Abstract:

Objective To examine the scope of patient decision tools for renal replacement therapy in the field of chronic kidney disease，to identify the methods and core elements of the development and validation of patient decision aids，and to provide guidance for the development of patient decision aids in China. Methods This scoping review was conducted under the guideline of the framework with a five-step approach developed by Arksey and O’Malley. A comprehensive search of literature was conducted in databases including PubMed，OVID database （Embase，Cochrane Library，JBI evidence-based database），CINAHL，ProQuest database，Ottawa Hospital Research Institute，NICE，and Option Grids，CNKI，Wanfang Data，and VIP Database. The limit of time was set from the date of databases’ establishment to February 24，2022. The qualified studies were analyzed and summarized. Results A total of 26 articles were included，including 14 studies related to the development and validation of patient decision aids，and 12 focused on patient decision aids tools. Generally，both stakeholders and non-stakeholders were involved in the development process of patients decision tools for chronic kidney disease. Meanwhile，Ottawa Decision support Framework and international patient decision aid standards were usually selected as the standard or theoretical framework for development. Validation research mainly involved three aspects：feasibility and availability of the tool，decision-related outcome of patients，and change of knowledge level among patients. The content elements mainly included health information，decision guidance，reference evidence，and supplementary information. The forms of information presentation mainly included：using diagrams to present obscure and abstract knowledge；employing a rating scale to help patients sort out their decision-making preferences，and realizing interactive functions through web pages. Conclusion Patient decision aids hold a positive impact on the pre-dialysis education of patients with chronic kidney disease and presents good acceptability and ease to use. Future research needs to consider the specific medical situation in China to develop more suitable patients decision aids and explore the facilitating and obstructive factors in promoting the implementation of shared decision-making.

Key words: Kidney Failure, Chronic, Renal Replacement Therapy, Decision Support Techniques, Review, Patient decision aids, Shared decision making