Abstract:

Educating older individuals with chronic kidney disease requires special consideration—these patients frequently are of low socioeconomic status, and may have low literacy levels. Many existing education materials are not written with these unique patient needs in mind. Yet effective patient education is imperative because older individuals with chronic kidney disease often face a difficult choice between treatments: dialysis or conservative kidney care (treatment with medications but without dialysis). Dialysis may slightly lengthen life expectancy but it may also cause many symptoms; however, the alternative, conservative kidney care, is associated with a better quality of life but possibly shorter life expectancy. The ultimate treatment choice should be in the hands of the patient. Yet communication between patients and doctors about treatment options is often poor. Patients frequently report that dialysis is simply done to them, and that they have little say in the decision making; ultimately, decisional regret is common. To give patients a voice and choice, patient education is needed—patients need to know their options and be empowered to gather information and express their own preferences.

We will overview two patient education materials that we developed—an education booklet (to teach patients about their treatment options) and a question prompt list (to encourage patients to ask their doctors questions relevant to their care). Our survey results show that these materials were widely acceptable to both patients are caregivers. Specifically, among 30 responders (9 caregivers, 21 patients), the majority held positive options of the education booklet: most felt that the booklet was very easy to read (90%), and all felt that the information was clear (100%). Moreover, respondents learned new helpful things from the booklet (96.67%), felt the length was right (80%), believed most information (96.67%), deemed the pictures helpful (76.67%), felt treatment options were clearly explained (93.33%), thought the book will help people (100%), would recommend it (100%), and liked the overall presentation (100%). Patients also responded positively to the question prompt list. All patients felt that they could completely read and understand the list (100%); most patients deemed that the list was helpful (94.44%), easy to understand (100%), helped put questions and concerns into words (83.33%), raised questions or concerns they had not considered before (77.78%), and most would recommend the list (94.44%). In this presentation, we will break down the specific implementations of theory that were likely helpful in achieving these positive results and outline future improvements. This presentation would be of interest to health educators—particularly those working with underserved populations —and would be useful in showing how cross-disciplinary collaboration, namely cooperation between physicians and educators, can improve patient education and outcomes.

Keywords:

Patient education, patient decision aids, health literacy, renal replacement therapy.