2021 [consultado 29 Jul 2024]. Disponible en: https://www.nefrologiaaldia.org/es-articulo-pautas-derivacion-unidad-enfermedad-renal-374
- Lucas Álvarez C, Martínez Rosero CV, Martelli Guerrero XY, Prieto Velasco M. Herramientas y estrategias para el éxito de un programa de toma de decisiones compartida. NefroPlus. 2023;15(1):1-15. DOI: https://doi.org/10.1016/S1888-9700(24)00003-3
- Aguilera AI, Alonso AC, Linares B, Prieto S, García L, Prieto M. Valoración de la elección de tratamiento conservador en la Enfermedad Renal Crónica. Enferm Nefrol. 2019;22(1):52-8. DOI: https://doi.org/10.4321/S2254-28842019000100008
- Isnard Bagnis C, Crepaldi C, Dean J, Goovaerts T, Melander S, Nilsson EL, Prieto-Velasco M, Trujillo C, Zambon R, Mooney A. Quality standards for predialysis education: results from a consensus conference. Nephrol Dial Transplant. 2015;30(7):1058-66. DOI: https://doi.org/10.1093/ndt/gfu225
- Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4(4):CD001431. DOI: https://doi.org/10.1002/14651858.CD001431.pub5
- Simón P, Barrio IM, Sánchez CM, Tamayo MI, Molina A, Suess A. et al. Satisfacción de los pacientes con el proceso de información, consentimiento y toma de decisiones durante la hospitalización. Anales Sis San Navarra [Internet]. 2007 [consultado 29 Jul 2024]; 30(2):191-8. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272007000300003&lng=es DOI: https://doi.org/10.4321/S1137-66272007000300003
- Barrett TM, Green JA, Greer RC, Ephraim PL, Peskoe S, Pendergast JFet all. Preferences for and Experiences of Shared and Informed Decision Making Among Patients Choosing Kidney Replacement Therapies in Nephrology Care. Kidney Med. 2021;3(6):905-15. DOI: https://doi.org/10.1016/j.xkme.2021.05.011
- Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Making. 2015;35(1):114-31. DOI: https://doi.org/10.1177/0272989X14551638
- Herramientas de ayuda a la toma de decisión para la Enfermedad Renal Crónica Avanzada. Cuestionario “Satisfacción con la elección” ECP-RR-PD-209 Ed:11712.
- Gil B, Portolés J, López P, Tornero F, Marques M, Rojo JL. Análisis de las transiciones en el modelo integrado de tratamiento sustitutivo renal en un sistema regional de salud. Nefrología. 2022;42(4):438-47. DOI: https://doi.org/10.1016/j.nefro.2021.07.004
- DePasquale N, Green JA, Ephraim PL, Morton S, Peskoe SB, Davenport CA, Mohottige D, McElroy L, Strigo TS, Hill-Briggs F, Browne T, Wilson J, Lewis-Boyer L, Cabacungan AN, Boulware LE. Decisional Conflict About Kidney Failure Treatment Modalities Among Adults With Advanced CKD. Kidney Med. 2022;4(9):100521. DOI: https://doi.org/10.1016/j.xkme.2022.100521
- Marcel Zeelenberg y Rik Pieters. A theory of regret regulation 1.0. Journal of Consumer Psychology. 2007;17(1):3-18. DOI: https://doi.org/10.1207/s15327663jcp1701_3
- Pawar AS, Thorsteinsdottir B, Whitman S, Pine K, Lee A, Espinoza Suarez NR, Organick Lee P, Thota A, Lorenz E, Beck A, Albright R, Feely M, Williams A, Behnken E, Boehmer KR. Decisional Regret Surrounding Dialysis Initiation: A Comparative Analysis. Kidney Med. 2023 20;6(3):100785. DOI: https://doi.org/10.1016/j.xkme.2023.100785
- Saeed F, Ladwig SA, Epstein RM, Monk RD, Duberstein PR. Dialysis Regret: Prevalence and Correlates. Clin J Am Soc Nephrol. 2020;15(7):957-63. DOI: https://doi.org/10.2215/CJN.13781119
- Gilman EA, Feely MA, Hildebrandt D, Edakkanambeth Varayil J, Chong EY, Williams AW, Mueller PS. Do patients receiving hemodialysis regret starting dialysis? A survey of affected patients. Clin Nephrol. 2017;87(3):117-23. DOI: https://doi.org/10.5414/CN109030
- Berkhout-Byrne N, Gaasbeek A, Mallat MJK, Rabelink TJ, Mooijaart SP, Dekker FW, van Buren M. Regret about the decision to start dialysis: a cross-sectional Dutch national survey. Neth J Med. 2017;75(6):225-34.
