Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions
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 = 1...
Ausführliche Beschreibung
Autor*in: |
Vandenberg, Ann E. [verfasserIn] Bowling, C. Barrett [verfasserIn] Adisa, Olufunmilola [verfasserIn] Sahlie, Abyalew [verfasserIn] Nadel, Leigh [verfasserIn] Lea, Janice [verfasserIn] Plantinga, Laura C. [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2019 |
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Schlagwörter: |
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Übergeordnetes Werk: |
Enthalten in: Patient education and counseling - Amsterdam [u.a.] : Elsevier Science, 1983, 102, Seite 1280-1287 |
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Übergeordnetes Werk: |
volume:102 ; pages:1280-1287 |
DOI / URN: |
10.1016/j.pec.2019.02.012 |
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Katalog-ID: |
ELV002353334 |
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520 | |a 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. | ||
650 | 4 | |a Renal dialysis | |
650 | 4 | |a End-stage renal disease | |
650 | 4 | |a Decision making | |
650 | 4 | |a Social values | |
650 | 4 | |a Physician-patient communication | |
700 | 1 | |a Bowling, C. Barrett |e verfasserin |4 aut | |
700 | 1 | |a Adisa, Olufunmilola |e verfasserin |4 aut | |
700 | 1 | |a Sahlie, Abyalew |e verfasserin |4 aut | |
700 | 1 | |a Nadel, Leigh |e verfasserin |4 aut | |
700 | 1 | |a Lea, Janice |e verfasserin |4 aut | |
700 | 1 | |a Plantinga, Laura C. |e verfasserin |4 aut | |
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2019 |
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44.07 |
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2019 |
allfields |
10.1016/j.pec.2019.02.012 doi (DE-627)ELV002353334 (ELSEVIER)S0738-3991(19)30037-0 DE-627 ger DE-627 rda eng 610 DE-600 44.07 bkl Vandenberg, Ann E. verfasserin aut Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Renal dialysis End-stage renal disease Decision making Social values Physician-patient communication Bowling, C. Barrett verfasserin aut Adisa, Olufunmilola verfasserin aut Sahlie, Abyalew verfasserin aut Nadel, Leigh verfasserin aut Lea, Janice verfasserin aut Plantinga, Laura C. verfasserin aut Enthalten in Patient education and counseling Amsterdam [u.a.] : Elsevier Science, 1983 102, Seite 1280-1287 Online-Ressource (DE-627)320596044 (DE-600)2019572-2 (DE-576)264423984 1873-5134 nnns volume:102 pages:1280-1287 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.07 Medizinische Psychologie AR 102 1280-1287 |
spelling |
10.1016/j.pec.2019.02.012 doi (DE-627)ELV002353334 (ELSEVIER)S0738-3991(19)30037-0 DE-627 ger DE-627 rda eng 610 DE-600 44.07 bkl Vandenberg, Ann E. verfasserin aut Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Renal dialysis End-stage renal disease Decision making Social values Physician-patient communication Bowling, C. Barrett verfasserin aut Adisa, Olufunmilola verfasserin aut Sahlie, Abyalew verfasserin aut Nadel, Leigh verfasserin aut Lea, Janice verfasserin aut Plantinga, Laura C. verfasserin aut Enthalten in Patient education and counseling Amsterdam [u.a.] : Elsevier Science, 1983 102, Seite 1280-1287 Online-Ressource (DE-627)320596044 (DE-600)2019572-2 (DE-576)264423984 1873-5134 nnns volume:102 pages:1280-1287 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.07 Medizinische Psychologie AR 102 1280-1287 |
allfields_unstemmed |
10.1016/j.pec.2019.02.012 doi (DE-627)ELV002353334 (ELSEVIER)S0738-3991(19)30037-0 DE-627 ger DE-627 rda eng 610 DE-600 44.07 bkl Vandenberg, Ann E. verfasserin aut Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Renal dialysis End-stage renal disease Decision making Social values Physician-patient communication Bowling, C. Barrett verfasserin aut Adisa, Olufunmilola verfasserin aut Sahlie, Abyalew verfasserin aut Nadel, Leigh verfasserin aut Lea, Janice verfasserin aut Plantinga, Laura C. verfasserin aut Enthalten in Patient education and counseling Amsterdam [u.a.] : Elsevier Science, 1983 102, Seite 1280-1287 Online-Ressource (DE-627)320596044 (DE-600)2019572-2 (DE-576)264423984 1873-5134 nnns volume:102 pages:1280-1287 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.07 Medizinische Psychologie AR 102 1280-1287 |
allfieldsGer |
10.1016/j.pec.2019.02.012 doi (DE-627)ELV002353334 (ELSEVIER)S0738-3991(19)30037-0 DE-627 ger DE-627 rda eng 610 DE-600 44.07 bkl Vandenberg, Ann E. verfasserin aut Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Renal dialysis End-stage renal disease Decision making Social values Physician-patient communication Bowling, C. Barrett verfasserin aut Adisa, Olufunmilola verfasserin aut Sahlie, Abyalew verfasserin aut Nadel, Leigh verfasserin aut Lea, Janice verfasserin aut Plantinga, Laura C. verfasserin aut Enthalten in Patient education and counseling Amsterdam [u.a.] : Elsevier Science, 1983 102, Seite 1280-1287 Online-Ressource (DE-627)320596044 (DE-600)2019572-2 (DE-576)264423984 1873-5134 nnns volume:102 pages:1280-1287 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.07 Medizinische Psychologie AR 102 1280-1287 |
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10.1016/j.pec.2019.02.012 doi (DE-627)ELV002353334 (ELSEVIER)S0738-3991(19)30037-0 DE-627 ger DE-627 rda eng 610 DE-600 44.07 bkl Vandenberg, Ann E. verfasserin aut Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Renal dialysis End-stage renal disease Decision making Social values Physician-patient communication Bowling, C. Barrett verfasserin aut Adisa, Olufunmilola verfasserin aut Sahlie, Abyalew verfasserin aut Nadel, Leigh verfasserin aut Lea, Janice verfasserin aut Plantinga, Laura C. verfasserin aut Enthalten in Patient education and counseling Amsterdam [u.a.] : Elsevier Science, 1983 102, Seite 1280-1287 Online-Ressource (DE-627)320596044 (DE-600)2019572-2 (DE-576)264423984 1873-5134 nnns volume:102 pages:1280-1287 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.07 Medizinische Psychologie AR 102 1280-1287 |
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Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions |
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Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions |
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Vandenberg, Ann E. |
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Vandenberg, Ann E. Bowling, C. Barrett Adisa, Olufunmilola Sahlie, Abyalew Nadel, Leigh Lea, Janice Plantinga, Laura C. |
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shared patient and provider values in end-stage renal disease decision making: identifying the tensions |
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Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions |
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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. |
abstractGer |
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. |
abstract_unstemmed |
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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