The Effect of Shared Decision-Making on Dialysis Therapy Choice and

Quality of Life.

Elaine A. Dean RN, BSN, CDN Jacksonville University, Brooks Rehabilitation Research Center

Purpose
The purpose of this study is to examine the role of shared
decision-making among the elderly cohort of end-stage renal
disease patients stages 4 and 5 in choosing independent home-
based therapies versus in-center hemodialysis and its influence on
improved quality of life
Research Question
Population
Fifty six participants (6 women and 50 men) between 65-95
years of age diagnosed with end-stage renal disease
Sample Instrument
The measurement instrument to be used is the Ferrans and
Powers Quality of Life Index Dialysis Version 111 (QLI – V111).
There are two parts to this instrument each part is a 35-item
section that measures importance and satisfaction based on
Data Analysis
The Statistical Package for Social Sciences (SPSS) with
regression will be used analyze the data. The level of
significance will be assessed for p = 0.05 or less which will
conclude statistical significance. The data will be organized and References
summarized using the descriptive function of SPSS to obtain 1. Aasen, E., A., Kvangarsnes, M., & Heggan, K. (2011).
output data including frequency, mean, median and standard Perceptions of patient participation amongst elderly patients
deviation. Inferential statistics, t-test will be used to determine with end-stage renal disease in a dialysis unit. Scandinavian
the strength of the relationship within the sample. Journal of Caring Sciences, 26, 61-
69.http;//dx.doi.org/10.1111/j.1471-6712.2012.00904

What is the effect of shared decision-making in choosing various aspects of life. The items are grouped into four 2. Chiou, C. P., & Chung, Y. C. (2011). The effective of

independent dialysis therapies compared to in-center subscale: health and functioning, psychological and spiritual, Table 2—Demographic Variables multimedia interactive patient education on knowledge,
uncertainty and decision-making in patients with end-stage
hemodialysis and the effect on quality of life among the older social and economical and family renal disease. Journal of Clinical Nursing, 21, 1223-1231.
adult with end-stage renal disease. http://dx.doi.org/10.1111/j.1365-2702.2011.03793.x
Data Analysis Shells
3. Harwood, L., & Clark, A., M. (2014). Dialysis modality
decision-making for older adults with chronic kidney disease.
Demographic Variables Level of Measurement Reason for Inclusion Descriptive Statistics
Journal of Clinical Nursing, 23, 3373-3390.
Age Interval Information is necessary for Frequency, mean, standard
http://dx.doi.org/10/1111/jocn.12582.
Framework
generalizability of population deviation, mean
4. Harwood, L., Wilson, B., Sontrop, J., Clark, A. M. (2012).
The frame work follow the concept of Orems Self-Care Deficit Chronic kidney disease stressors influence choice of dialysis
modality. Journal Of Advanced Nursing, 68(11), 2454-2465.
Nursing Theory. It is based on the premise that all individuals Gender Nominal Information is necessary for
generalizability of population
Frequency, percent
http://dx.doi.org/10.1111/j.1365-2648.2012.05943.x
are capable of self-care thus, they represent what Orem
5. Loiselle, M. C., O’Connor, A. M., & Michaud, C. (2011).
refers to as the self-care agency. The conceptual and Developing a decision support intervention regarding choice
structural concepts was organized based on the application of
Education Level Ordinal Is there a relationship between Frequency, percent , median
education and therapy choices
of dialysis modality. The CANNT Journal, 21(3).
shared decision-making to establish a relationship between
6. Nabolsi, M. M., Wardam, L., Al-Halabi, J. O., (2015).
self-care (performing independent therapies) and improved
Marital Status Ordinal Is there a relationship between Frequency, percent
marital status therapy choices Quality of life, depression, adherence to treatment and illness
quality of life.
and quality of life
perception of patient on hemodialysis. International Journal
of Nursing Practice, 21, 1-10.
Data Collection Ethnicity Nominal Information is necessary for the Frequency, percent
http://dx.doi.org/10.1111/ijn.12205
generalizability of the population
7. O’Shaughnessy, M. (2014). Application of Dorothea Orem’s
theory of self-care to the elderly patient on patient on
pertoneal dialysis. Nephrology Journal of Nursing, 41(5)
Data Collection Spreadsheet
Educational Marital Decisional Tool 8. Rosenroll, A.D., Higuchi, K. S., Dutton, K. S., Murray, M.
Table 3 – Study Variables
Nunerical ID Age Gender Pretest QLI Scores Post Test
Level Status Outcome
A., & Stacy, D. (2013). Perspective of significant others in
dialysis modality decision-making: A qualitative study. The
CANNT Journal, 23(4).
Study Variables Level of Measurement Descriptive Data Inferential Statistics
9. Sondrup, B., & Copeland, M. (2011). Supporting patient: An
intervention to promote independent dialysis therapies.
Quality of Life Ratio Mean, standard deviation, t-test
Nephrology Nursing Journal, 38(6).
percentages

Design
Shared Decision Making Nominal Frequency, percentages t-test
A quasi-experimental pretest and posttest comparison design
comparing the quality of life outcome of patients who received
shared decision- making intervention with similar patients who
did not receive the care. This classic experimental design will Sample APA Table for Results
identify the implementation of the independent variable (IV)
shared decision-making and the measurement of the dependent
variable (DV) quality of life.
Mean Standard Deviation (SD)

Figure 1
Data will be collected at the beginning and at the end of the
Total Scale QOL

study. Demographic data collection and pretest of both groups Subscale QOL

will be collected at the start. The intervention will be

administered to the experimental group. At the end of the
Health and Functioning

study the posttest and and Quality of Life Index will be Socioeconomic

completed. A Likert questionnair will gather some supplemental

data on the therapy chosen by both group. An excel spread Psychological and spiritual

sheet will facilitate the input of data. Accurate and concise

data management will be practiced.