Identifying Needs for Self-management Interventions for Adults With CKD and Their caregivers: A Qualitative study
Identifying Needs for Self-management Interventions for Adults With CKD and Their caregivers: A Qualitative study
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DOI：
10.1053/j.ajkd.2019.02.006
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发表时间：
2019-10-01
影响因子：
13.2
通讯作者：
Hemmelgarn, Brenda R.
中科院分区：
文献类型：
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作者：
Donald, Maoliosa;Beanlands, Heather;Hemmelgarn, Brenda R.
基本原理和目标：在护理人员和提供者的支持下，培养患者自我管理慢性肾病（CKD）的能力，可能会减缓疾病进展并改善健康结果。然而，很少有人知道这样的患者的自我管理干预的需求。本研究的目的是确定和描述成人慢性肾脏病患者和非正式照顾者对慢性肾脏病自我管理支持的需求。研究标志：采用半结构化访谈和焦点小组的描述性定性研究。（37名参与者）和11次与成人CKD患者的电话访谈（1-5期，未接受肾脏替代治疗）和来自加拿大各地的非正式护理人员。分析方法：主题分析。结果：确定了3个主要主题：（1）通过知识增强权能（对CKD的认识和理解、饮食挑战、药物和替代治疗、身体协调、财务影响、精神和身体健康后果、旅行和交通限制以及维持工作和教育），（2）通过信息共享激活（获取、有意义和相关、时间和数量），以及（3）对健康之旅的切实支持局限性：参与者主要是白色，受过教育，已婚，讲英语，这限制了普遍性。结论：有机会通过解决与CKD生活良好相关的知识以及共享信息和提供有形支持的优先领域来加强CKD自我管理支持。未来的努力可能会考虑根据本研究中确定的不同患者和护理人员的需求开发创新的CKD自我管理支持干预措施。
Rationale & Objective: Fostering the ability of patients to self-manage their chronic kidney disease (CKD), with support from caregivers and providers, may slow disease progression and improve health outcomes. However, little is known about such patients' needs for self-management interventions. We aimed to identify and describe the needs of adults with CKD and informal caregivers for CKD self-management support.Study sign: Descriptive qualitative study using semi-structured interviews and focus groups.Setting & Participants: 6 focus groups (37 participants) and 11 telephone interviews with adults with CKD (stages 1-5, not on renal replacement therapy) and informal caregivers from across Canada.Analytic Approach: Thematic analysis.Results: 3 major themes were identified: (1) empowerment through knowledge (awareness and understanding of CKD, diet challenges, medication and alternative treatments, attuning to the body, financial implications, mental and physical health consequences, travel and transportation restrictions, and maintaining work and education), (2) activation through information sharing (access, meaningful and relevant, timing, and amount), and (3) tangible supports for the health journey (family, community, and professionals).Limitations: Participants were primarily white, educated, married, and English speaking, which limits generalizability.Conclusions: There are opportunities to enhance CKD self-management support by addressing knowledge pertinent to living well with CKD and priority areas for sharing information and providing tangible support. Future efforts may consider the development of innovative CKD self-management support interventions based on the diverse patient and caregiver needs identified in this study.