Educating Patients about CKD: The Path to Self-Management and Patient-Centered Care

被引:171
作者
Narva, Andrew S. [1 ]
Norton, Jenna M. [1 ]
Boulware, L. Ebony [2 ]
机构
[1] NIDDKD, Div Kidney Urol & Hematol Dis, Natl Kidney Dis Educ Program, Bethesda, MD 20892 USA
[2] Duke Univ, Dept Med, Div Gen Internal Med, Durham, NC USA
来源
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2016年 / 11卷 / 04期
关键词
CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; SHARED DECISION-MAKING; BLOOD-PRESSURE CONTROL; STAGE RENAL-DISEASE; PREDIALYSIS PSYCHOEDUCATIONAL INTERVENTION; AFRICAN-AMERICAN PATIENTS; HEALTH LITERACY; APPROPRIATE INITIATION; TRANSLATIONAL RESEARCH;
D O I
10.2215/CJN.07680715
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Patient education is associated with better patient outcomes and supported by international guidelines and organizations, but a range of barriers prevent widespread implementation of comprehensive education for people with progressive kidney disease, especially in the United States. Among United States patients, obstacles to education include the complex nature of kidney disease information, low baseline awareness, limited health literacy and numeracy, limited availability of CKD information, and lack of readiness to learn. For providers, lack of time and clinical confidence combine with competing education priorities and confusion about diagnosing CKD to limit educational efforts. At the system level, lack of provider incentives, limited availability of practical decision support tools, and lack of established interdisciplinary care models inhibit patient education. Despite these barriers, innovative education approaches for people with CKD exist, including self-management support, shared decision making, use of digital media, and engaging families and communities. Education efficiency may be increased by focusing on people with progressive disease, establishing interdisciplinary care management including community health workers, and providing education in group settings. New educational approaches are being developed through research and quality improvement efforts, but challenges to evaluating public awareness and patient education programs inhibit identification of successful strategies for broader implementation. However, growing interest in improving patient-centered outcomes may provide new approaches to effective education of people with CKD.
引用
收藏
页码:694 / 703
页数:10
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