Should physicians rethink phrases used to explain kidney well being?

kidney
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Results from a brand new research point out a must rethink sure medical phrases and phrases that clinicians use when speaking with sufferers who’ve kidney illness. More patient-focused terminology might enhance affected person autonomy, satisfaction, and well being, in accordance with the authors of the CJASN research.

Communication between physicians and sufferers is essential to make sure that people can perceive physicians’ recommendation and might make knowledgeable selections about their care. When contemplating power kidney illness (CKD), among the language generally used to explain kidney well being could also be imprecise, deceptive, and maintain totally different meanings for sufferers and clinicians. To look into this, Allison Tong, Ph.D. (The University of Sydney, in Australia) and her colleagues designed a research to realize the views of sufferers and caregivers on phrases generally associated to kidney well being. “We wished to grasp the impacts that the phrases for kidney well being have on sufferers and their households, and to search out methods to enhance the phrases getting used,” mentioned Dr. Tong.

The research included 54 sufferers with CKD and 13 caregivers from the United States, United Kingdom, and Australia who participated in 10 focus teams to debate phrases for kidney well being (together with kidney, renal, CKD, end-stage kidney illness, kidney failure, and descriptors for kidney operate).

The researchers recognized four themes:

  • scary and exacerbating undue trauma (worry of the unknown, denoting impending dying, despair in having incurable or untreatable illness, untimely labeling and assumptions, judgment, stigma and failure of self);
  • pissed off by ambiguity (confused by medicalized language, missing private relevance, baffled by imprecision in which means, against out of date phrases);
  • making sense of the prognostic enigma (conceptualizing stage of kidney operate, correlating with signs and life impression, predicting development and wish for intervention); and
  • mobilizing self-management (confronting actuality, enabling planning and preparation, taking possession for change, studying medical phrases for self-advocacy, educating others).

The authors famous that some sufferers despised the time period “pre-dialysis” as a result of it was unnecessarily precipitating the necessity for dialysis—”it assumes you realize what the longer term holds.” Others interpreted kidney “failure” to imply that their “bodily existence is failing,” or they’d “finished one thing improper.” Some additionally perceived the time period “end-stage” to imply the “finish of a wholesome life, the tip of a constructive mindset,” and initially thought there was “nothing you are able to do about it.”

“We discovered that phrases similar to ‘end-stage kidney illness’ could cause undue misery in sufferers. Terms can also inadvertently suggest impending dying and be stigmatizing,” mentioned Dr. Tong. “There was additionally frustration, uncertainty, and worry as a result of some phrases had been complicated and ambiguous.”

Using constant and significant language that sufferers can perceive might assist to enhance sufferers’ well being and satisfaction.

An accompanying editorial by Paul T. Conway (American Association of Kidney Patients) addresses kidney specialists, stating, “If our shared agenda is to have extra sufferers to take part in medical trials and analysis, take higher care of themselves, and develop into extra concerned in advancing insurance policies that help innovation and analysis—ask your self a easy query: did the final dialog I’ve with a affected person encourage confidence that their kidney illness is manageable and that their distinctive affected person insights are useful and wanted within the combat to assist save different sufferers?”


Many sufferers with kidney failure remorse initiating dialysis


More info:
“Patient and Caregiver Perspectives on Terms Used to Describe Kidney Health,” CJASN DOI: 10.2215/CJN.00900120

Provided by
American Society of Nephrology

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Should physicians rethink phrases used to explain kidney well being? (2020, June 25)
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