Hope and advance care planning in patients with end stage renal disease: qualitative interview study
Top Cited Papers
- 21 September 2006
- Vol. 333 (7574), 886
- https://doi.org/10.1136/bmj.38965.626250.55
Abstract
Objective To understand hope in the context of advance care planning from the perspective of patients with end stage renal disease. Design Qualitative in-depth interview study. Setting Outpatient department of a university affiliated nephrology programme. Participants 19 patients with end stage renal disease purposively selected from the renal insufficiency, haemodialysis, and peritoneal dialysis clinics. Results Patients' hopes were highly individualised and were shaped by personal values. They reflected a preoccupation with their daily lives. Participants identified hope as central to the process of advance care planning in that hope helped them to determine future goals of care and provided insight into the perceived benefits of advance care planning and their willingness to engage in end of life discussions. More information earlier in the course of the illness focusing on the impact on daily life, along with empowerment of the patient and enhancing professional and personal relationships, were key factors in sustaining patients' ability to hope. This helped them to imagine possibilities for a future that were consistent with their values and hopes. The reliance on health professionals to initiate end of life discussions and the daily focus of clinical care were seen as potential barriers to hope. Conclusions Facilitated advance care planning through the provision of timely appropriate information can positively enhance rather than diminish patients' hope. Current practices concerning disclosure of prognosis are ethically and psychologically inadequate in that they do not meet the needs of patients.Keywords
This publication has 27 references indexed in Scilit:
- Hope and Spiritual Well-Being: Essentials for Living With AIDSPerspectives in Psychiatric Care, 2009
- Editorials: Dialysis Access Failure: An Indication for Immediate Kidney TransplantationSeminars in Dialysis, 2002
- Improving Advance Care Planning by Accommodating Family PreferencesJournal of Palliative Medicine, 2001
- Patient Hope: Exploring the Interactions between Physicians and HIV Seropositive IndividualsQualitative Health Research, 1997
- The discussion about advance directives. Patient and physician opinions regarding when and how it should be conducted. End of Life Study GroupArchives of Internal Medicine, 1995
- Oncology and narrative timeSocial Science & Medicine (1982), 1994
- Disclosing the cancer diagnosis. Procedures that influence patient hopefulnessCancer, 1993
- The power of compassion: Truth-telling among American doctors in the care of dying patientsSocial Science & Medicine (1982), 1993
- Negotiating reality after physical loss: Hope, depression, and disability.Journal of Personality and Social Psychology, 1991
- Negotiating reality after physical loss: Hope, depression, and disability.Journal of Personality and Social Psychology, 1991