Comprehensive pre-dialysis discussions between providers and older adults over age 75 years are needed but often lacking. The aim of this study was to develop an instrument to assess behavioral determinants of nephrology provider use of comprehensive pre-dialysis discussions with older adults. Study design consisted of cross-sectional development of the instrument and preliminary psychometric evaluation. Items were based on an integrated literature review, expert clinician input, and the Theory of Planned Behavior. Nephrologists, nurse practitioners, and physician assistants completed the instrument (n = 71). Baseline demographic data, exploratory factor analysis, and Cronbach’s alpha were analyzed. Initial factor analysis using principal components analysis and subsequent orthogonal rotation revealed loading on a four-factor model. Cronbach’s alphas for the instrument/items were 0.89/0.83 to 0.94. Variance explained by the four factors was 58%.

Continuing Education Instructions and Disclosure Information:

Contact hours available until 12/31/2023.

Requirements for Successful Completion:
Complete the learning activity in its entirety and complete the online nursing continuing professional development evaluation. You will be able to print your NCPD certificate after you complete the evaluation.

Disclosure of relevant financial relationships with ineligible companies (planners, faculty, reviewers, authors):

Editorial Board Disclosures:
Paula Dutka, MSN, RN, CNN, discloses that she is a consultant for Rockwell Medical.

All other members of the Editorial Board had no actual or potential conflict of interest in relation to this nursing continuing professional development education activity.

Author(s) Disclosures:
The author(s) reported no actual or potential conflict of interest.

Commercial Support:
No commercial support declared.

This article was reviewed and formatted for contact hour credit by Beth Ulrich, EdD, RN, FACHE, FAONL, FAAN, Nephrology Nursing Journal Editor-in-Chief, and Sally Russell, MN, CMSRN, CPP, ANNA Education Director.

Accreditation Statement:
The American Nephrology Nurses Association (ANNA) is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

ANNA is an approved provider of continuing nursing education by the California Board of Registered Nursing, Provider Number CEP 17499.

This NCPD article meets the Nephrology Nursing Certification Commission’s (NNCC’s) continuing nursing education requirements for certification and recertification.

ANNA urges participants to be aware of the CE requirements for re-licensure in the states in which they hold a license.

Learning Outcome:
After completing this learning activity, the learner, when participating in pre-dialysis discussions with adults over age 75 years, will apply study findings to inform future multidisciplinary shared decision-making discussions.

Ladda Thiamwong PhD, RN

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