Table 2 Providers’ perceived challenges to patients’ preparation for renal replacement therapy
Themes | Subthemes | Type of providers identifying |
|---|---|---|
System-level challenges | ||
Limited time for optimal patient preparation | • Limited time to prepare | Nephrology |
• Limited time to build trusting relationships | Nephrology | |
Referral process delays | • Delays in referral to vascular surgery | Nephrology |
Poor primary care/nephrology co-management | • Poor information exchange | Nephrology and Primary care |
• Lack of patient CKD education prior to nephrology referral | Nephrology | |
• Poor delineation of roles | Primary care | |
Provider-level challenges | ||
Provider difficulty with explaining CKD and confirming patient understanding | • Conveying CKD in lay terms | Nephrology |
• Uncertainty about patient understanding of RRT options | Nephrology | |
Patient-level challenges | ||
Patients’ poor acceptance and understanding of CKD | • Denial of CKD diagnosis and/or severity | Nephrology |
• Poor understanding of CKD | Nephrology | |
• Low awareness/understanding of treatment options | Nephrology | |
Patients’ low perceived urgency for RRT preparation | • Delayed preparation because asymptomatic | Nephrology |
• Poor compliance with RRT preparation appointments | Nephrology | |
Patients’ negative perceptions about RRT | • Fear/anxiety about dialysis | Nephrology |
Patient cultural or language differences | • Patient preference for alternative treatments | Nephrology |
• Poor patient understanding due to cultural and/or language differences | Nephrology | |
Lack of patient trust | • Low patient trust in health providers | Nephrology |