A SURVEY OF END OF LIFE CARE PREFERENCES AMONG PATIENTS ON MAINTENANCE AEMODIALYSIS IN KUANTAN

Abstract

Introduction: There are growing evidences of the end of life care role for end stage renal disease (ESRD) patients who are associated with high morbidity and mortality rate despite being on dialysis therapy. However, the local data on the patients’ preferences is yet sparse.

Method: The study aimed to describe the end of life care preferences among patients on haemodialysis (HD) in Kuantan, Pahang. A cross-sectional study was conducted among 350 patients from 14 outpatient centres. Patients were recruited via convenient sampling and data collection began from March till June 2019. Participants completed the validated questionnaire in structured, interview-based surveys.

Results: The highest number of respondents preferred a plan of care that relieves pain or discomfort and improves quality of life as much as possible over prolonging life. Patients’ preference of being at home approaching end of life rather than receiving active interventions and treatments in the hospital was reported in most respondents. Majority were comfortable to discuss end of life issues with their nephrologists on a regular basis. However, the discussion rarely took place with 60% of them never engage in any discussion concerning their preferences on the end of life care choices in the past 1 year.

Conclusion:  The study demonstrated that only a minority have engaged in the discussion on the end of life care choices and preferences with their treating health professionals despite their wish and comfortability to do so.