- García Castro R, González Díaz I, Fernández Merayo C, Fernández Pérez M, Fernández Peñarroya J, Díaz Corte C. Satisfacción del paciente en diálisis (hemodiálisis y diálisis peritoneal): aspectos a mejorar. Enferm Nefrol. 2016; 19(3):248-54. DOI: https://doi.org/10.4321/S2254-28842016000300007
- Romero-Ruiz Ana Belén, Sevillano-Jiménez Alfonso, Cardador-Trocoli Cristina. Factores asociados a la satisfacción del paciente en diálisis. Enferm Nefrol [Internet]. 2019 Jun [consultado 2024 Sep 04];22(2):112-23. DOI: https://doi.org/10.4321/S2254-28842019000200002
- Tan EGF, Teo I, Finkelstein EA, Meng CC. Determinants of regret in elderly dialysis patients. Nephrology (Carlton) 2019;24(6):622-29. DOI: https://doi.org/10.1111/nep.13400
- Juergensen E, Wuerth D, Finkelstein SH, Juergensen PH, Bekui A, Finkelstein FO. Hemodialysis and peritoneal dialysis: patients’ assessment of their satisfaction with therapy and the impact of the therapy on their lives. Clin J Am Soc Nephrol. 2006;1(6):1191-6. DOI: https://doi.org/10.2215/CJN.01220406
- López Toledano Mª Carmen, Luque Cantarero Isabel, Gómez López Victoria Eugenia, Casas Cuesta Rafael, Crespo Montero Rodolfo. La satisfacción del paciente como componente de la calidad en las unidades de diálisis. Enferm Nefrol. [Internet]. 2016 [consultado 2024 Sep 04];9(2):125-33. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2254-28842016000200004 DOI: https://doi.org/10.4321/S2254-28842016000200004
References
Prieto-Velasco M, Del Pino MD, Buades JM, Craver L, Pons R, Ruíz JC, et al. Unidades de Enfermedad Renal Crónica Avanzada en España: una encuesta nacional sobre los estándares de estructura, recursos, resultados y seguridad del paciente. Nefrología 2020;40(6):608–22. DOI: https://doi.org/10.1016/j.nefro.2020.06.006
Arenas MD, Collado S, Fernández-Chamarro M. Pautas de derivación a la Unidad de Enfermedad Renal Crónica Avanzada (ERCA). En: Lorenzo V, López Gómez JM (Eds). Nefrología al día. 2021 [consultado 29 Jul 2024]. Disponible en: https://www.nefrologiaaldia.org/es-articulo-pautas-derivacion-unidad-enfermedad-renal-374
Lucas Álvarez C, Martínez Rosero CV, Martelli Guerrero XY, Prieto Velasco M. Herramientas y estrategias para el éxito de un programa de toma de decisiones compartida. NefroPlus. 2023;15(1):1-15. DOI: https://doi.org/10.1016/S1888-9700(24)00003-3
Aguilera AI, Alonso AC, Linares B, Prieto S, García L, Prieto M. Valoración de la elección de tratamiento conservador en la Enfermedad Renal Crónica. Enferm Nefrol. 2019;22(1):52-8. DOI: https://doi.org/10.4321/S2254-28842019000100008
Isnard Bagnis C, Crepaldi C, Dean J, Goovaerts T, Melander S, Nilsson EL, Prieto-Velasco M, Trujillo C, Zambon R, Mooney A. Quality standards for predialysis education: results from a consensus conference. Nephrol Dial Transplant. 2015;30(7):1058-66. DOI: https://doi.org/10.1093/ndt/gfu225
Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4(4):CD001431. DOI: https://doi.org/10.1002/14651858.CD001431.pub5
Simón P, Barrio IM, Sánchez CM, Tamayo MI, Molina A, Suess A. et al. Satisfacción de los pacientes con el proceso de información, consentimiento y toma de decisiones durante la hospitalización. Anales Sis San Navarra [Internet]. 2007 [consultado 29 Jul 2024]; 30(2):191-8. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1137-66272007000300003&lng=es DOI: https://doi.org/10.4321/S1137-66272007000300003
Barrett TM, Green JA, Greer RC, Ephraim PL, Peskoe S, Pendergast JFet all. Preferences for and Experiences of Shared and Informed Decision Making Among Patients Choosing Kidney Replacement Therapies in Nephrology Care. Kidney Med. 2021;3(6):905-15. DOI: https://doi.org/10.1016/j.xkme.2021.05.011
Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Making. 2015;35(1):114-31. DOI: https://doi.org/10.1177/0272989X14551638
Herramientas de ayuda a la toma de decisión para la Enfermedad Renal Crónica Avanzada. Cuestionario “Satisfacción con la elección” ECP-RR-PD-209 Ed:11712.
