Experience of Patients and Caregivers During the Predialysis Period: A Thematic Analysis
Bibliographic record
Abstract
Background: Patients living with advanced chronic kidney disease (CKD) often plan to initiate dialysis when their kidney function declines. While several studies have explored components associated with dialysis modality choice, little is known as to how patients and their caregivers experience the period preceding dialysis initiation. Methods: In this qualitative study, semi-structured interviews were performed with patients (n = 9) followed in an advanced multidisciplinary CKD clinic with an eGFR <12 ml/min/1.73 m2 who had already chosen their dialysis modality and with caregivers (n = 9). Thematic analysis was used to identify patients and caregivers' experiences during the predialysis time. Results: Patients participants were 69 ±7 years, included 4 women and 5 men. Among them, 5 patients had chosen home dialysis and 4 facility hemodialysis. Caregivers were mostly women (n=7/9) and most were living with the patient with CKD. Four main themes described patients and caregivers experience: successive shocks of announcements (from CKD diagnosis to imminent need for dialysis), minimizing repercussions on lifestyle regardless of the choice of dialysis therapy, personality type influencing feelings linked to dialysis anticipation (optimist versus pessimist, hope versus despair), reassurancethrough support network (including loved one and healthcare professionals). Patients and caregiver pairs had mostly concordant experience and overall, emotions toward dialysis were more often positive (hope of better future), although grief was also often identified. Conclusion: This work highlights the need to individualize care of patients planning to start dialysis, not only at time of modality selection, but also as patients and caregivers near the initiation of dialysis. Funding: Government Support – Non-U.S.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.007 | 0.005 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".