Abstract: SA-PO1122
Patient and Caregiver Perceptions of Health Risks Associated with CKD: A Thematic Synthesis of Qualitative Studies
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
- Elliott, Meghan J., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Love, Shannan, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- King-Shier, Kathryn M., University of Calgary Faculty of Nursing, Calgary, Alberta, Canada
- Liu, Ping, University of Calgary, Calgary, Alberta, Canada
- Dumka, Heather, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- O'Connor, Caitrin, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Ravani, Pietro, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
Background
People with chronic kidney disease follow varying disease trajectories, but it is unclear how they understand and use information about their individual risk of adverse outcomes. We aimed to thematically synthesize the published qualitative literature on how patients with chronic kidney disease not receiving kidney replacement therapy and their care partners perceive their individual risk of disease progression, kidney failure, and death.
Methods
We searched relevant electronic databases for qualitative studies in adults with chronic kidney disease not receiving kidney replacement therapy or their care partners, and that explored perceptions of individual risks of progression to kidney failure or death. Studies were excluded if participants had committed to a kidney replacement therapy or were receiving palliative or end-of-life care. Two research team members screened titles and abstracts and retrieved relevant full-text articles for review. Disagreements were resolved through discussion. We extracted details of included studies and conducted a thematic synthesis of findings captured descriptively or as participant quotes from primary studies.
Results
Of the 7671 citations screened, we included 39 studies. All studies involved patients living with chronic kidney disease, and 5 involved care partners. Only 4 studies addressed perspectives on risk and prognosis as the primary research objective. We characterized 5 themes – Participants conveyed a lack of personalized conversations (Theme 1) and limited prognostic understanding (Theme 2), which contributed to decisional conflict when choosing between kidney failure treatment options that they perceived as equally unappealing (Theme 3). Individuals’ readiness and acceptance of information about their individual risks influenced if and how they took action to modify potential outcomes (Theme 4) and anticipated implications for life participation (Theme 5).
Conclusion
Few qualitative studies have explored the perspectives of patients and their care partners specifically related to their individual risks of kidney failure and death. Our findings highlight a lack of discussions about perceived risk and need for additional supports to facilitate decisions as patients' chronic kidney disease progresses.