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Table 2 Providers’ perceived challenges to patients’ preparation for renal replacement therapy

From: Specialist and primary care physicians’ views on barriers to adequate preparation of patients for renal replacement therapy: a qualitative study

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