Special ArticleDiscussions of the Kidney Disease Trajectory by Elderly Patients and Nephrologists: A Qualitative Study
Section snippets
Study Design, Setting, and Participants
We conducted focus groups and one-on-one semistructured interviews to explore how elderly patients and nephrologists understand and discuss the kidney disease trajectory and analyzed them using a qualitative approach.12 Qualitative methods are best suited for gathering rich descriptive information about a phenomenon for which few data or conceptual understanding exist.13
Participants were recruited from one academic setting, Duke University Health System, and one community nephrology practice in
Results
Letters were sent to 142 patients. Of these, 103 were called and 29 attended an interview or focus group (Fig 1). Two focus groups and one one-on-one interview were conducted for the 11 patients with CKD. For the 18 hemodialysis patients, 16 one-on-one interviews and one focus group were conducted. Hemodialysis patients preferred conducting interviews while receiving dialysis treatment, which necessitated primarily one-on-one interviews in this group. Two focus groups and one one-on-one
Discussion
This study highlights how discussions and understanding of the trajectory of kidney disease are challenging for both patients and nephrologists. Patients' strong emotions serve as a barrier to understanding their disease course and preparing for the future. Many also described lacking important information about their disease and its treatment. In turn, nephrologists expressed difficulty helping patients understand and prepare for a disease that is largely asymptomatic and difficult to predict.
Acknowledgements
We thank Dr Robert Gutman for support and assistance in conducting this study.
Support: This study was supported by fellowship grant T32 HS00079 from the Agency for Healthcare Research and Quality.
Financial Disclosure: The authors declare that they have no relevant financial interests.
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Originally published online January 6, 2012.