Abstract：
BACKGROUND: Young adults living with kidney failure make decisions to select a kidney replacement therapy choice in partnership with healthcare professionals. However, little is known about how they experience kidney replacement therapy treatment decision-making and the impact this has on their well-being.
OBJECTIVE: To explore young adults living with kidney failure experiences of treatment decision-making. The treatment decision-making investigated is about the choice of dialysis and/or kidney transplant options.
METHODS: A qualitative interpretive hermeneutic phenomenology study.
METHODS: Purposeful sampling was used to recruit young adults with kidney failure from social media, electronic media such as local kidney group websites and word of mouth. Semistructured interviews were conducted with (n = 18) participants aged 18-30 years.
METHODS: Inductive analysis of the data were performed using Braun and Clarke\'s thematic analysis framework.
RESULTS: The five themes generated were (1) awareness and anticipation of future kidney replacement therapy decision; (2) health information and education; (3) engaging in decision-making, support and choices; (4) implementation of kidney replacement therapy and transitioning into the new normal life and (5) the impact of decision-making and choice on well-being.
CONCLUSIONS: Decision-making significantly affected young adults\' psychosocial and mental well-being. Young adults had unmet informational and decisional needs and struggled to cope due to lack of support. A four-talk model, with an implement talk phase added to the existing three-talk (team talk, option talk, decision talk) shared decision-making model, would promote a focus on the implementation of choice and support the transitioning from previous life to long-term dependence on treatment.
OBJECTIVE: To explore young adults living with kidney failure experiences of treatment decision-making. The treatment decision-making investigated is about the choice of dialysis and/or kidney transplant options.
METHODS: A qualitative interpretive hermeneutic phenomenology study.
METHODS: Purposeful sampling was used to recruit young adults with kidney failure from social media, electronic media such as local kidney group websites and word of mouth. Semistructured interviews were conducted with (n = 18) participants aged 18-30 years.
METHODS: Inductive analysis of the data were performed using Braun and Clarke\'s thematic analysis framework.
RESULTS: The five themes generated were (1) awareness and anticipation of future kidney replacement therapy decision; (2) health information and education; (3) engaging in decision-making, support and choices; (4) implementation of kidney replacement therapy and transitioning into the new normal life and (5) the impact of decision-making and choice on well-being.
CONCLUSIONS: Decision-making significantly affected young adults\' psychosocial and mental well-being. Young adults had unmet informational and decisional needs and struggled to cope due to lack of support. A four-talk model, with an implement talk phase added to the existing three-talk (team talk, option talk, decision talk) shared decision-making model, would promote a focus on the implementation of choice and support the transitioning from previous life to long-term dependence on treatment.
摘要：
背景：患有肾衰竭的年轻成年人与医疗保健专业人员合作，决定选择肾脏替代疗法。然而,关于他们如何经历肾脏替代疗法治疗决策以及这对他们的健康的影响知之甚少。
目的：探讨青壮年肾衰竭患者的治疗决策经验。研究的治疗决策是关于透析和/或肾移植方案的选择。
方法：定性解释诠释学现象学研究。
方法：目的抽样用于从社交媒体招募肾衰竭的年轻人，当地肾组网站和口碑等电子媒体。对18-30岁的参与者进行了半结构化访谈（n=18）。
方法：使用Braun和Clarke的主题分析框架对数据进行归纳分析。
结果：产生的五个主题是：（1）对未来肾脏替代治疗决策的认识和预期；（2）健康信息和教育；（3）参与决策，支持和选择；（4）实施肾脏替代治疗并过渡到新的正常生活；（5）决策和选择对幸福感的影响。
结论：决策显著影响年轻人的社会心理和心理健康。年轻人的信息和决策需求未得到满足，并且由于缺乏支持而难以应对。四说话模式，在现有的三对话(团队对话，选项谈话，决策对话)共享决策模型，将促进对实施选择的关注，并支持从以前的生活过渡到长期依赖治疗。
目的：探讨青壮年肾衰竭患者的治疗决策经验。研究的治疗决策是关于透析和/或肾移植方案的选择。
方法：定性解释诠释学现象学研究。
方法：目的抽样用于从社交媒体招募肾衰竭的年轻人，当地肾组网站和口碑等电子媒体。对18-30岁的参与者进行了半结构化访谈（n=18）。
方法：使用Braun和Clarke的主题分析框架对数据进行归纳分析。
结果：产生的五个主题是：（1）对未来肾脏替代治疗决策的认识和预期；（2）健康信息和教育；（3）参与决策，支持和选择；（4）实施肾脏替代治疗并过渡到新的正常生活；（5）决策和选择对幸福感的影响。
结论：决策显著影响年轻人的社会心理和心理健康。年轻人的信息和决策需求未得到满足，并且由于缺乏支持而难以应对。四说话模式，在现有的三对话(团队对话，选项谈话，决策对话)共享决策模型，将促进对实施选择的关注，并支持从以前的生活过渡到长期依赖治疗。
