How do patients and carers make sense of renal dietary advice? A qualitative exploration (original) (raw)
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Integrating renal nutrition guidelines into daily family life: a qualitative exploration
Journal of Human Nutrition and Dietetics, 2017
Background: Renal dietary compliance is challenging for individuals with chronic renal disease. Advice may change depending on renal function and medical treatment. Although patients seek support from family members with these changes, no literature exists with respect to how family members experience the offering of this support. The present study aimed to describe and interpret this lived experience of family members. Methodology: Phenomenological qualitative semi-structured interviews were conducted with 12 adult family members via telephone (transcribed verbatim). Framework analysis and the qualitative software NVIVO, version 10 (QSR International Pty Ltd, Melbourne, VIC, Australia) were used. Participants commented on the themes for accuracy of experience representation. Results: Four major themes emerged: (i) intrusion of the renal diet; (ii) dealing with the recommendations of a renal diet; (iii) seeking a new identity; and (iv) transition of family dynamics. Perceived conflicting advice intruded into family life. Children in the family resulted in more complex nutritional decisions. Continuing a diet to avoid perceived family and wider social judgement was not an option. Balance between nurturing the family as a whole and the necessity of attending to the specific needs of one individual with renal disease was challenging. Transition to a new identity included family members being drawn to scientifically guided understandings of nutrition and a medicalisation of daily food requirements, which included low prioritisation of children's nutritional needs. Conclusion: Family members who cooked found the integration of renal nutrition guidelines challenging, with children presenting further challenges. The present study highlights the need to offer practical and psychological support to families who are coping with end-stage renal failure and renal nutritional guidelines.
Diseases
Diet is one of the modifiable lifestyle factors in management of kidney disease. We explored perceptions on adherence to dietary prescriptions for adults with chronic kidney disease on hemodialysis. This was a qualitative descriptive study. Participants were purposively selected at renal clinics/dialysis units at national referral hospitals in Kenya. Data were collected using in-depth interviews, note-taking and voice-recording. The data were managed and analyzed thematically in NVIV0-12 computer software. Study participants were 52 patients and 40 family caregivers (42 males and 50 females) aged 20 to 69 years. Six sub-themes emerged in this study: “perceived health benefits”; “ease in implementing prescribed diets”; “cost of prescribed renal diets”; “nutrition information and messages”; “transition to new diets” and “fear of complications/severity of disease”. Both patients and caregivers acknowledged the health benefits of adherence to diet prescriptions. However, there are mixed...
Determination of Dietary Knowledge among Patients Suffering from Chronic Renal Failure
Lahore Garrison University Journal of Life Sciences
Chronic renal diseases are usually mentioned as decreased functioning of kidneys. The main symptoms includes in this disease are kidney damage, greater loss of albumin in urine and a reduced glomerular filtration rate (GFR). The present study was aimed to determine the dietary knowledge about the patients that suffered in chronic renal failure along with various other impediments. A transverse study was performed for 4 months in Sir Ganga Ram Hospital and dataof one hundred patients with chronic kidney failure and impediments were selected. A non-probability sampling method was used to conduct this study. Out of the total 100 patients, 36% of patients knew the renal diet. While, only 28% of patients knew about potassium, 16% about phosphorous and 20% about salt restrictions. Similarly, 57% knew about red meat and 56% knew about pulses restriction. The symptoms of studied disease was more prevalent in males as compared to females which showed gender as major factor for the renal fail...
Understanding the role of patient and public involvement in renal dietetic research
Patient Experience Journal
The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations of attendance, the informational and physical needs of these service users. Service users wanted to share their experiences with people who would listen and were in a position to help make the changes. This gave them a sense of purpose and autonomy in their treatment and helped them cope with living with renal disease in society. However, feelings of doubt as to whether they could personally 'make a difference' as a co-researcher, were common. Consulting service users enabled the research team to recruit more people to interviews to explore motivation considering the unique personal and social needs of this service user group. Service users may need additional and continued support if they are to successfully take part in a clinical study research advisory group.
