Table 2.

Levels of Behavioral Activation Toward Access Creation in Patients

Illustrative Quotes

Avoidance/Denial

“I was undecided and very confused. I was even thinking maybe I don’t need to go through all these. All the dialysis, all the operations and all that. At first you will tend to have [this] escapist mind. Yes, I keep on thinking maybe I will be special. You don’t tend to believe in it. Maybe it’s not that bad, maybe they made a wrong diagnosis. At that point I felt that I was just listening to her [doctor] talk and then get out. You just want to shut your mind off.” (HD patient with catheter)

“Actually the dialysis thing is already out of mind. It’s only when somebody mention then I bring it up from my mind to you. If not, I put aside. I put aside, that’s why I told the coordinator be happy and I put aside.” (CKD4 patient)

Wait and See

“I will decide it later on when it is unbearable.” (HD patient with catheter)

“I feel that me doing dialysis, it’s a matter of time. My kidney functioning index will not get better. I tried my best to take medicine and try to delay as much as possible. I was hopeful.” (CKD4 patient) “I say, see a few years later. Wait till I act up then see how… I was unwilling to go… keep unwilling to go. Only wait till when I feel very lethargic in my whole body can’t get up then no choice I go.” (HD patient with catheter)

Active Intention

“I thought it [dialysis] will be coming very fast the way things are. So be prepared for it, so I need to do that [AVF].” (CKD4 patient)

“Because confirm I will be going for dialysis so it’s better to go for one operation instead of two.” (HD patient with AVF) “From blood test it shows that your kidney is not good. Don’t waste time, the more you wait, maybe the more [the] problem [will] affect other areas… at the end of the day I think dialysis is still the answer.” (HD patient with AVF)

Abbreviations: AVF, arteriovenous fistula; CKD4, chronic kidney disease stage 4; HD, hemodialysis.