Advance Care Planning With Patients Who Have End-Stage Kidney Disease: A Systematic Realist Review

Journal of Pain and Symptom Management
Peter O'HalloranKevin Brazil

Abstract

Patients with end-stage kidney disease have a high mortality rate and disease burden. Despite this, many do not speak with health care professionals about end-of-life issues. Advance care planning is recommended in this context but is complex and challenging. We carried out a realist review to identify factors affecting its implementation. The objectives of this study are 1) to identify implementation theories; 2) to identify factors that help or hinder implementation; and 3) to develop theory on how the intervention may work. We carried out a systematic realist review, searching seven electronic databases: Medline, Embase, CINAHL, PsycINFO, Cochrane Library, Google Scholar, and ScienceDirect. Sixty-two papers were included in the review. We identified two intervention stages-1) training for health care professionals that addresses concerns, optimizes skills, and clarifies processes and 2) use of documentation and processes that are simple, individually tailored, culturally appropriate, and involve surrogates. These processes work as patients develop trust in professionals, participate in discussions, and clarify values and beliefs about their condition. This leads to greater congruence between patients and surrogates; increase...Continue Reading

Citations

Dec 24, 2019·Nursing Standard·Claire CarswellClare McKeaveney
Mar 1, 2020·BMJ Open·Noel EngelsAnne M Stiggelbout
Jul 20, 2018·The Cochrane Database of Systematic Reviews·France LégaréNorbert Donner-Banzhoff
Sep 11, 2020·Journal of the American Society of Nephrology : JASN·Catherine R ButlerAnn M O'Hare
Feb 20, 2021·Journal of Palliative Medicine·Jennifer St Clair RussellAmber Paulus
Jun 8, 2021·Notfall & Rettungsmedizin·Spyros D MentzelopoulosLeo Bossaert
Jun 29, 2021·Journal of Nephrology·Micaella Sotera HansenRonald Lynel Castelino

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