RESUMO
Due to the high morbidity and mortality with limited life expectancy of dialysis patients, it is essential to implement advance care planning in order to know patients' values and care preferences and respect their autonomy. However, advance care planning is rarely carried out, due to the difficulties in initiating end-of-life discussions, both by patients and healthcare professionals. The use of "serious games" in the form of card games has shown promise in supporting the implementation of advance care planning. In this article, we present the development process of an advance care planning intervention for dialysis patients using a card game (the Go Wish), in the Division of Nephrology of the University Hospitals of Geneva.
Assuntos
Planejamento Antecipado de Cuidados , Nefrologia , Humanos , Diálise RenalRESUMO
INTRODUCTION: Chronic kidney disease (CKD) is an evolutive disease. In its early stages the disease often goes asymptomatic and unrecognized. For CKD patients, disease awareness is usually late, with the occurrence of the first symptoms. In more advanced stages, CKD implies massive consequences on patient's life. Extrarenal substitution methods (such as hemodialysis, peritoneal dialysis or transplantation) are presented to the patient, who is facing a very difficult choice, inducing major changes in his lifestyle. DESCRIPTION: In this article, we share the adaptation process of a therapeutic education program in nephrology, presenting its specificity and the encountered difficulties. We propose to develop an educative program adapted to patient's needs, which differs according to CKD stage. CONCLUSION: Therapeutic patient education (TPE) has become a need in the care of CKD patients, even at early stages of the disease. TPE allows to prepare the patients, favoring autonomy and shared decision making about his disease, in collaboration with healthcare workers and patient's relatives.
Assuntos
Educação de Pacientes como Assunto/métodos , Insuficiência Renal Crônica/terapia , Humanos , Falência Renal Crônica/terapiaRESUMO
Chronic kidney disease (CKD) usually goes unrecognized for patients until late symptomatic stages. In preterminal CKD, extrarenal substitution methods are usually presented to patients. This is felt like a breakdown, implying major modifications of everyday life. Acquisition of health literacy is necessary for patients with CKD to become autonomous and increase their empowerment toward the disease. Therapeutic education in nephrology plays a major role in improving the care of CKD patients.
L'insuffisance rénale chronique (IRC) est une maladie silencieuse, évolutive, souvent asymptomatique dans ses stades précoces. Elle devient réelle lorsque les symptômes apparaissent, lors des stades avancés. Lorsque l'insuffisance rénale est préterminale, les différentes méthodes de substitutions extrarénales sont présentées au patient. Ceci raisonne souvent comme un choc, car elles impliquent des modifications majeures de la vie quotidienne. L'acquisition des compétences en santé devient une nécessité dans la maladie chronique afin de permettre au patient son empowerment (autonomisation et autodétermination, englobant la capacité de prendre des décisions et d'exercer un contrôle sur sa vie). L'éducation thérapeutique en néphrologie tient donc une place prépondérante dans la prise en charge des patients atteints d'IRC, afin d'améliorer leur autonomisation dans leur prise en charge et leur qualité de vie.
