114027
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.4 Breast Cancer (Dove Med Press)
- 3.2 Clin Epidemiol
- 2.6 Cancer Manag Res
- 2.9 Infect Drug Resist
- 3.7 Clin Interv Aging
- 5.1 Drug Des Dev Ther
- 3.1 Int J Chronic Obstr
- 6.6 Int J Nanomed
- 2.6 Int J Women's Health
- 2.9 Neuropsych Dis Treat
- 2.8 OncoTargets Ther
- 2.0 Patient Prefer Adher
- 2.2 Ther Clin Risk Manag
- 2.5 J Pain Res
- 3.0 Diabet Metab Synd Ob
- 3.2 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 1.8 Pharmgenomics Pers Med
- 2.0 Risk Manag Healthc Policy
- 4.1 J Inflamm Res
- 2.0 Int J Gen Med
- 3.4 J Hepatocell Carcinoma
- 3.0 J Asthma Allergy
- 2.2 Clin Cosmet Investig Dermatol
- 2.4 J Multidiscip Healthc
已发表论文
一项针对终末期肾病透析患者的短期预前护理规划干预（VOICE）的有效性：一项随机对照试验
Authors Xu F, Cheng S , Shu P , Liang Y, Chen J, Bai H
Received 12 September 2025
Accepted for publication 16 December 2025
Published 22 December 2025 Volume 2025:19 Pages 4191—4206
DOI https://doi.org/10.2147/PPA.S567240
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Ramón Morillo-Verdugo
Fang Xu,* Shuang Cheng,* Peng Shu, Yilan Liang, Jie Chen, Haitao Bai
Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Haitao Bai, Email 13007152231@163.com
Background: Most randomized controlled trials (RCTs) on advance care planning (ACP) focus on advanced cancer, while evidence for dialysis patients with end-stage renal disease (ESRD) remains limited. This study aimed to evaluate the effectiveness of a structured educational intervention in enhancing ACP engagement among dialysis patients.
Methods: The VOICE study, an RCT, was conducted at the Central Hospital of Wuhan. Initially, 117 patients were enrolled; ultimately, data from 50 participants in the intervention group and 52 in the control group were included in the final analysis. Patients in the control group received standard care, while those in the intervention group received a structured ACP intervention specifically tailored to the needs of ESRD patients. The primary outcome assessed in the study was decisional conflict, evaluated through the use of the Decisional Conflict Scale (DCS). Secondary outcomes included ACP engagement (ACPES), attitudes toward death (DAP-R), and quality of life (KDQOL-36™).
Results: After six weeks, the intervention group showed significant but small reductions in the DCS Uncertainty subscale (P = 0.001, Cohen’s d=− 0.17), and improvements in the Informed (P = 0.049, Cohen’s d=− 0.12), Values Clarity (P = 0.003, Cohen’s d=− 0.11), and Effective Decision (P = 0.012, Cohen’s d=− 0.12) subscales. Regarding secondary outcomes, the intervention group demonstrated significantly higher scores across all ACP engagement domains (P < 0.05), reduced fear of death and death avoidance, and greater natural acceptance of death (all P < 0.05). Moreover, the intervention group reported significantly better quality of life, particularly in the Effects of Kidney Disease and Burden of Kidney Disease subscales (P < 0.05).
Conclusion: The VOICE ACP intervention improved short-term ACP engagement and led to modest improvements in several domains of decisional conflict in dialysis patients. Future multicenter, longitudinal trials are warranted to evaluate the sustainability and cost-effectiveness of such interventions.
Trial Registration: Chinese Clinical Trial Registry: ChiCTR2500097890. Registered 27 February 2025.
Keywords: dialysis, advance care planning, decision conflict, engagement, death attitudes, quality of life
Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Haitao Bai, Email 13007152231@163.com
Background: Most randomized controlled trials (RCTs) on advance care planning (ACP) focus on advanced cancer, while evidence for dialysis patients with end-stage renal disease (ESRD) remains limited. This study aimed to evaluate the effectiveness of a structured educational intervention in enhancing ACP engagement among dialysis patients.
Methods: The VOICE study, an RCT, was conducted at the Central Hospital of Wuhan. Initially, 117 patients were enrolled; ultimately, data from 50 participants in the intervention group and 52 in the control group were included in the final analysis. Patients in the control group received standard care, while those in the intervention group received a structured ACP intervention specifically tailored to the needs of ESRD patients. The primary outcome assessed in the study was decisional conflict, evaluated through the use of the Decisional Conflict Scale (DCS). Secondary outcomes included ACP engagement (ACPES), attitudes toward death (DAP-R), and quality of life (KDQOL-36™).
Results: After six weeks, the intervention group showed significant but small reductions in the DCS Uncertainty subscale (P = 0.001, Cohen’s d=− 0.17), and improvements in the Informed (P = 0.049, Cohen’s d=− 0.12), Values Clarity (P = 0.003, Cohen’s d=− 0.11), and Effective Decision (P = 0.012, Cohen’s d=− 0.12) subscales. Regarding secondary outcomes, the intervention group demonstrated significantly higher scores across all ACP engagement domains (P < 0.05), reduced fear of death and death avoidance, and greater natural acceptance of death (all P < 0.05). Moreover, the intervention group reported significantly better quality of life, particularly in the Effects of Kidney Disease and Burden of Kidney Disease subscales (P < 0.05).
Conclusion: The VOICE ACP intervention improved short-term ACP engagement and led to modest improvements in several domains of decisional conflict in dialysis patients. Future multicenter, longitudinal trials are warranted to evaluate the sustainability and cost-effectiveness of such interventions.
Trial Registration: Chinese Clinical Trial Registry: ChiCTR2500097890. Registered 27 February 2025.
Keywords: dialysis, advance care planning, decision conflict, engagement, death attitudes, quality of life