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Education for Patients With Progressive CKD and Acute-Start Dialysis

      For individuals living with CKD and those who have been discovered to have ESRD, the decisions facing them can be daunting. Such decisions include having renal replacement therapy (RRT) or conservative care, having a kidney transplant, or selecting a modality of dialysis that would fit their lifestyle and values. Education at this critical time is essential, but it must be tailored to the individual and his or her readiness to learn, and it must be provided with empathy and understanding of the chronicity of the disease and the magnitude of the effect of kidney failure on their life. We present strategies derived from education and psychology that can assist health-care practitioners to provide such education and support to individuals with advanced CKD. We also present an approach to educate and support those who have urgently started dialysis and require chronic RRT. This educational model has its basis in theories of education and decision-making and has been used with success in this population.

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      References

        • Devins G.M.
        • Mendelssohn D.C.
        • Barré P.E.
        • Binik Y.M.
        Predialysis psychoeducational intervention and coping styles influence time to dialysis in chronic kidney disease.
        Am J Kidney Dis. 2003; 42: 693-703
        • Goldstein M.
        • Yassa T.
        • Dacouris N.
        • McFarlane P.
        Multidisciplinary predialysis care and morbidity and mortality of patients on dialysis.
        Am J Kidney Dis. 2003; 44: 706-714
        • Devins G.M.
        • Mendelssohn D.C.
        • Barré P.E.
        • Taub K.
        • Binik Y.M.
        Predialysis psychoeducational intervention extends survival in CKD: a 20-year follow-up.
        Am J Kidney Dis. 2005; 46: 1088-1098
        • Registered Nurses’ Association of Ontario
        Decision support for adults living with chronic kidney disease.
        Registered Nurses’ Association of Ontario, Toronto, Canada2009 (Available at:) (Accessed February 19, 2013)
        • Stanton M.
        Teaching patients: some basic lessons for nurse educators.
        Nurs Manage. 1985; 16: 59-62
        • Miller W.R.
        • Rollnick S.
        Motivational interviewing: preparing people to change addictive behavior.
        The Guilford Press, New York, NY1985
        • Miller C.E.
        • Johnson J.L.
        Motivational interviewing.
        Can Nurse. 2001; 97: 32-33
        • Prochaska J.O.
        • Norcross J.C.
        • Diclemente C.C.
        Changing for good.
        Avon Books, New York, NY1994
        • Knowles M.
        The adult learner: a neglected species.
        Gulf, Houston, TX1973
        • Knowles M.S.
        The modern practice of adult education.
        Cambridge, The Adult Education Company, New York, NY1980
        • Ballerini L.
        • Paris V.
        Nosogogy: when the learner is a patient with chronic renal failure.
        Kidney Int. 2006; 70: S112-S126
        • Moss M.K.
        Communicating qualitative and quantitative decision support information.
        New Dir Inst Res. 2001; 112: 57-66
        • Murray M.A.
        • Brunier G.
        • Chung J.O.
        • et al.
        A systematic review of factors influencing decision-making in adults living with chronic kidney disease.
        Patient Educ Couns. 2009; 76: 149-158
        • Murray M.A.
        • Thomas A.
        • Wald R.
        • Marticorena R.
        • Donnelly S.
        • Jeffs L.
        Exploring the impact of a decision support intervention on vascular access decisions in chronic hemodialysis patients.
        BMC Nephrol. 2011; 12: 7
        • Knowles M.
        • Holton E.
        • Swanson R.
        The Adult Learner.
        6th ed. Elsevier, New York, NY2005
        • Watson D.M.
        Acute start—chronic needs: education and support for adults who have had acute start dialysis.
        Semin Dial. 2013; 26: 184-187
        • Murray M.A.
        • Bissonnette J.
        • Kryworuchko J.
        • Gifford W.
        • Calverley S.
        Whose choice is it? Shared decision making in nephrology care.
        Semin Dial. 2013; 26: 169-174
      1. Ottawa Hospital Research Institute. Ottawa Personal Decision Guide. Available at: http://decisionaid.ohri.ca/docs/das/OPDG.pdf. Accessed October 18. 2012.

      2. National Kidney Disease Education Program. Available at: http://nkdep.nih.gov/identify-manage/prepare-rrt.shtml. Accessed March 6, 2013.

        • Ong S.
        • Jassal S.V.
        • Porter E.
        • Logan A.G.
        • Miller J.A.
        Using an electronic self-management tool to support patients with chronic kidney disease (CKD): a CKD clinic self-care model.
        Semin Dial. 2013; 26: 195-202