Abstract: TH-PO936
Prognostic Awareness among Patients with ESKD and Care Partners: Preliminary Themes from Semistructured Interviews
Session Information
- Geriatric Nephrology: Innovations and Insights
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1300 Geriatric Nephrology
Authors
- Liu, Annie, Massachusetts General Hospital, Boston, Massachusetts, United States
- Reich, Amanda Jane, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Lakin, Joshua R., Dana-Farber Cancer Institute, Boston, Massachusetts, United States
- Kalim, Sahir, Massachusetts General Hospital, Boston, Massachusetts, United States
Background
End stage kidney disease (ESKD) patients have shown limited prognostic awareness and less is known about their care partners. With older adults on dialysis and care partners being a crucial support source, we aimed to characterize various domains of prognostic awareness among patient-care partner dyads to inform the future delivery of goal concordant care.
Methods
We conducted 12 initial semi-structured interviews with ESKD patients on hemodialysis at a Boston hospital and their care partners using an interview guide developed by our research team (comprised of nephrologists, palliative care physician, and qualitative researcher). Qualitative analysis of audio-recorded, de-identified, transcribed interviews was performed. Inductive codes were identified based on Antonovsky’s sense of coherence model.
Results
Analysis of 12 interviews (7 patients and 5 care partners) with a median duration of 33 minutes (19-40 minutes) revealed two preliminary themes: (1) Prognosis perception: Care partners viewed patient prognosis as time before death and shorter in duration than the patients. (2) Prognostic information preferences: Patients preferred prognostic information focused on changes in physical function, whereas care partners sought information on time remaining and expected end of life symptoms.
Conclusion
Preliminary data from this exploratory study suggest differing prognostic information needs within the dyads, possibly due to their distinct roles and responsibilities.
Participant sociodemographic and clinical characteristics
| Patient (n=7) | Care partner (n=5) | |
| Age (years) | M=74 (67-84) | M=53 (38-65) |
| Female | 2 (29%) | 4 (80%) |
| Education | ||
| High school or below | 2 (29%) | 1 (20%) |
| College or above | 5 (71%) | 4 (80%) |
| Employed | 2 (29%) | 3 (60%) |
| Married/partnered | 1 (14%) | 3 (60%) |
| Completion of Instrumental Activities of Daily Living | ||
| All | 2 (29%) | |
| Partial | 3 (43%) | |
| None | 2 (29%) | |
| Transplant Status | ||
| Active | 1 (14%) | |
| Temporarily inactive | 1 (14%) | |
| Ineligible | 5 (71%) | |
| Dialysis vintage (years) | M=3 (0.7-8) | |