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Perceptions de l’arrêt de la dialyse et des traitements de maintien de la vie chez la clientèle québécoise en hémodialyse hospitalière: comparaison selon l’âge

Published online by Cambridge University Press:  13 December 2012

Judith Gagnon ,
Jocelyne Saint-Arnaud ,
Marc Bourdeau ,
Josée Côté ,
Claire Chapados  and
Cécile Michaud
Judith Gagnon*
Affiliation:
Faculty of Nursing, University of Alberta
Jocelyne Saint-Arnaud
Affiliation:
Faculté des sciences Infirmières, Université de Montréal
Marc Bourdeau
Affiliation:
École Polytechnique, Université de Montréal Department of Medicine, Division of Nephrology, University of Alberta
Josée Côté
Affiliation:
Faculté des sciences Infirmières, Université de Montréal
Claire Chapados
Affiliation:
Faculté des sciences Infirmières, Université de Montréal
Cécile Michaud
Affiliation:
École des sciences Infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke
*
*La correspondance et les demandes de tirés-à-part doivent être adressées à : Correspondence and requests for offprints should be sent to: Judith Gagnon, M.Sc. 7708 154A Street NW Edmonton, AB T5R 1V2 (judith.gagnon@hotmail.com)
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Abstract

The End-Stage Renal Disease population is aging. Considering that hemodialysis is a treatment that maintains and prolongs life, this descriptive-comparative study looks at the perceptions of patients according to age group -<65 years, n=121 and ≥65 years, n=123, as it pertains to dialysis treatment cessation and life-sustaining treatments. Results: Older patients are more indecisive as to what dialysis treatment cessation may actually represent for them (p=0,01). They expressed a greater need for support from the health care team if they decided to stop dialysis treatments (p=0,02); a greater involvement from the physician (p=0,04); and, in the event patients could not take part in end-of-life decision-making, they would give priority to the wishes of loved ones instead of their own wishes (p=0,01). Conclusion: Advanced care planning is necessary to demystify hemodialysis withdrawal and to support patients and their loved ones through this process.

Résumé

La clientèle au stade terminal d’insuffisance rénale est vieillissante. Considérant le fait que l’hémodialyse est un traitement qui maintien et prolonge la vie cette étude décrit et compare les perceptions de deux groupes de patients en hémodialyse selon l’âge -<65ans, n=121 et ≥65 ans, n=123) - quant à l’arrêt de la dialyse et les traitements de fin de vie. Résultats: Les ≥65 ans sont indécis quant à ce que représente un arrêt de dialyse (p= 0,01); ils souhaitent davantage le soutien de l’équipe de soins advenant l’arrêt de dialyse (p=0,02); ils sont plus nombreux à vouloir que le médecin décide pour eux des traitements de fin de vie (p=0,04); et, si inaptes, ils veulent d’avantage que les volontés de leurs proches aient priorité sur les leurs (p=0,01). Conclusion: Une planification des soins de fin de vie intégrée aux soins peut aider à démystifier l’arrêt de l’hémodialyse et à soutenir la clientèle âgée dans ce processus.

Keywords

stopping dialysisend of lifetreatment to sustain lifehaemodialysisArrêt de dialysefin de vietraitement de maintien de la viehémodialyse
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 4 , December 2012 , pp. 435 - 444
Copyright
Copyright © Canadian Association on Gerontology 2012 

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