Understanding of advance care planning by family members of persons undergoing hemodialysis

West J Nurs Res. 2014 Nov;36(10):1357-73. doi: 10.1177/0193945913514637. Epub 2013 Dec 10.

Abstract

The purpose of this qualitative descriptive study was to explore hemodialysis patients' family members' understanding of end-of-life decision-making processes. The project aimed to address (a) family members' constructions of advance care planning (ACP), including their roles and responsibilities, and (b) family members' perceptions of health care providers' roles and responsibilities in ACP. Eighteen family members of persons undergoing hemodialysis were recruited primarily from outpatient dialysis facilities and interviewed individually. Confirmed transcript data were analyzed, coded, and compared, and categories were established. Interpretations were validated throughout the interviews and peer debriefing sessions were used at a later stage in the analysis. The overarching construct identified was one of Protection. Family members protect patients by (a) Sharing Burdens, (b) Normalizing Life, and (c) Personalizing Care. Recommendations for future research include the need to explore ACP of persons undergoing hemodialysis who do not have a family support system.

Keywords: advance care planning; family members; hemodialysis; qualitative research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advance Care Planning / statistics & numerical data*
  • Aged
  • Comprehension*
  • Decision Making
  • Family / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Qualitative Research
  • Renal Dialysis / psychology*