What is the role of nephrologists and nurses of the dialysis department in providing fertility care to CKD patients? A questionnaire study among care providers.
PURPOSE
This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrologists and nurses in the dialysis department.


METHODS
Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N = 312) and dialysis nurses (N = 1211).


RESULTS
Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9.0% of the nephrologists and 15.6% of the nurses. 61.7% of the nephrologists and 23.6% of the nurses informed ≥50% of their patients on potential changes in fertility due to a decline in renal function. Fertility subjects discussed by nephrologists included "wish to have children" (91.2%), "risk of pregnancy for patients' health" (85.8%), and "inheritance of the disease" (81.4%). Barriers withholding nurses from discussing FD were based on "the age of the patient" (62.6%), "insufficient training" (55.2%), and "language and ethnicity" (51.6%). 29.2% of the nurses felt competent in discussing fertility, 8.3% had sufficient knowledge about fertility, and 75.7% needed to expand their knowledge. More knowledge and competence were associated with providing fertility health care (p < 0.01).


CONCLUSIONS
In most nephrology departments, the guidelines to appoint which care provider should provide fertility care to CKD patients are absent. Fertility counseling is routinely provided by most nephrologists, nurses often skip this part of care mainly due to insufficiencies in self-imposed competence and knowledge and barriers based on cultural diversity. The outcomes identified a need for fertility guidelines in the nephrology department and training and education for nurses on providing fertility care.
['van Ek|Gaby F|GF|', 'Krouwel|Esmée M|EM|', 'Nicolai|Melianthe P J|MPJ|', 'Den Oudsten|Brenda L|BL|', 'Den Ouden|Marjolein E M|MEM|', 'Dieben|Sandra W M|SWM|', 'Putter|Hein|H|', 'Pelger|Rob C M|RCM|', 'Elzevier|Henk W|HW|']
D000328:Adult D000368:Aged D002983:Clinical Competence D003144:Communication Barriers D003430:Cross-Sectional Studies D054521:Cultural Competency D004501:Education, Medical D004506:Education, Nursing D005260:Female D005298:Fertility D007722:Health Knowledge, Attitudes, Practice D006801:Humans D007802:Language D008297:Male D008875:Middle Aged D009398:Nephrology D009426:Netherlands D024802:Nurse's Role D010044:Outpatient Clinics, Hospital D010353:Patient Education as Topic D010819:Physician's Role D017410:Practice Guidelines as Topic D006435:Renal Dialysis D051436:Renal Insufficiency, Chronic D020377:Self Efficacy D011795:Surveys and Questionnaires D055815:Young Adult
Fertility care Questionnaires Chronic kidney disease Practice patterns Renal care providers