Supporting patient-centered pregnancy counseling in nephrology care: a semi-structured interview study of patients and nephrologists

BackgroundIndividuals with chronic kidney disease (CKD) are at increased risk of adverse pregnancy outcomes and susceptible to disempowerment decisional burden when receiving reproductive counseling considering pregnancy. Nephrologists do not commonly counsel about health, no tools exist support patient-centered for those CKD.MethodsThirty patients aged 18-45 CKD stages 1-5 who were assigned female sex birth 12 nephrologists from a single academic medical center participated in semi-structured qualitative interviews. They asked information needs, decision-support as well facilitators barriers health care counseling. Thematic analysis was performed.ResultsFour main themes identified: 1) assessing intentions; 2) disease; 3) risk; 4) communication decision-making needs. Patients’ intentions varied over time shaped the content needed nephrologists. Patients both felt could be improved but focused on different aspects improve quality this counseling; providing individualized estimates balancing risks benefits management. desired bring up topic clinic, is or systematically done currently.ConclusionsThis work highlights critical need more dialog care, identified differences what think important decision-making, provides an step developing nephrology. Individuals CKD. Thirty performed. Four currently. This