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Prevalence and Predictors of Decisio...

Hamler, Tyrone C.

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Prevalence and Predictors of Decisional Conflict Among Older African Americans with Advanced Chronic Kidney Disease.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Prevalence and Predictors of Decisional Conflict Among Older African Americans with Advanced Chronic Kidney Disease./
Author:	Hamler, Tyrone C.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
Description:	229 p.
Notes:	Source: Dissertations Abstracts International, Volume: 84-09, Section: B.
Contained By:	Dissertations Abstracts International84-09B.
Subject:	Aging. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30360105
ISBN:	9798371915276

Prevalence and Predictors of Decisional Conflict Among Older African Americans with Advanced Chronic Kidney Disease.
Hamler, Tyrone C.

Prevalence and Predictors of Decisional Conflict Among Older African Americans with Advanced Chronic Kidney Disease. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 229 p.

Source: Dissertations Abstracts International, Volume: 84-09, Section: B.

Thesis (Ph.D.)--Case Western Reserve University, 2023.

This item must not be sold to any third party vendors.

Chronic kidney disease (CKD) has emerged as a major public health concern in the U.S., particularly among African Americans. African Americans remain just over three times more likely to develop CKD than White individuals. Older African Americans are a vulnerable population that have remained understudied in the CKD literature, despite future projections of an increasingly diverse population of older adults. Decision-making is a central concern for older African Americans who must navigate their management of advanced chronic kidney disease. Decisional conflict (DC), or the presence of uncertainty regarding taking action during the decision-making process, has been linked to adverse health outcomes and difficulties in making health choices. Therefore, this study's objectives were as follows: (1) to determine the level of DC experienced by pre-dialysis older African Americans with advanced CKD and (2) whether perceived chronic kidney disease knowledge, clinical characteristics (self-rated health status, depression, anxiety, and number of comorbidities), and personal characteristics predict DC.Study participants (N =125) were recruited from a outpatient nephrology clinic in a midwestern hospital and administered a telephone survey. Participants were African American, aged 50 and older, pre-dialysis and diagnosed with Stage 4 or 5 CKD. A hierarchical ordinary least-squares (OLS) regression analysis was conducted to examine the relationship between DC, personal characteristics, perceived chronic kidney disease knowledge, and clinical characteristics.Study participants reported mean scores of DC in the moderate range. Multivariate analyses indicated that DC was only significantly associated with perceived chronic kidney disease knowledge. Individuals with lower levels of perceived chronic kidney disease knowledge reported higher levels of DC.The findings of this study indicated that DC is a critical area to continue to investigate among older African Americans with advanced CKD. Knowledge emerged as a key predictor of DC. Social workers are well-positioned to impact levels of knowledge in this population through working on interdisciplinary teams in medical settings. This study provides additional evidence for the necessity of pre-dialysis educational intervention. This is an area in which medical social workers can directly assist to lessen DC among older African Americans with advanced CKD.

ISBN: 9798371915276Subjects--Topical Terms:

543123
Aging.
Subjects--Index Terms:

Kidney disease

Prevalence and Predictors of Decisional Conflict Among Older African Americans with Advanced Chronic Kidney Disease.
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