Applying Shared Decision Making With End-Stage Renal Disease Patients Undergoing Renal Replacement Therapy to Reduce Decision Making Conflicts

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The shared decision making (SDM) is an innovative, emerging clinical medical decision model in Taiwan. This model allows patients to understand the possible benefits, hazards, and risks of different treatment options and to choose the treatment option that best aligns with their values and preferences, thereby reducing patients' decisional conflicts. The survival rate of patients with end-stage renal disease (ESRD) has improved, in part due to the rapid development of medical technologies and treatment modalities. However, survival requires that patients face the choice conflicts associated with renal replacement therapy. All of the various renal replacement therapy treatment options impact the physical state of patients, cause changes in their daily life, and undermine their normal work and social roles. Patients often deal with conflict, uncertainty, and hesitation when they engage in making decisions about renal replacement therapy, as the course of treatment is long-term and the effects accompany the patients for the remainder of their life. This article discusses the decisional conflicts of ESRD patients in renal replacement therapy and its influencing factors. The authors propose the SDM approach to renal replacement therapy as a care reference for clinical health professionals.