The DOI matches its Crossref record; 14 of the 14 references it cites were found in a registry or an index.
Nephrologists’ Reported Preparedness for End-of-Life Decision-Making
Abstract
Nephrologists commonly engage in end-of-life decision-making with patients with ESRD and their families. The purpose of this study was to determine the perceived preparedness of nephrologists to make end-of-life decisions and to determine factors that are associated with the highest level of perceived preparedness. The nephrologist members of the Renal Physicians Association (RPA) and the Canadian Society of Nephrology were invited to participate in an online survey of their end-of-life decision-making practices. A total of 39% of 360 respondents perceived themselves as very well prepared to make end-of-life decisions. Age >46 yr, six or more patients withdrawn from dialysis in the preceding year, and awareness of the RPA/American Society of Nephrology (ASN) guideline on dialysis decision-making were independently associated with the highest level of self-reported preparedness. Nephrologists who reported being very well prepared were more likely to use time-limited trials of dialysis and stop dialysis of a patient with permanent and severe dementia. Compared with Americans, Canadian nephrologists reported being equally prepared to make end-of-life decisions, stopped dialysis of a higher number of patients, referred fewer to hospice, and were more likely to stop dialysis of a patient with severe dementia. Nephrologists who have been in practice longer and are knowledgeable of the RPA/ASN guideline report greater preparedness to make end-of-life decisions and report doing so more often in accordance with guideline recommendations. To improve nephrologists' comfort with end-of-life decision-making, fellowship programs should teach the recommendations in the RPA/ASN guideline and position statement.
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“ESRD patients spend an average of only 14 days in hospice, in contrast to the average of 59 days for patients with other diseases, suggesting that they are referred late in the dying process [35].”
From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [35]
Citations
Cites
Davison, S. N., Jhangri, G. S., & Johnson, J. A. (2006) · Kidney International · doi:10.1038/sj.ki.5000184 · Cited by 294
Self-citationKidney Failure and the Federal Government
Institute of Medicine (1991) · National Academies Press eBooks · doi:10.17226/1818 · Cited by 189
The need for end-of-life care training in nephrology: national survey results of nephrology fellows
Holley, J. L., Carmody, S. S., Moss, A. H., Sullivan, A. M., Cohen, L. M., Block, S. D., & Arnold, R. M. (2003) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(03)00868-0 · Cited by 165
Self-citationUse of Hospice in the United States Dialysis Population
Murray, A. M., Arko, C., Chen, S.-C., Gilbertson, D. T., & Moss, A. H. (2006) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.00970306 · Cited by 156 · cited 2×
“4% of patients who die while still receiving chronic dialysis have been referred to hospice programs before death (16).”
BackgroundSelf-citationPostal Surveys versus Electronic Mail Surveys
Mavis, B., & Brocato, J. J. (1998) · Evaluation & the Health Professions · doi:10.1177/016327879802100306 · Cited by 87
Chronic Pain in End-Stage Renal Disease
Davison, S. N. (2005) · Advances in Chronic Kidney Disease · doi:10.1016/j.ackd.2005.03.008 · Cited by 85
Self-citationMoss, A. H., Stocking, C. B., Sachs, G. A., & Siegler, M. A. (1993) · Journal of the American Society of Nephrology · doi:10.1681/asn.v42229 · Cited by 71
Self-citationDialysis decision making in Canada, the United Kingdom, and the United States
McKenzie, J. K., Moss, A. H., Feest, T., Stocking, C., & Siegler, M. A. (1998) · American Journal of Kidney Diseases · doi:10.1053/ajkd.1998.v31.pm9428446 · Cited by 67
Self-citationMoss, A. H., Holley, J. L., Davison, S. N., Dart, R. A., Germain, M. J., Cohen, L., & Swartz, R. D. (2004) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2003.12.009 · Cited by 64
Self-citationHolley, J. L. (2005) · Seminars in Dialysis · doi:10.1111/j.1525-139x.2005.18208.x · Cited by 63
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End-of-Life Care Preferences and Needs
Davison, S. N. (2010) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.05960809 · Cited by 630
“The majority of nephrologists do not feel well prepared to make end-of-life decisions for their patients (19).”
BackgroundSelf-citationDavison, S. N., Levin, A., Moss, A. H., Jha, V., Brown, E. A., Brennan, F. P., Murtagh, F. E., Naicker, S., Germain, M. J., O'Donoghue, D. J., et al. (2015) · Kidney International · doi:10.1038/ki.2015.110 · Cited by 583
Self-citationGuidelines for the management of chronic kidney disease
Levin, A., Hemmelgarn, B. R., Culleton, B. F., Tobe, S. W., McFarlane, P., Ruzicka, M., Burns, K. D., Manns, B., White, C., Madore, F., et al. (2008) · Canadian Medical Association Journal · doi:10.1503/cmaj.080351 · Cited by 428
Predicting Six-Month Mortality for Patients Who Are on Maintenance Hemodialysis
Cohen, L. M., Ruthazer, R., Moss, A. H., & Germain, M. J. (2010) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.03860609 · Cited by 391
“Clinically, this is necessary to allow patients and families to be informed of prognosis and provided with the opportunity to engage in meaningful advance care planning discussions (46).”
BackgroundSelf-citationRevised Dialysis Clinical Practice Guideline Promotes More Informed Decision-Making
Moss, A. H. (2010) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.07170810 · Cited by 187
“and Canadian nephrologists who were aware of and used the original guideline reported themselves significantly more prepared to make end-of-life decisions with their dialysis patients than those who were not aware of the guideline (5).”
BackgroundSelf-citation
Metadata
- Authors
- Davison, S. N., Jhangri, G. S., Holley, J. L., & Moss, A. H.
- Affiliations
- West Virginia University (US)
- Corresponding author
- Davison, Sara N.
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2006-11
- Volume
- 1
- Issue
- 6
- Pages
- 1256-1262
- ISSN
- 1555-9041 (ISSN-L)
- OpenAlex
- W2083351167
- Cited by
- 154
- References
- 14
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 1 · 2020: 7 · 2019: 9 · 2018: 4 · 2017: 8 · 2016: 17 · 2015: 17 · 2014: 7 · 2013: 11 · 2012: 16
- FWCI
- 8.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- end-of-life decisions, nephrologists, end-stage renal disease, dialysis withdrawal, physician preparedness, advanced dementia, hospice referral
- MeSH terms
- Adult, Aged, Canada, Decision Making, Humans, Kidney Failure, Chronic, Middle Aged, Nephrology, Surveys and Questionnaires, Societies, Medical, Terminal Care, United States
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