Gil B, Portolés J, López P, Tornero F, Marques M, Rojo JL. Análisis de las transiciones en el modelo integrado de tratamiento sustitutivo renal en un sistema regional de salud. Nefrología. 2022;42(4):438-47. DOI: https://doi.org/10.1016/j.nefro.2021.07.004
DePasquale N, Green JA, Ephraim PL, Morton S, Peskoe SB, Davenport CA, Mohottige D, McElroy L, Strigo TS, Hill-Briggs F, Browne T, Wilson J, Lewis-Boyer L, Cabacungan AN, Boulware LE. Decisional Conflict About Kidney Failure Treatment Modalities Among Adults With Advanced CKD. Kidney Med. 2022;4(9):100521. DOI: https://doi.org/10.1016/j.xkme.2022.100521
Marcel Zeelenberg y Rik Pieters. A theory of regret regulation 1.0. Journal of Consumer Psychology. 2007;17(1):3-18. DOI: https://doi.org/10.1207/s15327663jcp1701_3
Pawar AS, Thorsteinsdottir B, Whitman S, Pine K, Lee A, Espinoza Suarez NR, Organick Lee P, Thota A, Lorenz E, Beck A, Albright R, Feely M, Williams A, Behnken E, Boehmer KR. Decisional Regret Surrounding Dialysis Initiation: A Comparative Analysis. Kidney Med. 2023 20;6(3):100785. DOI: https://doi.org/10.1016/j.xkme.2023.100785
Saeed F, Ladwig SA, Epstein RM, Monk RD, Duberstein PR. Dialysis Regret: Prevalence and Correlates. Clin J Am Soc Nephrol. 2020;15(7):957-63. DOI: https://doi.org/10.2215/CJN.13781119
Gilman EA, Feely MA, Hildebrandt D, Edakkanambeth Varayil J, Chong EY, Williams AW, Mueller PS. Do patients receiving hemodialysis regret starting dialysis? A survey of affected patients. Clin Nephrol. 2017;87(3):117-23. DOI: https://doi.org/10.5414/CN109030
Berkhout-Byrne N, Gaasbeek A, Mallat MJK, Rabelink TJ, Mooijaart SP, Dekker FW, van Buren M. Regret about the decision to start dialysis: a cross-sectional Dutch national survey. Neth J Med. 2017;75(6):225-34.
García Castro R, González Díaz I, Fernández Merayo C, Fernández Pérez M, Fernández Peñarroya J, Díaz Corte C. Satisfacción del paciente en diálisis (hemodiálisis y diálisis peritoneal): aspectos a mejorar. Enferm Nefrol. 2016; 19(3):248-54. DOI: https://doi.org/10.4321/S2254-28842016000300007
Romero-Ruiz Ana Belén, Sevillano-Jiménez Alfonso, Cardador-Trocoli Cristina. Factores asociados a la satisfacción del paciente en diálisis. Enferm Nefrol [Internet]. 2019 Jun [consultado 2024 Sep 04];22(2):112-23. DOI: https://doi.org/10.4321/S2254-28842019000200002
Tan EGF, Teo I, Finkelstein EA, Meng CC. Determinants of regret in elderly dialysis patients. Nephrology (Carlton) 2019;24(6):622-29. DOI: https://doi.org/10.1111/nep.13400
Juergensen E, Wuerth D, Finkelstein SH, Juergensen PH, Bekui A, Finkelstein FO. Hemodialysis and peritoneal dialysis: patients’ assessment of their satisfaction with therapy and the impact of the therapy on their lives. Clin J Am Soc Nephrol. 2006;1(6):1191-6. DOI: https://doi.org/10.2215/CJN.01220406
López Toledano Mª Carmen, Luque Cantarero Isabel, Gómez López Victoria Eugenia, Casas Cuesta Rafael, Crespo Montero Rodolfo. La satisfacción del paciente como componente de la calidad en las unidades de diálisis. Enferm Nefrol. [Internet]. 2016 [consultado 2024 Sep 04];9(2):125-33. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2254-28842016000200004 DOI: https://doi.org/10.4321/S2254-28842016000200004