Special ArticlePatient Views About Treatment of Stage 5 CKD: A Qualitative Analysis of Semistructured Interviews
Section snippets
Data Collection
Interviews with 95 nonindigenous patients from the IMPAKT (Improving Access to Kidney Transplantation) study conducted in Australian renal units in 2005-2006 were analyzed13 (Fig 1). The IMPAKT study investigated reasons for disparity in access to kidney transplants for indigenous Australians through a large-scale in-depth interview study involving patients, nephrologists, and key decision-making staff at selected Australian transplant and dialysis sites (Fig 2).14 Each patient was asked
Participant Demographics
Most patients were Anglo-Australian men aged 50-69 years who were not employed (Table 1). Fifty-two patients were receiving satellite HD in a limited care setting: 8, incenter HD; 8, CAPD; 5, APD; 4, home HD; and 18 patients had a functioning transplant at the time of the interview (Fig 1). Seventeen of 18 transplant recipients had previously experienced dialysis therapy (94%) and 8 of 77 dialysis patients had previously received a transplant (10%). Fifty-four percent of patients had a carer or
Discussion
Patients preferred RRTs that enhanced their freedom and autonomy and were convenient, effective, and simple. Treatments that minimized confinement and risk also were viewed positively. Only 1 patient mentioned longevity as a positive characteristic associated with dialysis. Although transplant was perceived to closely resemble normal life, the risks associated with major surgery and immunosuppression were seriously considered by patients, within the context of their age and their prior
Acknowledgements
The authors acknowledge the support of the study participants, participating treatment sites, transplant units, and their associated reference groups. The authors specifically thank Joan Cunningham for helpful comments on the final draft of the manuscript and Cilla Preece for conducting a large number of patient interviews.
Support: Ms Morton is supported by a university postgraduate award and through National Health and Medical Research Council (NHMRC) grants #457281 and #571372. Dr Cass is
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Originally published online as doi:10.1053/j.ajkd.2009.11.011 on February 1, 2010.