Table 3.

Selected illustrative quotations

Theme	Illustrative Quotations
Contributing to treatment longevity
Making or breaking treatment	Paramount significance, as it can make or break PD.[PD infection, HP] Absolutely important. No access = No dialysis [catheter complications, HP] Vital to the whole process of PD. Like a car without a motor. Got the parts but nothing to drive it. [membrane function, PC] If the catheter doesn’t work, you can’t conduct treatment therefore it is critically important to maintain that lifeline with great care.[catheter complications, PC] I would have like to know more about the function of my membrane and, more importantly, how to keep it functioning well. PD is my preferred dialysis treatment and I would not like to have to switch to hemo. [membrane function, PC]
Demanding frequent monitoring	If it is not monitored properly the outcome could be devastating. [PD infection, PC] Repeat instructions, education and constant monitoring is required to maintain an optimal fluid status. [fluid, HP] Must be diligent in monitoring. [diabetes, PC] The need to chart the patient’s weight each day and report any significant changes to medical staff is time consuming but necessary. [weight change, PC]
Preserving quality of life
Quality versus quantity	QOL is about thriving not just surviving. [usual activities, PC] All of us will one day have to go through this, but it would have been better to improve the quality of life of the patient than to pay attention to the question of death. [death, PC] Death comes to us all. So it isn’t that important, more important is remaining as healthy as possible until you do die.[death, PC] Death is death, I’m more interested in helping people get more out of living. [death, HP] Life is more than not dying. [usual activities, HP] Death is still the hard outcome to be analysed what can be more important? [death, HP] It remains an important outcome for us as health professionals, we hope to save life. [death, HP]
Interfering with daily life	This is ongoing each day and can impact on my work and recreational activities [fatigue, PC] I rated this highly because travel, even for short trips, was very complicated. You have to be very organized and plan ahead. You can’t just take off for the weekend or take advantage of an airline seat sale. Feels very limiting. [usual activities, PC] This is an ongoing daily problem that can sometimes interfere with working and recreational life. [gastrointestinal problems, PC]
Escalating morbidity
Debilitating symptoms	The single worst symptom. Determined my ability to do anything. [fatigue, PC] Most visible and first hand impactful part of PD that affected me as the patient 24/7 [catheter complications, PC] This is one of the most hardest feelings to deal with and it effects most of the day to day things in life having to work around fatigue and tiredness. [fatigue, PC]
Calamitous complications	Associated with morbidity, catheter loss, transfer to hemodialysis, membrane damage, and occasionally death. So, is crucial. [PD infection, HP] On a day by day basis this causes a lot of problems - and is an important reason for switch to HD [catheter complications, HP] It has direct impact on outcomes (CV disease, Hospitalization rate, Death) [fluid, HP] Infection = PD failure or death [PD infection, HP]
Irrelevant and futile information and treatment
Avoiding redundant information	An important outcome, but I believe we already know enough about it. [residual renal function, HP] Too much studied in the past… more important for HD patients. [blood pressure, HP] Already extensive research so danger duplication. [diabetes, PC]
Imperceptible or intangible	I suppose I should give greater importance to death, but it seems far away to me. It’s hard for me to imagine when I feel okay. [death, PC] Never had an issue so could not fully determine the consequences. [PD infection, PC] BP does not tell me a how a person feels. [blood pressure, HP]
Inability to control	If it’s failed, it’s failed. Not much can be done about it. [PD failure, HP] I aim for a positive attitude, death is a fact of life I’ll cross deterioration in health as I get to it. [death, PC] Although sleep is very important, having sleep disturbance is part and parcel of being on PD and having end stage disease in general. [sleep, HP]
Easy to prevent and treat	One of the things we can actually (usually) control. [blood pressure, HP] Usually solvable with current treatments. [anemia, HP] I think that if you keep everything clean and your technique is good, you can avoid infections. [PD infection, PC] Peritonitis is a preventable event and therefore modifiable. There is an opportunity to fix it. [PD infection, HP]

Abbreviations: HP – Healthcare Professional; PC – Patient/Caregiver