The physician-patient relationship in dialysis (original) (raw)
Related papers
A relação entre médico e pessoa doente na diálise
Introduction: Despite many technical and scientific advances in haemodialysis, the outcomes in patients with end stage renal disease are far from reaching the desired targets. How can they be improved? The doctor-patient relationship is a key issue in the healthcare provided to patients with end stage chronic kidney disease on dialysis. Patients and Methods: We, therefore, built a patient-centred biopsychosocial personalized approach to enhance patient autonomy and self-care as an alternative to the conventional medical approach to dialysis patients. We compared patient satisfaction achieved in both approaches using a patient satisfaction questionnaire, and we assessed the correlation between satisfaction and social, clinical and biological outcomes. Results and Conclusion: The alternative physician-patient relationship approach achieved better outcomes than the conventional one, and so it must be the choice approach for these patients.
The physician patient relationship publicacao 2013 10
Introduction: Despite many technical and scientific advances in haemodialysis, the outcomes in patients with end stage renal disease are far from reaching the desired targets. How can they be improved? The doctor-patient relationship is a key issue in the healthcare provided to patients with end stage chronic kidney disease on dialysis. Patients and Methods: We, therefore, built a patient-centred biopsychosocial personalized approach to enhance patient autonomy and self-care as an alternative to the conventional medical approach to dialysis patients. We compared patient satisfaction achieved in both approaches using a patient satisfaction questionnaire, and we assessed the correlation between satisfaction and social, clinical and biological outcomes. Results and Conclusion: The alternative physician-patient relationship approach achieved better outcomes than the conventional one, and so it must be the choice approach for these patients.
Factors Affecting Hemodialysis Patients' Satisfaction with Their Dialysis Therapy
International Journal of Nephrology, 2010
Aim. To assess the degree of satisfaction among hemodialysis patients and the factors influencing this satisfaction. Methods. Patients were recruited from 3 Saudi dialysis centers. Demographic data was collected. Using 1 to 10 Likert scale, the patients were asked to rate the overall satisfaction with, and the overall impact of, their dialysis therapy on their lives and to rate the effect of the dialysis therapy on 15 qualities of life domains. Results. 322 patients were recruited (72.6% of the total eligible patients). The mean age was 51.7 years (±15.4); 58% have been on dialysis for >3 years. The mean Charlson Comorbidity Index was 3.2 (±2), and Kt/V was 1.3 (±0.44). The mean satisfaction score was (7.41 ± 2.75) and the mean score of the impact of the dialysis on the patients' lives was 5.32 ± 2.55. Male patients reported worse effect of dialysis on family life, social life, energy, and appetite. Longer period since the commencement of dialysis was associated with adverse effect on finances and energy. Lower level of education was associated with worse dialysis effect on stress, overall health, sexual life, hobbies, and exercise ability. Conclusion. The level of satisfaction is affected by gender, duration on dialysis, educational level, and standard of care given.
Examination of the Satisfaction Levels of Hemodialysis Patients
Studies on Ethno-Medicine, 2017
The purpose of this study is to examine the satisfaction levels of patients who are being treated in hemodialysis unit in terms of different variables. A total of 222 patients were included in the research and they were being treated in nursing homes in the provinces of Istanbul,
Satisfaction with care in peritoneal dialysis patients
Kidney International, 2006
Patient satisfaction is an important aspect of dialysis care, only recently evaluated in clinical studies. We developed a tool to assess peritoneal dialysis (PD) customer satisfaction, and sought to evaluate and validate the Customer Satisfaction Questionnaire (CSQ), quantifying PD patient satisfaction. The CSQ included questions regarding administrative issues, Delivery Service, PD Training, Handling Requests, and transportation. The study was performed using interviews in all Hungarian Fresenius Medical Care dialysis centers offering PD. CSQ results were compared with psychosocial measures to identify if patient satisfaction was associated with perception of social support and illness burden, or depression. We assessed CSQ internal consistency and validity. Factor analysis explored potential underlying dimensions of the CSQ. One hundred and thirty-three patients treated with PD for end-stage renal disease for more than 3 months were interviewed. The CSQ had high internal consistency. There was high patient satisfaction with customer service. PD patient satisfaction scores correlated with quality of life (QOL) and social support measures, but not with medical or demographic factors, or depressive affect. The CSQ is a reliable tool to assess PD customer satisfaction. PD patient satisfaction is associated with perception of QOL. Efforts to improve customer satisfaction may improve PD patients' quantity as well as QOL.
The care preferences of patients under hemodialysis
Journal of renal injury prevention, 2017
Introduction: Patient-centered care is an approach to healthcare that focuses on the preferences and needs of the patients. Clarifying patients' care preferences helps facilitate and improve the process of advance care planning. Objectives: The present study was conducted to examine the care preferences of patients under hemodialysis. Patients and Methods: The present study uses qualitative content analysis to examine the care preferences of patients under hemodialysis. The data required for the study was collected through semi-structured interviews held with 20 participants selected according to purposive sampling and continued until data saturation was reached. Results: The analysis of the data led to the extraction of the two sub-themes of "dependence on dialysis" and "protection" for the main theme of "preserving life", the three sub-themes of "acceptance of hemodialysis", "receiving information" and "adapting to limitations" for the main theme of "self-care", the two sub-themes of "friendly relationships" and "competent staff" for the main theme of "expert care providers", and the three sub-themes of "support", "equipment" and "facilities" for the main theme of "proper care conditions." Conclusion: "Preserving life" comprised the main care preference of the examined patients under hemodialysis. Clarifying the patients' care preferences helps maintain their health and provide them with a more comfortable and satisfactory experience of hemodialysis.