Dietary Application for the Management of Patients with Hemodialysis: A Formative Development Study
Healthcare Informatics Research
Objectives: To describe the step-by-step person-centered, theory-based development of the KELA.AE app for Arabic speaking hemodialysis patients. Methods: A step-by-step person-driven theory-based approach was conducted to develop a self-monitoring and educational dietary app for hemodialysis patients. The development follows the Integration, Design, Assessment, and Sharing (IDEAS) framework. Qualitative, semi-structured interviews with 6 hemodialysis patients and 6 healthcare practitioners (dietitians and nephrologists) were performed to assess the need for an app, the willingness to use an app, and features desired in an app. Results: The KELA.AE app, which includes a self-monitoring feature, CKD-friendly recipes, and a theory-based, evidence-based educational feature was developed. Qualitative analysis of interviews revealed two predominant themes from patient interviews 'Experience with the diet' , ' App evaluation' , and one theme from interviews with healthcare practitioners ' App evaluation'. Patients expressed frustration with current accessibility of dietary information along with the need for educational materials in the app. The review of the KELA.AE prototype was positive overall, and patients reported a willingness to use the app. Healthcare practitioners considered the app accurate, simple, and culturally sensitive but expressed concerns about app misuse and the replacement of healthcare practitioners. Conclusions: The KELA.AE app was found to be satisfactory and supportive of the participants' needs. Changes were made to the app as suggested during the interviews.
BMC nephrology, 2016
Dietary treatment is helpful in CKD patients, but nutritional interventions are scarcely implemented. The main concern of the renal diets is its feasibility with regards to daily clinical practice especially in the elderly and co-morbid patients. This study aimed to evaluate the effects of a pragmatic, step-wise, personalized nutritional support in the management of CKD patients on tertiary care. This is a case-control study. It included 823 prevalent out-patients affected by CKD stage 3b to 5 not-in-dialysis, followed by tertiary care in nephrology clinics; 305 patients (190 males, aged 70 ± 12 years) received nutritional support (nutritional treatment Group, NTG); 518 patients (281 males, aged 73 ± 13 years) who did not receive any dietary therapy, formed the control group (CG). In the NTG patients the dietary interventions were assigned in order to prevent or correct abnormalities and to maintain a good nutritional status. They included manipulation of sodium, phosphate, energy a...
BMC Nutrition, 2020
Background Nutrition and dietary patterns are modifiable factors that can be utilized to prevent or slow the progression of Chronic kidney disease (CKD). Adherence to current dietary recommendations can reduce the incidence, or slow the progression of CKD and reduce mortality. The objectives of this study was to compare the dietary nutrient intake of CKD patients (CKD above stage 3 including hemodialysis) to dietary recommendations and to assess the correlations of those dietary nutrient intakes with each other and with chosen laboratory measurements. Methods A hospital-based cross-sectional study was conducted among 100 patients with CKD. A consecutive 7 days dietary record supplemented with interviews for data completion was used to assess dietary intake. Recent clinical laboratory measurements were obtained from patients’ medical records. The obtained dietary data were analyzed by the Ethiopian food composition database and the nutrisurvey software. Dietary energy and nutrients i...
