Study: Patients’ emotional response to dialysis may be linked to level of decision regret
Key takeaways:
- Patients with high decisional regret showed resignation toward dialysis.
- Patients with low regret showed positivity and successful dialysis integration.
Many patients may experience post-dialysis disruption, but their emotional response to adversity depends on whether they feel high or low levels of regret, according to recently published data.
“Decisional regret is an unpleasant emotion elicited when patients feel that an alternative choice may have resulted in a more favorable outcome. The prevalence of decisional regret in patients with kidney failure varies between 7% and 61%,” Aditya S. Pawar, MD, of the Beth Israel Deaconess Medical Center in Boston and Community Internal Medicine at Mayo Clinic in Rochester, Minnesota, and colleagues wrote. “This study identifies emotional responses to dialysis that may be modifiable through patient-support interventions.”
Researchers used a comparative analysis and mixed-methods explanatory sequential design to examine decisional regret regarding dialysis initiation.
For 3 weeks, 78 patients from a single academic medical center were prescribed maintenance in-center hemodialysis, home hemodialysis or peritoneal dialysis. Researchers used a decision regret scale and illness intrusiveness scale as predictors, and patients with the highest (15 patients) and lowest (20 patients) decisional regret levels were invited for semi-structured interviews.
Investigators studied the correlation between the two scales to gauge regret levels and illness impact, and patients were placed in the highest and lowest decision regret scale quartiles for further interviews. Overall, 21 patients (eight with high regret, 13 with low regret) were included.
According to the findings, patients with high decisional regret showed resignation toward dialysis, disruption of their sense of self and social roles, as well as self-blame. In contrast, researchers found that patients with low decisional regret showed positivity, successful integration of dialysis into their identity and a sense of self-compassion.
While patients with the highest levels of decisional regret may have already withdrawn from dialysis, the researchers concluded that the “differences observed between the low regret and high regret groups highlight contrasting perspectives and responses to challenges. These emerging themes indicate potential psychologic and cognitive differences in how patients perceive and adjust to life while receiving dialysis, providing valuable insights into the complex factors that contribute to [treatment initiation] regret.”
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