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Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions.

dc.contributor.author Ameling, Jessica M
dc.contributor.author Auguste, Priscilla
dc.contributor.author Ephraim, Patti L
dc.contributor.author Lewis-Boyer, LaPricia
dc.contributor.author DePasquale, Nicole
dc.contributor.author Greer, Raquel C
dc.contributor.author Crews, Deidra C
dc.contributor.author Powe, Neil R
dc.contributor.author Rabb, Hamid
dc.contributor.author Boulware, L Ebony
dc.coverage.spatial England
dc.date.accessioned 2014-01-27T03:44:26Z
dc.date.issued 2012-12-01
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/23198793
dc.identifier 1472-6947-12-140
dc.identifier.uri https://hdl.handle.net/10161/8328
dc.description.abstract BACKGROUND: Few educational resources have been developed to inform patients' renal replacement therapy (RRT) selection decisions. Patients progressing toward end stage renal disease (ESRD) must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients' treatment and support patients' decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. METHODS: We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in "stages." For the video, stages included (1) directed interviews with culturally appropriate patients and families and preliminary script development, (2) video production, and (3) screening the video with patients and their families. For the handbook, stages comprised (1) preliminary content design, (2) a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3) screening the handbook with patients and their families. RESULTS: The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals' testimonials regarding various considerations that might influence patients' and families' treatment selections. The handbook was comprised of written words, pictures of patients and health care providers, and diagrams describing the findings and quality of scientific studies comparing treatments. The handbook text was written at a 4th to 6th grade reading level. Pilot study results demonstrated that a majority of patients could understand information presented in the handbook. Patient and families screening the nearly completed video and handbook reviewed the materials favorably. CONCLUSIONS: This rigorously designed decision aid may help patients and families make informed decisions about their treatment options for RRT that are well aligned with their values.
dc.language eng
dc.publisher Springer Science and Business Media LLC
dc.relation.ispartof BMC Med Inform Decis Mak
dc.relation.isversionof 10.1186/1472-6947-12-140
dc.subject Adult
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Baltimore
dc.subject Choice Behavior
dc.subject Decision Support Techniques
dc.subject Female
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Pamphlets
dc.subject Patient Education as Topic
dc.subject Patient Participation
dc.subject Patient Satisfaction
dc.subject Pilot Projects
dc.subject Renal Replacement Therapy
dc.subject Video Recording
dc.title Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions.
dc.type Journal article
duke.contributor.id DePasquale, Nicole|0809060
duke.contributor.id Boulware, L Ebony|0078608
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/23198793
pubs.begin-page 140
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Community and Family Medicine
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, General Internal Medicine
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 12
dc.identifier.eissn 1472-6947
duke.contributor.orcid Boulware, L Ebony|0000-0002-8650-4212


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