Abstract
Background The incidence rate of end-stage renal disease (ESRD) in Taiwan is the highest worldwide. Patients often hesitate and feel helpless when deciding whether to receive dialysis. However, the resulting delay in starting dialysis can potentially threaten patients' lives. Purpose This study aimed to understand the current situation and correlations between hope, social support, and decisional conflict among patients with ESRD deciding whether to receive dialysis. In addition, the role of social support as a mediating variable of the relationship between hope and decisional conflict was investigated. Methods This study was a cross-sectional, descriptive correlation study. Data, including demographic information, were collected from 85 patients with ESRD who were deciding whether to receive dialysis. Research tools included the Chinese versions of the Herth Hope Index, the Interpersonal Support Evaluation List, and the Decisional Conflict Scale. Results When deciding whether to receive dialysis, patients with ESRD felt a low sense of hope, a moderate degree of social support, and a moderate degree of decisional conflict. Hope was significantly correlated with social support and decisional conflict. Social support demonstrated a full mediating effect of 47.7% (P < 0.001). Conclusions Patients with ESRD facing the decision to receive dialysis felt a low sense of hope and exhibited decisional conflict. Social support was found to be a mediating variable of the relationship between hope and decisional conflict; therefore, medical personnel should increase the social support of patients with ESRD who are deciding whether to commence dialysis to promote patients' hope and reduce their decisional conflict.
Highlights
End-stage renal disease (ESRD) has been a health focus for many countries worldwide
According to 2018 statistics published by the United States Renal Data System, Taiwan recorded the highest incidence of renal disease globally in 2016 [1]
Once diagnosed with ESRD, patients must decide upon undergoing kidney transplantation or long-term dialysis for survival
Summary
End-stage renal disease (ESRD) has been a health focus for many countries worldwide. According to 2018 statistics published by the United States Renal Data System, Taiwan recorded the highest incidence of renal disease globally in 2016 [1]. Studies have shown that dialysis patients with good social support demonstrate positive reactions when faced with ESRD, adjust favorably to their illness, and have less hopelessness, reduced depression and anxiety, and increased self-care ability and quality of life [12,13,14]. Herth emphasized in his hope intervention plan that favorable interpersonal relationships are critical to increasing patients’ hope [8]. When people face life-threatening diseases or require long-term treatment, hope and social support can serve as buffer factors against physiological or psychological distress and coping and adjustment strategies. Is study has two primary research purposes: (1) to understand the current situation of and correlations among hope, social support, and decisional conflict in patients with ESRD facing dialysis treatment and (2) to verify whether social support is a mediating variable in the relationship between hope and decisional conflict in patients with ESRD and if so examine its degree of influence
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