Exploring the nature of illness perceptions in people with end‐stage kidney disease

Rees, Jessica; Chilcot, Joseph; Donnellan, Warren; Soulsby, Laura

doi:10.1111/jorc.12225

Cited by 17 publications

(25 citation statements)

References 61 publications

(106 reference statements)

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“…These are important findings for clinicians because being attentive to the how a patient and their carer may be feeling has been associated with positive clinical benefits (Rees et al . ). Being attentive to the emotional state of patients and carers will also influence the timing, content and teaching techniques used by clinicians in their renal diet education (Ormandy ).…”

Section: Discussionmentioning

confidence: 97%

“…However, participants in this study also described moving on from feeling overwhelmed and frustrated, to accepting that the diet was important to maintain their health and developed strategies enabling them to apply the renal diet to their everyday lives. These are important findings for clinicians because being attentive to the how a patient and their carer may be feeling has been associated with positive clinical benefits (Rees et al 2017). Being attentive to the emotional state of patients and carers will also influence the timing, content and teaching techniques used by clinicians in their renal diet education (Ormandy 2008).…”

Section: Discussionmentioning

confidence: 99%

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How do patients and carers make sense of renal dietary advice? A qualitative exploration

Lambert

Mansfield

Mullan

2018

Journal of Renal Care

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SUMMARY Background Dietary modification is an integral part of chronic kidney disease (CKD) management. However, adherence to the renal diet is often suboptimal. Methods The aims of this study were to (i) describe the experiences of patients with CKD and their carers in their process of interpreting and implementing renal dietary advice; (ii) to explore strategies they used to make sense of and apply renal diet information and (iii) to develop recommendations for improved clinical practice. To achieve these aims, individual semi‐structured interviews with 26 patients and 10 carers were conducted, using interview questions guided by Sensemaking theory. Findings Six themes emerged from the data which did not differ according to CKD stage, geographic location or renal replacement therapy (RRT) type. The renal diet was perceived by patients and carers to be overwhelming, frustrating and emotionally demanding; as well as being complex and challenging. To help make sense of and apply renal dietary advice, participants highly valued the input of the dietitian; and patients believed that their carer support was important. Individual problem‐solving strategies were developed by participants to help them make sense of the renal diet, and many of them expressed a desire for additional resources and/or support. Conclusions This study highlights that learning to make sense of renal diet information is an emotionally challenging journey for patients and carers. In addition to utilising the expertise of dietitians, carer support was perceived to be integral to learning and using renal dietary advice. The study describes a number of important problem‐solving strategies utilised by patients and carers, as well as recommendations to help improve sensemaking and adherence to the renal diet.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

How do patients and carers make sense of renal dietary advice? A qualitative exploration

Lambert

Mansfield

Mullan

2018

Journal of Renal Care

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“…Different studies underpin that these illness representations predict a range of outcomes in patients undergoing dialysis. 22,23…”

Section: Discussionmentioning

confidence: 99%

Patients’ experiences of transitioning between different renal replacement therapy modalities: A qualitative study

et al. 2020

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Background: Different kidney replacement therapy modalities are available to manage end-stage kidney disease, such as home-based dialysis, in-center hemodialysis, and kidney transplantation. Although transitioning between modalities is common, data on how patients experience these transitions are scarce. This study explores patients’ perspectives of transitioning from a home-based to an in-center modality. Methods: Patients transitioning from peritoneal dialysis to in-center hemodialysis were purposively selected. Semi-structured interviews were performed, digitally recorded, and transcribed verbatim. Data analysis, consistent with Charmaz’ constructivist approach of grounded theory was performed. Results: Fifteen patients (10 males; mean age 62 years) participated. The conditions of the transitioning process impacted the participants’ experiences, resulting in divergent experiences and associated emotions. Some participants experienced a loss of control due to the therapy-related changes. Some felt tied down and having lost independence, whereas others stated they regained control as they felt relieved from responsibility. This paradox of control was related to the patient having or not having (1) experienced a fit of hemodialysis with their personal lifestyle, (2) a frame of reference, (3) higher care requirements, (4) insight into the underlying reasons for transitioning, and (5) trust in the healthcare providers. Conclusions: Care teams need to offer opportunities to elicit patients’ knowledge and fears, dispel myths, forge connections with other patients, and visit the dialysis unit before transition to alleviate anxiety. Interventions that facilitate a sense of control should be grounded in the meaning that the disorder has for the person and how it impacts their sense of self.

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“…[19] Cognitive and emotional attributes form illness representation which is explained in terms of cause, consequences, control, identity and timeline. [20] Coping strategies include approach coping (active seeking of advice, help or medicine) and avoidance coping (the denial of symptoms and/or diagnosis and refusal to seek help).…”

Section: Discussionmentioning

confidence: 99%

Models and theories of care applicable to predicting and improving adherence behaviours among Chronic Kidney Disease (CKD) patients

Chironda¹,

Bhengu²,

Manwere³

2019

Rwanda Journal of Medicine and Health Sciences

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Introduction: Models which relate to cognitive variables and processes may apply to adherence behaviours in patients with chronic conditions. Management of Chronic Kidney Disease (CKD) requires incorporation of these models to facilitate the positive adherence behaviours among patients. Aim: This article critiques models and theories of care applicable to predicting and improving adherence behaviours among patients with chronic kidney disease (CKD). Methods: Medline, Ebsco, PubMed, Google Scholar, Cinahl and grey literature were used to identify the relevant articles from the years 1990-2018. A conclusive search was done using the following key words: Models OR 'Theories of care AND Prediction [tab]' AND Improving AND adherence behaviours AND Chronic Kidney Disease Results: The search identified 23 articles containing information on models and theories of care applicable to the management of CKD patients. The Common-Sense Model, Orem Self-care and Theory of Planned Behaviour Models were applied in predicting and improving adherence among CKD patients. Other identified possible models in predicting and improving adherence included Tran's Theoretical Model, the Theory of Reasoned Action, and the Social Cognitive and Health Belief Models. Conclusion: These theories and models provide a baseline assessment regarding predicting and improving adherence in chronic kidney disease patients. However, there is no model or theory which comprehensively explains an understanding of predicting and improving adherence of CKD patients to their management, hence the need to consider the available models/theories to effectively engage CKD patients with their integrated management to promote the highest level of adherent behaviour.

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Exploring the nature of illness perceptions in people with end‐stage kidney disease

Cited by 17 publications

References 61 publications

How do patients and carers make sense of renal dietary advice? A qualitative exploration

How do patients and carers make sense of renal dietary advice? A qualitative exploration

Patients’ experiences of transitioning between different renal replacement therapy modalities: A qualitative study

Models and theories of care applicable to predicting and improving adherence behaviours among Chronic Kidney Disease (CKD) patients

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