Dr Chi Wai Lee1, Dr SARAH SO1
1DEPARTMENT OF MEDICINE, NEPEAN HOSPITAL, Kingswood, Australia
Biography:
Chi Wai Lee is an experienced renal nurse and nurse educator with a career spanning advanced clinical practice, research, and academic teaching. Specialising in renal nursing since 1989, he has delivered comprehensive care for clients undergoing chronic haemodialysis and peritoneal dialysis and currently practises in a haemodialysis unit in Sydney. His research centres on end-of-life care for dialysis patients, with his doctoral work examining how patients and carers prioritise care at end-of-life and subsequent studies promoting advance care planning among patients and the broader public. He remains committed to advancing renal nursing and maintaining a reflective, evidence-informed practice.
Abstract:
Background: End-stage kidney disease patients on dialysis face high risks of hospitalization and mortality, only 30% have discussed their end-of-life (EoL) care preferences with relatives or healthcare professionals in Australia. Barriers to these discussions include uncertainty about the disease process, disengagement from decision-making and discussions about their treatment preferences and EoL care.
Aim: The study aimed to utilize the Go Wish Card (GWC) as an alternative method to facilitate discussions about EoL care and advance care planning (ACP) among haemodialysis patients. Methods: This purposive cross-sectional study was conducted in a local health district in Sydney, Australia. Demographic data, advance care planning engagement survey, and quality of life outcomes measure (EQ-5D-5L) were collected. Participants selected the ten GWCs with statements that they considered “very important” and ten as “not important” in ranked order.
Results: Thirty-seven patients participated in the study. Among the top five highest frequencies of “very important” care preferences, three related to social needs, and two to physical needs. “I don’t want to be a burden to my family” (social needs) was ranked as the most important care preference. Seventy-three per cent of participants felt that the GWC assisted them in planning their ACP. Eighty-one per cent would recommend the GWC to others.
Conclusion: The study revealed that patients on haemodialysis prioritize social needs at the EoL phase. These findings offer valuable insights into the care preferences and priorities of patients, which can help inform family members and healthcare professionals, leading to more guided practices in EoL care planning