ArticleBMC nephrology2025
Barriers and preferences in advance care planning: a mixed-methods study of end-stage kidney disease patients and caregivers in India.
Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Indian Nephrologists' Approaches to Shared Decision-Making, Advance Care Planning, and Palliative Care.Kidney international reports · 2026Article
- Randomized Controlled Trial of Integrated Kidney Supportive Care in End-Stage Kidney Disease.Kidney international reports · 2026Article
- Patterns of kidney supportive care referrals in a tertiary hospital in India: a six-year audit.BMC nephrology · 2026Article
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Authors and funding
8 authors.
Funding
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Abstract
objectivesTo understand preferences for illness-related information, decision-making roles, and barriers to Advance Care Planning (ACP) documentation among patients with End-stage Kidney Disease (ESKD) and their caregivers in India.
methodsA convergent parallel mixed-methods study was conducted from October 2022 to September 2023 at a tertiary care hospital in South India. Quantitative data were collected using a validated ACP questionnaire from 247 patient-caregiver dyads. Qualitative data were obtained from semi-structured interviews with 34 patients and 6 caregivers. Quantitative data were analyzed using descriptive and inferential statistics; qualitative data were analyzed thematically using Braun and Clarke's framework.
resultsMost patients (90.7%) and caregivers (94.1%) preferred detailed illness-related information, yet ACP documentation interest was low (20.4% dialysis, 9.2% non-dialysis patients). The majority preferred collaborative decision-making involving family and clinicians. Barriers to ACP included limited awareness, emotional burden, and systemic challenges. Enablers included family support and provider guidance.
conclusionsWhile interest in illness information and shared decision-making is high, ACP documentation remains limited. Tailored strategies are needed to promote ACP engagement. PRACTICE IMPLICATIONS: Integrating culturally sensitive ACP discussions into routine nephrology care and involving families can improve ACP participation.
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