Psychosocial Factors, Intentions to Pursue Arteriovenous Dialysis Access, and Access Outcomes: A Cohort Study

Rationale & Objective Suboptimal dialysis preparation of patients with chronic kidney disease (CKD) is common, but little known about its relationship to psychosocial factors. This study aimed assess patients’ attitudes access creation and identify factors associated intentions regarding outcomes. Study Design Prospective cohort study. Setting Participants 190 stage 4/5 CKD not receiving treated at 2 hospitals in Singapore 128 their family members. Predictors Self-reported measures illness perception, health-related quality life, toward creation. Sociodemographic clinical were also obtained. Outcome Intention create an arteriovenous fistula (AVF; ie, proceed vs wait see) time a functional AVF. Analytical Approach Exploratory factor analysis (EFA) was undertaken construct internally consistent subscales for newly developed questionnaire Logistic regression cause-specific hazards models conducted outcomes, respectively. Results EFA (explained 50.1% variance) revealed 4 domains: concerns, need dialysis, worry cost, value access. A high risk intention delay (51.1%) found among despite early referral education. Multivariable (R2 = 0.45) showed that the greater perceived from (odds ratio, 2.61; 95% CI, 1.46-4.65; P < 0.001). Limitations Limited generalization, as only those already nephrology care studied. Conclusions Approximately half studied planned The evaluate may help individuals whom decision-support programs would be useful. These findings highlight understand address concerns