Table 5.
Predictors of a good outcome and methods of assessment, derived from reflexive interpretative analysis
| Physical factors | |
| ● prominent uraemic symptoms that may be relieved by dialysis (e.g., nausea, anorexia) | |
| ● low levels of pre-existing frailty/physical dependence | |
| ● absence of pre-existing significant symptoms that are unlikely to be relieved by dialysis (e.g., chronic pain, depression) | |
| ● the ability to tolerate dialysis, particularly fluid removal | |
| ● a functional access for dialysis which is not problematic to use/maintain | |
| Psychological factors | |
| ● lack of conflict or ambiguity around the decision to start dialysis | |
| ● expectations from dialysis that are reasonable and achievable | |
| ● illness perception - an internal locus of control, willingness to take responsibility for own health | |
| ● understanding of dialysis treatment and need for lifestyle changes, food/fluid restrictions | |
| ● actively choosing a positive attitude; not “giving up”, willingness and opportunity to adapt to changing circumstances | |
| ● hopeful; engaged with the future; “meaning and purpose” in life | |
| Social factors | |
| ● family as motivation: providing physical/psychological support, family that requests continuance on dialysis or other treatment, participants who continue dialysis in order to be able to look after their family members | |
| ● involvement of close family/friends/carers in daily life, in healthcare decisions | |
| ● participants who derive social benefit from interactions of the dialysis unit (particularly if socially isolated) | |
| ● ability to travel or engage in other activities (personal or social) separate from dialysis | |
| Healthcare provider/institutional/societal factors: | |
| ● positive relationships with healthcare providers, where patients feel valued and listened to | |
| ● appropriate skill sets among medical and nursing staff | |
| ● opportunity to consider or participate in advance care planning | |
| ● patient-friendly staff and dialysis facilities (e.g., flexible schedules, comfortable chairs, adequate heating) | |
| ● easy access to dialysis facilities, including proximity, transport arrangements | |
| ● financial stability or lack of financial penalties from being on dialysis | |
| ● access to social/formal community support that is affordable and always available |