Hope and advance care planning in patients with end stage renal disease: qualitative interview study
Open accessAbstract
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.
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- Authors
- Davison, S. N., & Simpson, C.
- Affiliations
- University of Alberta (CA)
- Dalhousie University (CA)
- Corresponding author
- Davison, Sara N
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2006-09-21
- Volume
- 333
- Issue
- 7574
- Pages
- 886
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1626305
- OpenAlex
- W2096265595
- Cited by
- 329
- References
- 33
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 12 · 2023: 11 · 2022: 13 · 2021: 21 · 2020: 18 · 2019: 20 · 2018: 11 · 2017: 24 · 2016: 25 · 2015: 20 · 2014: 18 · 2013: 21 · 2012: 34
- FWCI
- 12.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- hope, advance care planning, end-stage renal disease, end-of-life discussions, goals of care, patient values, patient empowerment, prognosis disclosure, dialysis patients, patient-professional relationship, barriers to advance care planning
- MeSH terms
- Activities of Daily Living, Adult, Aged, Aged, 80 and over, Emotions, Family Relations, Female, Humans, Kidney Failure, Chronic, Male, Middle Aged, Patient Education as Topic, Professional-Patient Relations, Advance Care Planning
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