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The Communication and Bioethical Training (CoBiT) Program for assisting dialysis decision-making in Spanish ACKD units
Authors:Helena García-Llana  Maria-Auxiliadora Bajo  Javier Barbero  Rafael Selgas  Gloria Del Peso
Affiliation:1. Nephrology Department, University Hospital La Paz, IdiPAZ, Madrid, Spain;2. Nephrology Department, University Hospital La Paz, Autonomous University of Madrid, IdiPAZ, FRIAT-IRSIN, REDinREN, Madrid, Spain;3. Hematology Department, University Hospital La Paz Madrid, Madrid, Spain;4. Nephrology Department, University Hospital La Paz, IdiPAZ, FRIAT-IRSIN, REDinREN, Madrid, Spain
Abstract:Healthcare professionals currently working in Advanced Chronic Kidney Disease (ACKD) units must cope with difficult situations regarding assisting patients with the dialysis decision-making process, and they are often untrained for these conversations. Although we have evidence from the literature that these skills can be learned, few professionals feel confident in this area. A Communication and Bioethical Training (CoBiT) Program for ACKD staff (physicians, nurses and allied health professionals) was developed to improve their ability and self-confidence in conducting these conversations. A four-stage study was conducted: (1) development of the CoBiT program, beginning with the creation of an interdisciplinary focus group (N = 10); (2) design of a questionnaire to assess self-confidence based on the areas identified by the focus group. The face validity of the instrument was tested using an inter-judge methodology (N = 6); (3) design of the format and contents of the program; (4) piloting the program. Thirty-six health professionals took an 8-h workshop based on role-playing methodology. Participants assessed their self-confidence in their communication skills before and after the program using self-report measures. The results show that after the program, participants reported significantly higher levels of self-confidence measured with a five-point Likert scale (p < 0.001). Participants felt that communication with colleagues of other professions significantly increased after the workshop (p = 0.004). The CoBiT program improves ACKD Unit healthcare professionals’ self-confidence in their ability to perform a specific communication task.
Keywords:Communication  bioethics  ACKD units  training program
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