THE INFLUENCE OF PATIENT-PROVIDER COMMUNICATION ON PATIENT CKD AWARENESS, RISK FOR KIDNEY FAILURE, AND SELF-MANAGEMENT

Chronic kidney disease (CKD) is a global and national health crisis affecting 10% of the global population and 15% of Americans. These individuals often experience a diminished quality of life, an increased risk for cardiovascular disease, and a markedly reduced life expectancy. Even with the significant costs and prevalence associated with CKD, 90% of adults in the United States are unaware of their diagnosis. Healthcare providers are key contributors to patient CKD awareness, yet the nature of CKD conversations between providers and patients is not well understood and the influence of provider communication on patient awareness and self-management of CKD has been significantly understudied. This dissertation explores how patient-provider communication impacts patients’ awareness and self-management of their chronic disease. This dissertation is composed of three papers and uses a multi-method study design to quantitatively investigate if provider communication style is associated with patient CKD awareness and risk for kidney failure. Qualitative methods are used to explore patients’ experiences communicating with their primary care providers (PCPs) and the influence it may have had on their self-management. Secondary data analysis revealed that age is associated with patient awareness of CKD status, with older participants less likely to be aware of their CKD. Qualitative data analysis revealed that patients desire more information from providers regarding the self-management of their CKD. To fulfill this desire for information, participants describe how they build a relationship with their provider, come to clinic visits prepared with questions to facilitate communication, and independently sought out information on CKD management. This is the first study to examine the link between provider communication style and patient CKD awareness and patient-provider communication and CKD self-management. Findings from this dissertation study showed an impact of patient-provider communication on patient self-management of CKD. Additional work is needed to evaluate the influence of provider communication style on patient CKD awareness and risk for kidney failure in a larger study population. Further qualitative investigation into the influence of patient-provider communication on patient self-management of CKD among marginalized and vulnerable populations is also warranted.