Nephrology‐tailored geriatric assessment as decision‐making tool in kidney failure.

Background: Dialysis might not benefit all older patients with kidney failure, particularly those with multimorbid conditions and frailty. Patients' and healthcare professionals' awareness of the presence of geriatric impairments could improve outcomes by tailoring treatment plans and decisions for...

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Publicado en:Journal of Renal Care Vol. 50; no. 2; pp. 112 - 128
Autores principales: Berkhout‐Byrne, Noeleen C., Voorend, Carlijn G. N., Meuleman, Yvette, Mooijaart, Simon P., Brunsveld-Reinders, Anja H., Bos, Willem Jan W., Van Buren, Marjolijn
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2024
      vid: 50
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jorc.12466
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        atl: Nephrology‐tailored geriatric assessment as decision‐making tool in kidney failure.
      aug:
        au:
          Berkhout‐Byrne, Noeleen C.
          Voorend, Carlijn G. N.
          Meuleman, Yvette
          Mooijaart, Simon P.
          Brunsveld-Reinders, Anja H.
          Bos, Willem Jan W.
          Van Buren, Marjolijn
        affil: Department of Internal Medicine (Nephrology), Leiden University Medical Center, Leiden, The Netherlands
      sug:
        subj:
          Geriatric Assessment
          Patient Attitudes
          Attitude of Health Personnel
          Decision Making
          Kidney Failure, Chronic Therapy
          Nephrology
          Human
          Exploratory Research
          Qualitative Studies
          Dialysis
          Purposive Sample
          Thematic Analysis
          Quality of Life
          Renal Replacement Therapy
          Funding Source
          Aged
          Semi-Structured Interview
          Gerontologic Care
          Professional-Patient Relations
          Aged: 65+ years
      ab: Background: Dialysis might not benefit all older patients with kidney failure, particularly those with multimorbid conditions and frailty. Patients' and healthcare professionals' awareness of the presence of geriatric impairments could improve outcomes by tailoring treatment plans and decisions for individual patients. Objective: We aimed to explore the perspectives of patients and healthcare professionals on nephrology‐tailored geriatric assessment to fuel decision‐making for treatment choices in older patients with kidney failure. Design: In an exploratory qualitative study using focus groups, participants discussed perspectives on the use and value of nephrology‐tailored geriatric assessment for the decision‐making process to start or forego dialysis. Participants and Measurements: Patients (n = 18) with kidney failure, caregivers (n = 4), and professionals (n = 25) were purposively sampled from 10 hospitals. Interviews were audio‐recorded, transcribed verbatim and inductively analysed using thematic analysis. Results: Three main themes emerged that supported or impeded decision‐making in kidney failure: (1) patient psycho‐social situation; (2) patient‐related factors on modality choice; (3) organisation of health care. Patients reported feeling vulnerable due to multiple chronic conditions, old age, experienced losses in life and their willingness to trade longevity for quality of life. Professionals recognised the added value of nephrology‐tailored geriatric assessment in three major themes: (i) facilitating continual holistic assessment, (ii) filling the knowledge gap, and (iii) uncovering important patient characteristics. Conclusions: nephrology‐tailored geriatric assessment was perceived as a valuable tool to identify geriatric impairments in older patients with kidney failure. Integration of its outcomes can facilitate a more holistic approach to inform choices and decisions about kidney replacement therapy.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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