Advance Care Planning and Chronic Kidney Disease: What Do Patients Know and What Do They Want?

Nephrol Nurs J. 2018 Nov-Dec;45(6):513-523.

Abstract

There is a gap in the research literature regarding advance care planning with this population of patients. This article reports on a study about the end-of-life knowledge, needs, and preferences of patients on hemodialysis - as reported by patients - within a hospital or community-based setting that addresses this gap. Data were collected using a survey method; non-probability, consecutive sampling (n=133) resulted in a high response rate of 64.0%. There were three key findings: 1) patients do not identify themselves as having a progressive health condition, 2) patients are comfortable discussing end-of-life issues, and 3) patients want discussions about end-of-life care when they request to do so or when their health worsens. We report on these findings and discuss three key recommendations: 1) patients with chronic kidney disease be consulted about the appropriate time for advance care planning, 2) symptom management needs greater attention, and 3) the role of family requires more consideration.

Keywords: advance care planning; chronic kidney diseaseD; end of life; hemodialysis; quantitative survey research.

MeSH terms

  • Advance Care Planning*
  • Humans
  • Renal Dialysis
  • Renal Insufficiency, Chronic / psychology*
  • Surveys and Questionnaires
  • Terminal Care*