Adhering to Behaviour Change in Older Pre‐dialysis Populations—what Do Patients Think? A Qualitative Study

Abstract

SUMMARY Background: Chronic Kidney Disease (CKD) is associated with the development of serious co‐morbidities. Patients with CKD are encouraged to adhere to regimens to lower this risk. This study aimed to explore the experiences of patients attempting to integrate lifestyle changes into their lives. Method: Face‐to‐face recorded interviews were conducted with nine consenting patients with CKD Stage 4 under the care of a consultant nephrologist. Each recording was analysed by two independent investigators using thematic analysis. Results: Five themes emerged: Self in relation to others, Control, Adherence, Beliefs about treatment and illness and Uncertainty. Participants highlighted the importance of personal support and recounted their sense of being a burden on close family. They described how they approached disclosure about their condition, their beliefs regarding treatment and their decision making processes and how these factors impacted on adherence to behaviour change. Conclusion: Practical support from family and healthcare professionals, a willingness to disclose their condition and help to make good decisions in difficult circumstances were identified as important factors in supporting success with behaviour change.

Medication‐taking behaviours in chronic kidney disease with multiple chronic conditions: a meta‐ethnographic synthesis of qualitative studies

“…) including consultants, nurses, and physicians (Walker et al . ). This encounter can occur in a hospital or provider clinic office setting or any setting in which there is a communication between a patient and a provider who has responsibilities for prescribing.…”

“…Patient behaviours associated with patient–provider communication included managing conflicting advice from providers (Walker et al . ), withholding information from physicians to avoid new prescriptions (Williams & Manias ), and questioning why they were taking certain medications (Walker et al . ).…”

“…), withholding information from physicians to avoid new prescriptions (Williams & Manias ), and questioning why they were taking certain medications (Walker et al . ). Distrust of providers was a concern and patients spent a great deal of time searching for satisfactory health care resulting in frequent provider changes (Senteio & Veinot ).…”

“…The decision to fill a prescription involves appraisal, that is patients questioning the need for different medications (Walker et al . ) and making risk assessments regarding, for example the long‐term implications of medications (Williams et al . ) and the cumulative effect of their diseases (Williams et al .…”

Dietary and Fluid Restrictions in CKD: A Thematic Synthesis of Patient Views From Qualitative Studies

“…of life based on their own critical experiences, such as severe fluid overload. 25,29 Some patients gained confidence in their own dietary strategies by regulating their diet according to blood test results 6 : "I've kept my chemistries at a level and I know that if it goes up, I know how to bring it down." 34 Preventing CKD progression (5 studies).…”