Show simple item record

dc.contributor.advisorGardiner, Heather M.
dc.creatorUrbanski, Megan
dc.date.accessioned2020-08-25T19:13:17Z
dc.date.available2020-08-25T19:13:17Z
dc.date.issued2020
dc.identifier.urihttp://hdl.handle.net/20.500.12613/259
dc.description.abstractChronic kidney disease is an urgent public health problem in the U.S., affecting 15% of all adults, and more than 740,000 have progressed to end-stage renal disease (ESRD), requiring life-sustaining renal replacement therapy (RRT). ESRD has devastating health, quality-of-life, and economic consequences, rendering most patients unable to maintain employment and costing Medicare $36 billion in 2017. Arguably, the most disadvantaged subgroup is the subset of patients that received no or minimal pre-ESRD nephrology care, which currently accounts for one third of the total ESRD population. This subgroup suffers increased morbidity and mortality, and has limited access to kidney transplantation, the optimal RRT. Despite this subgroup representing a large minority of the ESRD patient population, there has been no U.S.-based examination of their ESRD diagnosis experiences, coping styles and strategies, and RRT decision-making preferences. Therefore, we conducted a study that compared the ESRD diagnosis experiences, coping styles and strategies, and RRT decision-making preferences among patients with varying amounts of pre-ESRD nephrology care. We also assessed nephrologists’ current practices and perspectives on the manner and timing of RRT education for patients with varying amounts of pre-ESRD care. This mixed methods study provides a comprehensive understanding of the diagnosis experiences, coping styles and strategies, and RRT decision-making preferences of patients facing sudden and unexpected ESRD diagnosis. The study contributes important knowledge about this subgroup of patients that can influence and improve health care delivery. The results of this research will inform future intervention-based investigations to improve care for patients with minimal or no pre-ESRD nephrology care.
dc.format.extent297 pages
dc.language.isoeng
dc.publisherTemple University. Libraries
dc.relation.ispartofTheses and Dissertations
dc.rightsIN COPYRIGHT- This Rights Statement can be used for an Item that is in copyright. Using this statement implies that the organization making this Item available has determined that the Item is in copyright and either is the rights-holder, has obtained permission from the rights-holder(s) to make their Work(s) available, or makes the Item available under an exception or limitation to copyright (including Fair Use) that entitles it to make the Item available.
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectPublic Health
dc.subjectSocial Research
dc.subjectChronic Kidney Disease
dc.subjectDialysis
dc.subjectEnd-stage Renal Disease
dc.subjectUnplanned
dc.subjectUrgent
dc.title'Crashing' Onto Dialysis: Diagnosis Experiences, Coping Styles and Strategies, and Treatment Decision-Making Preferences Among Patients with Unexpected End-Stage Renal Disease
dc.typeText
dc.type.genreThesis/Dissertation
dc.contributor.committeememberDumenci, Levent
dc.contributor.committeememberGadegbeku, Crystal
dc.contributor.committeememberSiminoff, Laura A.
dc.contributor.committeememberWaterman, Amy D.
dc.description.departmentPublic Health
dc.relation.doihttp://dx.doi.org/10.34944/dspace/243
dc.ada.noteFor Americans with Disabilities Act (ADA) accommodation, including help with reading this content, please contact scholarshare@temple.edu
dc.description.degreePh.D.
dc.identifier.proqst14170
dc.creator.orcid0000-0001-5054-0716
dc.date.updated2020-08-06T16:07:20Z
refterms.dateFOA2020-08-25T19:13:18Z
dc.embargo.lift08/06/2021
dc.identifier.filenameUrbanski_temple_0225E_14170.pdf


Files in this item

Thumbnail
Name:
Urbanski_temple_0225E_14170.pdf
Embargo:
2021-08-06
Size:
1.901Mb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record