Antecedents and consequences of shared decision making for patients with chronic kidney diseases: A cross-sectional survey

Background: Chronic kidney disease (CKD) has a strong negative impact on patients. Finding ways to improve CKD patients' conditions by shared decision-making is receiving much attention. However, little attention has been paid to influencing antecedents and effects of shared decision-making. Meanwhile, as advanced technol-ogies bring in new communication devices, effects of different types of communications used in shared decision -making need to be addressed.Objective: This study proposes a research framework to determine the influencing antecedents of shared decision -making, and to evaluate the effects of shared decision-making on patient outcomes when they are computer -mediated and when the decision-makers communicate face-to-face.Methods: A cross-section survey was conducted and a total of 48 valid samples were obtained. The participants were CKD Stage III, IV, or V patients who had received medical treatment in a hospital in Taiwan. The collected data were subjected to an independent t -test and partial least squares analysis to validate the research framework. Results: Doctor-patient communication (DPC) and doctor-patient relationship (DPR) have no significant direct impact on patient outcomes. Nevertheless, both DPC and DPR significantly impact shared decision-making which in turn impacts patient outcomes. Moreover, patients who use computer-mediated communication were found to have significantly higher perceptions of shared decision-making than those who did not.Conclusions: The incidence and prevalence of end-stage renal disease in Taiwan are among the highest in the world. The results of this study can serve as a reference for hospitals to improve CKD patients' outcomes. Meanwhile, during the COVID-19 pandemic, this study suggested hospitals should encourage shared decision -making with computer-mediated communication to ensure that patients receive proper treatment and have the desired outcomes.

Automated summary

Chronic kidney disease (CKD) has a significant negative impact on patients, and the focus on improving CKD patients' conditions through shared decision-making is increasing. This study explores the antecedents and effects of shared decision-making, as well as the influence of different types of communication methods.