Barriers to effective communication between veterans with chronic kidney disease and their healthcare providers: Table 1.

Abstract

BackgroundMany patients with chronic kidney disease (CKD) have insufficient knowledge about CKD, which is associated with poorer health outcomes. Effective patient–provider communication can improve CKD patients' knowledge, thereby augmenting their participation in self-care practices. However, barriers to addressing CKD patients' information needs have not been previously characterized.MethodsAdults with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 or on chronic dialysis or with a kidney transplant were recruited from a Department of Veterans Affairs (VA) nephrology clinic. Semi-structured telephone interviews were conducted to assess patients' CKD information needs and demographic characteristics. A qualitative approach was used to analyze interview transcripts and identify themes pertaining to communication dynamics.ResultsThirty-two patients participated. The mean age of participants was 63 years; most were male (94%) and non-Hispanic white (53%). CKD severity groups represented included CKD-3 (eGFR 30–59 mL/min/1.73 m2; 34%), CKD-4 (eGFR 15–29 mL/min/1.73 m2; 25%), CKD-5 (eGFR <15 mL/min/1.73 m2; 16%), end-stage kidney disease on dialysis (13%) and kidney transplant recipients (12%). Several key themes emerged about barriers to patient–provider communication based on patients' reported care at both VA and non-VA facilities, including patients perceived their role as a ‘listener’, reported limited CKD knowledge, did not understand physicians' explanations and were dissatisfied with the patient–provider relationship.ConclusionsSeveral barriers to patient–provider communication prevent patients from meeting their information needs and perpetuate patient passivity. Future research should evaluate whether interventions that empower CKD patients to actively participate in their care increase knowledge and improve health outcomes.

Kidney symptom questionnaire: Development, content validation and relationship with quality of life

“…However, a qualitative study aiming to explore barriers to effective communication amongst CKD patients found that a number of patients described their role to be listening (Lederer et al . ). These patients displayed greater levels of dissatisfaction with their physician relationship and less CKD knowledge in comparison to patients adopting a more active role (Lederer et al .…”

Hemodialysis Adequacy Sacrificed for Business: A Qualitative Study

“…Lederer also conducted a qualitative study on veterans with chronic kidney disease (CKD) and showed that passive behavior and being just a listener are of the barriers to effective communication between patients and healthcare providers (37). In the same vein, the current study revealed that passive behavior is one of the barriers to dialysis adequacy.…”

Self-Management Program for People with Chronic Kidney Disease in Vietnam: A Pragmatic Randomised Controlled Trial

“…Several studies have examined communication in CKD (Lederer et al, 2015;Walker et al, 2017;Washington, Zimmerman, & Browne, 2016). These studies have found that there are minimal discussions of CKD.…”

“…These studies have found that there are minimal discussions of CKD. For instance, Lederer et al (2015) in a study conducted in the U.S.…”

“…This finding highlights that participants perceived their role as a listener, a passive partner in the communication process. By being passive, CKD knowledge and understanding of medical practitioners' explanations may not improve (Lederer et al, 2015). Thus, effective communication between patients and healthcare providers is crucial to help patients with self-management activities such as home BP monitoring, weight management, and dietary changes (Lederer et al, 2015;Lopez-Vargas et al, 2014) to slow the disease progression and improve HRQoL.…”