Kidney Week

Abstract: SA-PO1125

Experience of Patients and Caregivers During the Predialysis Period: A Thematic Analysis

Session Information

• CKD: Patient-Oriented Care and Case Reports
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Nadeau-Fredette, Annie-Claire, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada

Annie-Claire Nadeau-Fredette, MD, MS, MSc

• Robitaille, Émilie, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada

Émilie Robitaille

• Cyr, Guylaine, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada

Guylaine Cyr

• Tennankore, Karthik K., Nova Scotia Health Authority, Halifax, Nova Scotia, Canada

Karthik K. Tennankore, MD, MS

• Kilpatrick, Kelley, McGill University, Montreal, Quebec, Canada

Kelley Kilpatrick, PhD, RN

Group or Team Name

• On behalf of the TRANSIT-CARE Study Group.

Background

Patients living with advanced chronic kidney disease (CKD) often plan to initiate dialysis when their kidney function declines. While several studies have explored components associated with dialysis modality choice, little is known as to how patients and their caregivers experience the period preceding dialysis initiation.

Methods

In this qualitative study, semi-structured interviews were performed with patients (n = 9) followed in an advanced multidisciplinary CKD clinic with an eGFR <12 ml/min/1.73 m² who had already chosen their dialysis modality and with caregivers (n = 9). Thematic analysis was used to identify patients and caregivers' experiences during the predialysis time.

Results

Patients participants were 69 ±7 years, included 4 women and 5 men. Among them, 5 patients had chosen home dialysis and 4 facility hemodialysis. Caregivers were mostly women (n=7/9) and most were living with the patient with CKD. Four main themes described patients and caregivers experience: successive shocks of announcements (from CKD diagnosis to imminent need for dialysis), minimizing repercussions on lifestyle regardless of the choice of dialysis therapy, personality type influencing feelings linked to dialysis anticipation (optimist versus pessimist, hope versus despair), reassurance through support network (including loved one and healthcare professionals). Patients and caregiver pairs had mostly concordant experience and overall, emotions toward dialysis were more often positive (hope of better future), although grief was also often identified.

Conclusion

This work highlights the need to individualize care of patients planning to start dialysis, not only at time of modality selection, but also as patients and caregivers near the initiation of dialysis.

Funding

• Government Support – Non-U.S.