Decision-making Support to Respect the Thoughts of Older Adults in Relation to Withdrawing Maintenance Hemodialysis

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  • 維持血液透析見合わせにおける高齢者の思いに添った意思決定支援
  • イジ ケツエキ トウセキ ミアワセ ニ オケル コウレイシャ ノ オモイ ニ ソッタ イシ ケッテイ シエン

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Abstract

<p>Purpose: The purpose of this study is to clarify the contents of decision-making support aimed to respect the thoughts of older adults in relation to withdrawing maintenance hemodialysis.</p><p>Methods: Semi-structured interviews were conducted targeting 13 Certified nurses in dialysis nursing, and analysis was conducted using a Modified Grounded Theory Approach.</p><p>Result: According to the certified dialysis nurses, it is necessary to “understand each specific situation of older adults as well as how they view dialysis treatment and prognosis” and to “provide information on dialysis treatment and prognosis in line with each specific situation and views of older adults.” It also became clear that, even after a patient has opted to withdraw treatment, it is important to provide “continuous support with future reversal of the decision to withdraw maintenance hemodialysis in mind” by “understanding how the older adult and his/her family view the decision to withdraw maintenance hemodialysis,” and it is important to provide “support in making a decision that is based on the desires of older adults” as well as “examination of optimal measures for older adults based on interprofessional collaboration.”</p><p>Conclusion: Results suggested that it is necessary to repeatedly conduct these types of support in accordance with the fluctuating moods of older adults.</p>

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