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The views and experiences of older people with conservatively managed renal failure: A qualitative study of communication, information and decision-making

BMC Nephrology Feb 12, 2019

Selman LE, et al. - Researchers examined the views and experiences of communication, information provision and treatment decision-making among older patients receiving conservative care via performing in-depth qualitative interviews with patients with stage 5 chronic kidney disease from three UK renal units. Participants described positive experiences of communicating with clinicians and receiving information, but also negative experiences involving insensitivity, rushing or ambiguity. As per participants, clinicians omitted/avoided conversations regarding diagnosis and prognosis, and described what helped and hindered good communication and support. Clinicians find communication particularly challenging when there was uncertainty about the disease trajectory and patients’ ambivalence regarding information. They identified criticality of tailoring information to patient preferences and conveying it clearly and sensitively. This study suggests the necessity for support and training for renal clinicians to ensure decision-making support for older patients is patient-centred.
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