Suma Prakash|A. McGrail|Steven Lewis|Jesse D. Schold|Mary Ellen Lawless|Ashwini R. Sehgal|Adam T. Perzynski
Behavioral Stage of Change and Dialysis Decision-Making
MetroHealth Medical Center|Case Western Reserve University|MetroHealth|MetroHealth Medical Center|MetroHealth|MetroHealth Medical Center|Cleveland Clinic|MetroHealth Medical Center|Case Western Reserve University|MetroHealth Medical Center|Case Western Reserve University|MetroHealth Medical Center|Case Western Reserve University
behavioral stage change soc algorithms classify patients readiness medical treatment decisionmaking precontemplation stage patients intention take action within 6 months contemplation stage action intended within 6 months preparation stage patients intend take action within 30 days action stage change made study examines influence soc dialysis modality decisionmakingsoc relevant covariates measured associations dialysis decisionmaking determined indepth interviews conducted 16 patients dialysis elicit experiences qualitative interview data informed survey design surveys administered adults ckd egfr25 mlmin173 m2 august 2012 june 2013 multivariable logistic regression modeled dialysis decisionmaking predictors soc provider connection dialysis knowledge scorefiftyfive patients completed survey 71 women 39 white 59 black median annual income 17500 total 65 patients precontemplationcontemplation thinking 35 patients preparationmaintenance acting soc 62 patients made dialysis modality decisions doctors explaining modality options higher dialysis knowledge scores fewer lifestyle barriers associated acting versus thinking soc p002 patients making modality decisions doctors explained dialysis options 76 versus 43 acting versus thinking soc 50 versus 10 higher dialysis knowledge scores 14 versus 05 lower egfr 139 versus 168 mlmin173 m2 p005 adjusted analyses dialysis knowledge significantly associated decisionmaking odds ratio 42 95 confidence interval 14 129 p001 soc borderline significance odds ratio 58 95 confidence interval 10 326 p005 model c statistic 087dialysis decisionmaking associated soc dialysis knowledge physicians discussing treatment options future studies determining ways assist patients ckd making satisfying modality decisions warranted