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Kidney Week

Abstract: PO1379

Qualitative Interview Study on Advanced Care Planning for Patients with Advanced CKD and Their Families: The Impact of the MY WAY Advance Care Planning Intervention

Session Information

Category: Educational Research

  • 800 Educational Research

Authors

  • Grimes Webster, Tinsley, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Pearson, Elise M., University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Ernecoff, Natalie C., University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Schell, Jane O., University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
Background

Despite recommendations for shared decision-making approaches to advance care planning (ACP) for people with chronic kidney disease (CKD), doctor-patient conversations about ACP are infrequent. The MY WAY educational and patient-coaching intervention aims to elicit patient values to increase rates of ACP. This qualitative sub-study sought to: (1) gain understanding of participant responses to MY WAY ACP materials, and (2) learn about participant wishes for kidney care within ACP.

Methods

We conducted semi-structured interviews with participants from the intervention arm of the MY WAY study. Fifteen people with CKD were queried about their experiences of the MY WAY print materials and coaching session. Interviews were recorded and transcribed for simultaneous coding by two researchers. Data were analyzed using thematic analysis.

Results

Fifteen intervention participants ages 59-87 were interviewed (10 women, 5 men). Five major themes emerged: participant advice for interventionists; experience with ACP before and after the intervention; participant experience of printed materials; participant response to coaching session; and chronic kidney disease thoughts and communication. Differences between participant experiences of general and CKD-specific ACP emerged, including willingness to discuss care wishes with family members and clinicians.

Conclusion

Participants perceived the coaching session to have high utility in facilitating ACP, but expressed less engagement with CKD-specific care plans. Findings suggest that characteristics of the coach, including empathy and problem-solving, play a key role in participant comfort with ACP conversations, and that engagement with ACP may not correlate with engagement with CKD-specific care wishes. Notably, even participants who engaged actively with general ACP expressed that kidney-specific care would be addressed with their nephrologists if or when the need arose. Future studies should further explore the interrelation of general ACP and CKD-specific care planning.

Funding

  • Private Foundation Support