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How perceived feelings of “wellness” influence the decision‐making of people with predialysis chronic kidney disease
Author(s) -
CampbellCrofts Sandra,
Stewart Glenn
Publication year - 2018
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.14220
Subject(s) - renal replacement therapy , feeling , kidney disease , medicine , qualitative research , disease , exploratory research , family medicine , nursing , intensive care medicine , psychology , social psychology , social science , sociology , anthropology
Aims and objectives To identify the subjective meanings attached to decisions made by people living with chronic kidney disease as they consider their transition to renal replacement therapy. Background Within the challenging world of chronic illness, people draw upon their temporal life experiences to help them make the best or most balanced primary healthcare decisions. Understanding the risks and benefits associated with these decisions has been an area of intense interest in health research. Design An exploratory qualitative descriptive design. Method A convenience sample of twelve people, at stages 3B to 5 of chronic kidney disease, attending two predialysis renal clinics in Sydney, Australia, consented to be interviewed. The semi‐structured interviews centred on their decision‐making experiences as they considered their transition to renal replacement therapy. Results Three themes emerged from participant narratives which have been framed into the following questions: (i) Do I need renal replacement therapy? (ii) What is the “right” renal replacement therapy for me? and (iii) When should I start renal replacement therapy? Decisions about the transition to renal replacement therapy were impacted upon by the participants’ perceived feelings of wellness and the belief that renal replacement therapy would not be needed at any time in the foreseeable future. Conclusion This study highlights the importance of optimising person‐centred care and raises important issues for the education and management of people with chronic kidney disease in the predialysis stages of the illness. Relevance to clinical practice In order to facilitate the transition to renal replacement therapy, renal clinicians have a responsibility to more fully understand the patient journey during the predialysis stages of chronic kidney disease. A clearer understanding of patients’ perceptions and decision‐making experiences creates a space for mutual understanding. This is essential for the future development and implementation of collaborative, person‐centred educational strategies and long‐term renal healthcare outcomes.