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Living well without dialysis: Patients’ and healthcare professionals’ evaluation of the innovative, online Conservative Kidney Management Pathway
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- Author / Creator
- Hussain, Syed T
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Introduction
Conservative kidney management (CKM) is a non-dialysis treatment option for older end-stage kidney disease (ESKD) patients with multiple comorbidities and poor functional status. For such patients who are unlikely to benefit from dialysis, Alberta recently launched a CKM Pathway that
standardizes CKM and focuses on preserving kidney function, managing ESKD symptoms and offering
holistic psychosocial support to patients and families. The CKM Pathway was introduced in four
kidney clinics through a guided implementation process with staff engagement and education. An
evaluation was undertaken to assess the CKM Pathway in improving CKM through quantitative and
qualitative measures. The focus of this thesis is on the qualitative evaluation of the CKM Pathway
from the perspectives of patients/families and healthcare providers.
Methods
A qualitative descriptive design was used. Patients and healthcare providers at four kidney clinics in
Edmonton and Red Deer participated. Individual in-depth interviews with CKM patients/families and
semi-structured focus groups with staff were conducted, recorded and transcribed verbatim.
Thematic analysis was done using line-by-line coding.Results
Ten patient/family interviews with 16 participants and five focus groups with 25 healthcare
providers were conducted across the four kidney clinics. Three patient/family themes were
identified. The CKM Pathway: a) supported facilitated decision-making; b) provided effective CKM
patient resources; and c) promoted patient-centered care.
From the staff focus groups, three related themes were identified. The CKM Pathway: a) improved
kidney clinic processes and patient care; b) addressed a gap in CKM resources; and c) facilitated
shared care with community- based healthcare providers.iii
Conclusion
Themes show overlap between patients/families’ and healthcare providers’ evaluation of the CKM
Pathway. Kidney clinic staff piloting the CKM Pathway felt it provided evidence-based, standardized
care and CKM patients felt supported with the pathway’s tools and resources. Both felt the CKM
Pathway facilitated patient-centered CKM by engaging primary care providers as partners. Future
studies should evaluate the CKM Pathway from the community care providers’ perspective. -
- Graduation date
- Fall 2019
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- Type of Item
- Thesis
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- Degree
- Master of Science
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- License
- Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.