Advanced Careplanning for Patients with Chronic Kidney Disease: A Systematic Review
- Patients with chronic kidney disease(CKD) are less familiar with advance care planning (ACP). Because CKD is an irreversible disease,patients need to make decisions for medical treatments when the disease progresses to the end stage.Information from literatures indicated thatpatients with chronic kidney disease do not understand what ACP is neither medical staff. ACP was not discussed among patients, their families and medical staff. This phenomenon may leadpatients only choose hemodialysis as a treatment at the end stage renal disease and decrease the quality of life at the end of their life. Therefore, by encouraging advanced care planning, it will be able to help patients make their own decision about their future treatments and obtain a better living experience.
Aim - To explore the application of advance care planning in patients with chronic kidney disease by systematic review.
Method - A systematic review was conducted. The search terms includedadvance care planning and chronic kidney disease. We used the Hierarchy of Evidence scale to screen,the inclusive criteria are Systematic Reviews and Randomized Controlled TrailsArticlespublished in English or Chinese. A comprehensivesearch was undertaken in September 2016 from the Chinese Electronic Periodical Services (CEPS), Chinese Electronic Theses, and Dissertations Service (CETD), Medline, Cumulative index to Nursing and Allied Health Literature (CINAHL), PubMed and Cochrane Library databases.Quality of all the articles wasgraded and assessed using Modified Jadad Scale. After retrieving the articles from the search, duplicated literatures were deleted. Six randomized control trial experimental studies and four qualitative studies were found.All reference lists, including research studies and related articles, will be checked.
Expected result - The results indicated that ACP may improve the understanding of disease progress among patients and caregivers.Most literature has indicated ACP will improve the comfort and dignity in the end of lifefor patients with CKD. The grieving process among family members will also be smooth when implementing ACP during the disease process.
Conclusion - This study mayprovide the health care providerreference of theACP and help CKD patients how to choosetheir decision inthe end of life.