Knowledge deficit of patients with stage 1-4 CKD: A focus group study
Knowledge deficit of patients with stage 1-4 CKD: A focus group study
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DOI：
10.1111/nep.12206
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发表时间：
2014-04-01
期刊：
影响因子：
2.5
通讯作者：
Craig, Jonathan C.
中科院分区：
文献类型：
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作者：
Lopez-Vargas, Pamela A.;Tong, Allison;Craig, Jonathan C.
背景早期慢性肾脏病(CKD)患者必须改变生活方式并坚持治疗方案，以防止他们进展为终末期肾脏疾病。本研究旨在探讨慢性肾脏病(CKD)1-4期患者对疾病的看法，特别关注他们在处理和生活在CKD及其后遗症方面的信息需求。结果从9个焦点小组的38名参与者中，确定了6个主要主题：医疗关注(共同决策、融洽、冷漠和不敏感)；学习自我管理(饮食和营养、体力活动障碍、用药安全)；背景并存(慢性肾脏病突出、矛盾治疗)；预后不确定性(绝望、对疾病进展的恐惧、对诊断的怀疑)；动机和应对机制(从事研究、积极管理、乐观、感觉正常)；以及知识差距(实际建议、信息获取、对病理结果和CKD诊断的理解、对全科医生的教育)。结论CKD患者减缓CKD进展的能力可能受限于他们对疾病及其合并症、心理社会影响的了解，以及他们与医疗保健提供者有效互动和沟通的能力。来自多学科护理团队的支持，加上提供全面、可获得和实用的教育资源，可能会增强患者获得和坚持治疗和生活方式干预的能力和动机，以延缓CKD的进展。概述本文提出的重要观点是，通过提高患者对疾病及其合并症的认识，以及与医疗保健提供者更好地沟通，患者对治疗的依从性可能会提高。这样做可以更好地延缓慢性肾脏病的进展。多学科护理团队的方法可能会加强这一管理过程。
BackgroundPatients with early-stage chronic kidney disease (CKD) must make lifestyle modifications and adhere to treatment regimens to prevent their progression to end-stage kidney disease. The aim of this study was to elicit the perspectives of patients with stage 1-4 CKD about their disease, with a specific focus on their information needs in managing and living with CKD and its sequelae.MethodsPatients with CKD stages 1-4 were purposively sampled from three major hospitals in Sydney, Australia to participate in focus groups. Transcripts were thematically analysed.ResultsFrom nine focus groups including 38 participants, six major themes were identified: medical attentiveness (shared decision-making, rapport, indifference and insensitivity); learning self-management (diet and nutrition, barriers to physical activity, medication safety); contextualizing comorbidities (prominence of CKD, contradictory treatment); prognostic uncertainty (hopelessness, fear of disease progression, disbelief regarding diagnosis); motivation and coping mechanisms (engage in research, pro-active management, optimism, feeling normal); and knowledge gaps (practical advice, access to information, comprehension of pathology results and CKD diagnosis, education for general practitioners).ConclusionPatients capacity to slow the progression of CKD may be limited by their lack of knowledge about the disease, its comorbidities, psychosocial influences and their ability to interact and communicate effectively with their health-care provider. Support from a multidisciplinary care team, combined with provision of comprehensive, accessible and practical educational resources may enhance patients' ability and motivation to access and adhere to therapeutic and lifestyle interventions to retard progression of CKD.Summary at a Glance This paper makes the important point that, by improving the patients' knowledge about the disease and its comorbidities, together with better communication with the health-care provider, the adherence to therapy may improve. In so doing, retardation in the progression of CKD may be better achieved. A multidisciplinary care team approach may enhance this management process.