Chapter 71
Shared Decision-making
Jane Schell,
Kerri Cavanaugh,
Talia Gutman,
Jane Schell
Section of Palliative Care and Medical Ethics, Division of Renal-Electrolyte, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Health System, Pittsburgh, PA, USA
Search for more papers by this authorKerri Cavanaugh
Division of Nephrology & Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
Search for more papers by this authorTalia Gutman
Sydney School of Public Health, The University of Sydney, NSW, Australia
The Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
Search for more papers by this authorJane Schell,
Kerri Cavanaugh,
Talia Gutman,
Jane Schell
Section of Palliative Care and Medical Ethics, Division of Renal-Electrolyte, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Health System, Pittsburgh, PA, USA
Search for more papers by this authorKerri Cavanaugh
Division of Nephrology & Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
Search for more papers by this authorTalia Gutman
Sydney School of Public Health, The University of Sydney, NSW, Australia
The Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia
Search for more papers by this authorBook Editor(s):Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS,
Donald A. Molony MD,
Giovanni F.M. Strippoli MD, PhD, MPH, MM (Epi),
Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS
Matthew Flinders Distinguished Professor Vice President and Executive Dean
College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorDonald A. Molony MD
Professor of Medicine Distinguished Teaching Professor of the University of Texas System
Division of Renal Diseases and Hypertension AND Center for Clinical Research and Evidence-based Medicine, McGovern Medical School University of Texas, Houston, TX, USA
Search for more papers by this authorGiovanni F.M. Strippoli MD, PhD, MPH, MM (Epi)
Professor of Nephrology Adjunct Professor of Epidemiology
Department of Emergency and Organ Transplantation – University of Bari, Bari, Italy
School of Public Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorFirst published: 18 November 2022
Summary
Shared Decision-making (SDM) in nephrology care is an essential component to ensuring patients to make informed decisions that reflect their priorities. This chapter summarizes SDM in nephrology care, particularly for older patients with advanced comorbidities facing difficult decisions about treatment of advanced kidney disease and preferences for end-of-life care. It also discusses communication strategies to facilitate clinicians in engaging in SDM. SDM responds to the limitations of these traditional models and addresses real-world challenges to decision making within healthcare. A fundamental component of SDM in advanced kidney disease involves providing patient-specific prognostic information. Advance care planning is a continuous process through which providers engage in discussions with patients and their families to learn their goals and preferences toward future medical treatments. Decision tools can help patients consider the treatment options in terms of their values and priorities.
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