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Table 10 Excerpt 9. Pulling back and sending mixed messages

From: Shared decision making in chronic kidney disease: a qualitative study of the impact of communication practices on treatment decisions for older patients

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69.

Doc1:

But of course I’m not going to, you know, force her to have anything.

70.

CKD-P18’s son:

Hm.

71.

Doc1:

Um, it’s on choice and when it comes to it, it’s, you know, for dialysis they’ll just put in a and dialyse.

72.

CKD-P18’s son

Mm-hm.

73.

Doc1:

So, that’s the thing. She’ll definitely consider dialysis, is that?

74.

CKD-P18’s son:

Well, yes, um, haemodialysis, to be specific.

75.

Doc1:

Yes.

76–103 omitted

104.

Doc1:

Yeah, I know. No, I - I mean I totally get what she’s saying, she - she’s a bit worried and scared and she wants to kind of postpone that, er, thing as much as possible. Everyone wants to postpone it, no one wants to get into dialysis straight up, um, and we will not start on dialysis, um, unless she needs it.

105.

CKD-P18’s son:

Hm, like eight, and say…

106.

Doc1:

And also, just because she has a AV fistula doesn’t mean that she goes onto dialysis.

107–121 omitted (mother and son conversing in Korean)

122.

Doc1:

Because I’m worried that she’s—she’s—she’s lost weight not just because she’s, you know, suddenly started exercising or going on a diet, but I’m worried because of the kidney impairment that, you know is impacting her …

123–141 omitted

142.

Doc1:

Okay, anyway, it doesn’t matter.

143.

CKD-P18’s son:

Sure.

144.

Doc1:

There is no emergency to start it at the moment anyway, um, it’s just that it would be good to, you know, prepare, that’s all, um…

145.

[Over speaking]

146.

CKD-P18’s son:

That’s right, yeah. Well thanks for the, you know, heads up.

147–231 omitted

232.

Doc1:

But if you decide, er, let, er, [first name kidney nurse] know…

233.

CKD-P18’s son:

Mm-hm.

234.

Doc1:

…so we can organise the AV fistula.

235.

CKD-P18’s son:

Sure.

236.

Doc1:

Okay, just because you get the [fistula] doesn’t mean we’ll start dialysis but at least…

237.

CKD-P18’s son:

That’s right.

238.

Doc1:

…get the ball rolling.

239.

CKD-P18’s son:

Mm-hm. I’ll make sure she understands that.

240.

Doc1:

Yeah.