Dialysis decision regret less likely for those who discuss prognosis with doctors, complete living will
FRIDAY, June 5, 2020 (HealthDay News) — Patients who report choosing dialysis to please doctors or family members more often report decisional regret, according to a study published online June 4 in the Clinical Journal of the American Society of Nephrology.
Fahad Saeed, M.D., from the University of Rochester School of Medicine and Dentistry in New York, and colleagues administered a 41-item questionnaire to adult patients receiving maintenance dialysis in seven units located in Cleveland. Predictors of regret were identified.
The researchers found that 21 percent of the 397 respondents reported decisional regret. No significant demographic correlates of regret were identified. When patients reported choosing dialysis to please doctors or family members, regret was more common (odds ratio, 2.34). The likelihood of reporting regret with dialysis initiation was lower for patients who reported having a prognostic discussion about life expectancy with their doctors and for those who completed a living will (odds ratios, 0.42 and 0.48, respectively).
“Patients might be less likely to experience regret if nephrology fellows and nephrologists receive training in primary palliative care skills, including goals-of-care communication, prognostic discussions, shared decision-making, and documentation of end-of-life wishes,” the authors write. “Future research, should examine how interventions targeting risk factors for dialysis regret might mitigate regret by enhancing patient participation in decisions about whether and when to initiate dialysis.”
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