https://www.ijhsr.org/IJHSR\_Vol.11\_Issue.3\_March2021/IJHSR-Abstract.026.html, 2021
Objectives: Diet therapy is the critical component of the treatment of chronic renal failure (CRF) patients undergoing hemodialysis. The dietary restrictions is vital to maintain optimal health for the CRF patients. The study was aimed at assessing the knowledge regarding dietary modifications & perceived barriers regarding compliance to dietary modifications among patients undergoing hemodialysis. The study also had secondary objective to associate the knowledge and perceived barriers regarding dietary modifications with their selected demographic variables and to associate knowledge with perceived barriers regarding dietary modifications among patients undergoing hemodialysis. Methods: Exploratory descriptive research design was used in the study. 60 subjects were included in the study with non probability convenience sampling at dialysis unit of tertiary care hospital. Data related to knowledge was collected with structured questionnaire and data related to perceived barriers regarding dietary modification was collected with Likert scale from patients visiting for their hemodialysis Results: -Assessment of knowledge regarding dietary modifications among patients undergoing hemodialysis revealed that majority of them 35 (58.3%) had highly adequate knowledge, 24 (40%) had moderately adequate knowledge and a minority of 1 (1.7%) had inadequate knowledge. Knowledge regarding Sodium and Potassium was highest followed by knowledge related to calories and proteins, followed by fluid allowance and Phosphorous. Assessment of perceived barriers regarding compliance to dietary modifications revealed that majority of subjects 47 (88.3%) the barriers were not a problem at all, for 12 (20%) of patients the barriers were somewhat of a problem and for a minority 1 (1.7%) of the patients the barriers were a very important problem. In perceived barrier, behavioural factors were a very important problem, followed by physical condition, technical difficulties and resource adequacy. Social network was the perceived barrier that was of a least problem. There was significant association between marital status and level of knowledge whereas perceived barriers were significantly associated with family income & occupation. Knowledge is significantly associated with perceived barriers. As the knowledge increases the perceived barriers decrease and those with have high perceived barriers have low knowledge. There was no significant association of knowledge and perceived barriers with the age of patient, gender, education, type of diet, duration of hemodialysis & frequency of hemodialysis Conclusion: - Dietary intake is a complex process that involves biological, social, cultural, psychological factors and their interaction. It is believed that the behavior in controlling dietary and fluid intake is determined by individual food choices. Food is at the same time a source of energy, pleasure and reward as well as a social bond and so choices reflect all these characteristics. Besides keeping continuous education on adequate dietary habits, it is necessary to implement behavioural interventions in order to decrease hemodialysis patients’ distress over diet and improve adherence and the control of clinical parameter that implicate on their quality of life. The provision of CKD comprehensive patient care in terms of dialysis plan, medication, fluid and dietary restriction is crucial in slowing the progression and complications of CKD.
Dietary and Fluid Regime Adherence in Chronic Kidney Disease Patients
Introduction: Patients with Chronic Kidney Disease (CKD) needs to modify their lifestyle chiefly focusing on diet and fluid intake as the prognosis of these patients largely depends on adherence to the recommended nutritional regime. Non adherence to the suggested diet and fluids regime leads to rapid worsening of the condition. Methods: Cross sectional survey was conducted to determine the level of adherence to the dietary and fluids restriction among CKD patients. Inclusion criteria's was, age between 18-65 years, patients with CKD for at least 6 months and received dietary counseling. Consecutive sampling technique was used to select 100 patients. Data was collected with self-reported Dialysis Diet and Fluid non adherence Questionnaire (DDFQ). Results: Majority (73%) of the subjects was males, 64% belongs to 40-60 years age, majority of them were unemployed. Mean Body Mass Index (BMI) was 20.52 kg/m 2 , the mean duration of the treatment is 2.15 years and mean fluid intake was 2153ml ml/day and inter-dialytic weight gain was 1.48 kg. Regarding adherence, 20% of them had mild deviation and 69% of them had moderate deviation from dietary restrictions and similarly 69 % of the participants had moderate deviation, and 22% of them had mild deviation from fluid restriction guidelines. Low level of adherence to fluid and diet restrictions was noted in illiterate patients which was significant P<0.05. Conclusion: In spite of the dietary counseling, considerable proportions of the patients were non adherent to the diet and fluid restrictions which necessitate regular counseling to patient and family members.
Journal of Human Nutrition and Dietetics, 2017
BackgroundDietitians provide individuals with tailored, practical nutritional advice. For this reason, skills in effective interpersonal communication are essential. In the case of chronic kidney disease, the specifics of dietary advice may change according to renal function. The conveyance of accurate dietary advice and compliance is critical and requires full engagement with the service. The effect of communication styles on patients ' engagement experiences with renal dietetics is unknown. Accordingly, the present study aimed to explore patients ' engagement experiences with renal dietitians.MethodsA qualitative phenomenology study using semi‐structured in‐depth interviews was undertaken with 20 adult renal service users who had engaged with renal dietitians to receive dietary advice. Interpretive phenomenological analysis was used to analyse data.ResultsTwo main themes emerged from consultation experiences: helpful and unhelpful engagement styles. Individuals reporting h...