CHAN M1,2,3, McDERMOTT K2, STEFOSKA-NEEDHAM A2
1The St. George Hospital, KOGARAH, Australia, 2University of Wollongong, Wollongong, Australia, 3University of NSW, KOGARAH, Australia
Aim: To explore non-dialysis dependent chronic kidney disease (NDCKD) patients’ and renal dietitians’ perceptions of what nutritional outcomes matter to the patients (stages 4-5).
Background: Nutrition is an integral part of medical management in patients with NDCKD. To formulate effective intervention strategies, it is important to close the discrepancy of treatment goals between patients and healthcare professionals.
Methods: A comprehensive literature review was performed to identify clinical, nutritional and patient centred-outcomes of nutrition interventions. Results of which were used to construct a survey to NDCKD patients on pre-dialysis or conservative care and Australian renal dietitians. Respondents were asked to rate the importance of forty–eight intervention outcomes on a nine-point Likert scale, with a score of 9 reflecting the highest “importance”. Descriptive statistics and non-parametric t-tests were performed to analyse data.
Results: Forty-one patients and forty-seven dietitians participated in the survey. Both patient and dietitian groups rated twenty-nine out of forty–eight (60.4%) outcomes of similar importance (p>0.05). Patient centred outcomes, “symptom control“ and “quality of life” were perceived by both patient and dietitan groups to be of very high importance (8.53±0.76 vs.8.48±0.48, p=0.42 and 8.45±0.75 vs. 8.52±0.88, p=0.38 respectively). Long term clinical outcomes, “delaying the need for dialysis” and “slow disease progression rate”, were of highest and significant importance to the patient than dietitian groups (8.82±0.58 vs.7.49±1.82, p<0.001 and 8.69±0.58 vs. 8.02±1.28, p<0.001 respectively. Compared to the patients, dietitians rated intermediate outcome e.g. “constipated management” as being of higher importance (7.00±1.58 vs.7.91±1.28, p=0.004)
Conclusions: This study revealed that patients and dietitians share many common outcome priorities. However, discrepancy existed in the expectation for improving various outcomes; therefore individualised goal setting is needed for routine nutritional care.
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