Project 444491

Kidney failure is the most advanced stage of chronic kidney disease, where dialysis is often needed as a life-sustaining therapy. Adults with kidney failure have complex health care needs and are at increased risk of developing urgent health complications. People with kidney failure visit the emergency department 8 times more often than people without kidney failure for a variety of health issues. Research tells us about the patient characteristics and medical reasons for emergency department visits among people with kidney failure. However, we know very little about how or why someone with kidney failure decides to seek care (or not) in the emergency department. These decisions are complex and require a person to consider his or her past experiences, values, and preferences. It is important to understand how people's need for dialysis and the availability of kidney care services might influence their decision making, so that care can be provided in a way that meets their needs and preferences. In this research study, we will examine the medical and non-medical factors that contribute to the decisions of people with kidney failure to seek emergency care for a variety of health issues. This is a qualitative study, which means that we will interview patients and their loved ones about their experiences with urgent health issues and the medical care they received. We will ask them about the circumstances leading up to their emergency department visit, and what or who may have influenced their decision to seek emergency care. We will analyze transcripts of our discussions and present patterns that summarize and explain the decision-making process. Findings from this study will provide direction for future research by our team to develop and test novel ways of providing urgent care for people with kidney failure.