Conceptualizing Chronic Kidney Disease Dialysis Modality Decision-Making and Home-Dialysis Service Usage

• Author / Creator

  Harwood, Lori E

• Abstract

  People with Chronic Kidney Disease (CKD) are asked to make important decisions about if, where and how they will receive dialysis. As the population in Canada ages with increased co-morbidity such as diabetes and hypertension, the need for high cost treatments for CKD such as dialysis will persist. However, understanding the complexity of these decisions and influences of decision-making related to these treatments is limited. This work was undertaken to conceptualize the complexity of CKD modality decision-making with a focus on home-dialysis and older adults. Critical realism provided the framework for this inquiry.
  This paper-based dissertation includes an introductory chapter, four publishable papers and a discussion chapter. The first paper conceptualizes dialysis modality decision-making using critical realism and serves as the theoretical framework for this work. The second paper is a systematic literature review and meta-ethnography of the qualitative research on dialysis modality decision-making. The third paper is a quantitative study which examines the relationship between chronic kidney disease stressors as determinants of dialysis modality service usage. The forth paper, describes a qualitative study exploring home-dialysis modality decision-making for aging adults with advanced kidney disease. The conclusion of this dissertation is a discussion of the complete thesis, and includes implications for practice, policy and research.

• Subjects / Keywords

  • Dialysis
  • Critical Realism
  • Chronic Kidney Disease

• Graduation date

  Spring 2015

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R3K91M

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.