"I don't want it to be left up to anybody else."— A Qualitative Study of Patient Experiences with Advance Care Planning in a Chronic Kidney Disease Clinic Employing the MY WAY Intervention

Abstract

Evidence-based practice requires input of patient preferences and values to improve patient outcomes and support their desired quality of life. Advance care planning (ACP) is used to coordinate care, and motivational interviewing (MI) can facilitate this process. This study, part of a larger randomized clinical trial, provides insights emerging during ACP discussions with chronic kidney disease (CKD) pre-dialysis patients. Data generated from 33 recorded patients were analyzed using qualitative Content analysis. One overarching theme emerged prominently from the data: eliciting conversations. Four themes and ten sub-themes contributed to the overarching theme. ACP discussions with patients who have CKD are beneficial when starting predialysis. Use of an MI approach provides focus on the patient’s narrative and guides the patient toward a more productive ACP discussion.