Journal article
Exploring the Relationship Between Patient Activation, Treatment Satisfaction, and Decisional Conflict in Patients Approaching End-Stage Renal Disease
Annals of behavioral medicine, Vol.53(9), pp.816-826
08/16/2019
DOI: 10.1093/abm/kay091
PMCID: PMC6937620
PMID: 30535065
Abstract
Abstract Background Patients approaching end-stage renal disease (ESRD) experience a high level of decisional conflict because they are often not provided with sufficient support and information regarding different treatment options prior to renal failure. Decisional conflict is an important correlate of treatment satisfaction, as it is associated with disease- and treatment-related knowledge that can inform decision-making. Patient activation, the willingness and ability to independently manage one’s own health and healthcare, is an individual difference factor that may have important mitigating effects on decisional conflict. Purpose To identify modifiable factors that may enhance the decision-making process in patients approaching ESRD by exploring potential mediational effects between decisional conflict, treatment satisfaction, and patient activation. Methods Sixty-four patients approaching ESRD completed self-report measures (32% response rate). Measures included the Decisional Conflict Scale, the Kidney Disease Treatment Questionnaire, and the Patient Activation Measure Short Form. Results There was a high level of self-reported decisional conflict in this sample. Linear regressions revealed main effects among treatment satisfaction, patient activation, and decisional conflict. These variables were entered into PROCESS to assess a mediational pattern. Results showed that higher chronic kidney disease-related treatment satisfaction predicted lower decisional conflict through higher patient activation in a statistical mediational relationship. Conclusions While the link between treatment satisfaction and decision-making is well established, these results suggest this relationship might be partially explained by patient activation, a potentially modifiable process in patients approaching ESRD. Therefore, interventions that encourage patients to become actively involved in their care could also reduce decisional conflict among patients approaching ESRD.
Details
- Title: Subtitle
- Exploring the Relationship Between Patient Activation, Treatment Satisfaction, and Decisional Conflict in Patients Approaching End-Stage Renal Disease
- Creators
- Miriam Vélez-Bermúdez - Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IowaAlan J Christensen - Department of Psychological & Brain Sciences, University of Iowa, Iowa City, Iowa, Department of Internal Medicine, University of Iowa Hospitals & Clinics, Iowa City, IAEllen M Kinner - Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IowaAnne I Roche - Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IowaMony Fraer - Department of Internal Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Annals of behavioral medicine, Vol.53(9), pp.816-826
- DOI
- 10.1093/abm/kay091
- PMID
- 30535065
- PMCID
- PMC6937620
- ISSN
- 0883-6612
- eISSN
- 1532-4796
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health
- Comment
- Test development: Kidney Disease Treatment Questionnaire
- Language
- English
- Date published
- 08/16/2019
- Academic Unit
- Neurology; Psychological and Brain Sciences; Nephrology; Internal Medicine
- Record Identifier
- 9984094364402771
Metrics
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