Satisfaction with health care of hemodialysis patients
Research in Nursing & Health, 1987
The purpose of this study was to assess the satisfaction with care of hemodialysis patients, and to explore the relationships between satisfaction with care, quality of life, and background variables. The sample (n = 416) was randomly selected from the adult, in unit hemodialysis patient population of a north central state. Overall, patients were satisfied with their care (M = 5.04, range = 1 to 6). An ANOVA demonstrated that patients were most satisfied with physician related aspects of care, followed by nursing/dialysis treatment aspects, and least satisfied with financial/transportation aspects (F(2,830) = 28.44, p < 0.0001). Overall satisfaction with care was most highly correlated with satisfaction with medical (r = 0.74) and nursing care (r = 0.74). Satisfaction with care was moderately correlated with quality of life (r = 0.42) and satisfaction with health and functioning (r = 0.42). Somewhat weaker relationships were found between satisfaction with care and socioeconomic aspects of life (r = 0.31), psychological/spiritual aspects (r = 0.32), and family (r = 0.27). Patients who had been on dialysis for a shorter length of time or who had less education were more satisfied with care.
Patient satisfaction with in-centre haemodialysis care: an international survey
BMJ Open, 2014
Objectives: To evaluate patient experiences of specific aspects of haemodialysis care across several countries. Design: Cross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire. Setting: Haemodialysis clinics within a single provider in Europe and South America.
Open Journal of Nephrology, 2019
Background: Patients' satisfaction is a relevant component in assessing healthcare services. The objective of this study was to study the level of satisfaction of chronic hemodialysis patients and the associated factors in Cotonou CNHU-HKM dialysis center. Patients and Methods: It was a cross-sectional, descriptive and analytical study conducted by administering a questionnaire on days off dialysis. It was carried out from 1 st November 2015 to 1 st January 2016 in CNHU-HKM Nephrology University Clinic of Cotonou. Hemodialysis patients aged 18 years and above having given their informed consent were included in the study. Patients' recruitment was comprehensive. Likert scale was used in assessing the level of satisfaction with 4 as "very satisfied" and 1 for "very dissatisfied". Satisfaction was evaluated on the basis of Ware dimensions. The threshold for satisfaction was 50. Outcomes: Overall, 377 patients were included in the study. Respondents' mean age was 51.5 ± 13.3 years with 1.37 as sex ratio. Arteriovenous fistula was used for 80.1% of hemodialysis patients. 77.7% of the patients underwent dialysis twice a week while 45.9% were administered a four-hour dialysis. The overall average proportion of "satisfied" was 76.5%. The level of satisfaction was 52% for healthcare environment, 61% for service delivery, 73.9% for healthcare accessibility, 76.1% for healthcare structure, 77.5% for healthcare management, 90.3% for quality of healthcare, 88.3% for interpersonal relationship and 93.2% for efficiency and continuum of healthcare. Factors associated with satisfaction included age (p = 0.02), vascular access (p = 0.04) and urea reduction ratio (p = 0.01). In addition, the degree of satisfaction of hemodialysis patients was not How to cite this paper:
American Journal of Kidney Diseases, 1997
Quality assessment efforts to enhance public accountability in dialysis care and to support provider efforts to improve care have lacked patient input. To develop brief patient evaluation or satisfaction surveys suitable for busy clinical settings, knowing patients' priorities can be helpful in deciding which aspects of care should be tracked. We conducted a study to identify salient attributes of dialysis care and to rank the importance of these attributes from the perspective of dialysis patients. We analyzed the content of patient focus group transcripts to characterize dialysis care from the patients' perspective. We then surveyed 86 patients to determine how patients would rank the importance of each aspect to quality of dialysis care. The 18 broad aspects of care identified in the focus group included: (1) care provided by nephrologists, (2) care provided by other physicians (nonnephrologists), (3) care provided by dialysis center nurses, (4) care provided by social workers and psychologists, (5) care provided by dieticians, (6) clergy, (7) care provided by technicians and physician assistants/nurse practitioners, (8) care provided by dialysis center staff in general, (9) supplies, (10) treatment choice and effectiveness, (11) patient education and training, (12) self-care, (13) dialysis machines, (14) unit environment and policies, (15) cost containment, (16) billing, (17) cost of care, and (18) health outcomes. Items ranked in the top 10 by both groups of patients included issues related to nephrologists, other doctors, nurses, and patient education and training. Compared with hemodialysis patients, peritoneal dialysis patients gave higher ratings to hospital doctors' and nurses' attention to cleanliness when working with access sites, how correct the nephrologist's instructions to patients are, whether emergency room doctors check with nephrologists, the amount of information patients get about their diet, and how well nurses answer patients' questions. Patients value certain aspects of dialysis care highly, and these aspects differed in some respects for the relatively small number of hemodialysis and peritoneal dialysis patients studied. Construction of brief questionnaires for quality assessment and assurance requires thoughtful consideration of what questions to include. Knowing patients' priorities regarding the most important aspects of care that have high potential for dissatisfaction may be helpful to continuous quality improvement of end-stage renal disease care.