Exploration of low-phosphate diet management of patients receiving renal dialysis: An interpretive description

IF 1.5 4区 医学 Q3 NURSING
Kenneth M. Christensen MHS, Eithne H. Bauer MScN, Christina Prinds PhD
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引用次数: 0

Abstract

Background

Patients with dialysis-dependent kidney failure and treated for hyperphosphatemia receive a combination of dietary advice, phosphate binders and prolonged dialysis. However, research focusing on the challenges patients meet in everyday life addressing diet and medication is sparse.

Objective

The objective of this study is to explore the everyday challenges patients meet when following treatment for hyperphosphatemia.

Design

Interpretive description was the methodological approach. Semistructured in-depth interviews were employed to study the challenges patients experienced. Data were analysed using Braun and Clarke's reflexive thematic analysis.

Participants

Patients (n = 14) receiving haemodialysis and treated for hyperphosphatemia from two hospitals in Southern Denmark.

Findings

The analysis resulted in one over-arching theme; separation in social gatherings and two subthemes; a new social code, and my food and their food. Participants experienced difficulty integrating diet and medication in daily life, especially at social gatherings. They felt separated from others when special menus were provided for them or struggled when choosing between high and low phosphate-containing food. A new awareness of self and others arose, especially their position among families and friends, and how they presented themselves and their social identity to others. Likewise, a new social code manifested itself, which was difficult to accept. Most participants experienced that diet and medication were accompanied by a moral responsibility of whether to accept prepared food with high phosphorus content or not, which affected commensality.

Conclusion

Patients were often nonadherent to hyperphosphatemia treatment at social gatherings. Hyperphosphatemia treatment led to new social identities with new social codes, which patients found difficult to accept.

对肾透析患者低磷饮食管理的探索:解释性说明。
背景:透析依赖型肾衰竭患者在接受高磷血症治疗的同时,还需要接受饮食建议、磷酸盐结合剂和延长透析时间等综合治疗。然而,有关患者在日常生活中应对饮食和药物治疗挑战的研究却很少:本研究旨在探讨患者在接受高磷血症治疗时遇到的日常生活挑战:设计:采用解释性描述的方法。采用半结构式深度访谈来研究患者所经历的挑战。采用布劳恩和克拉克的反思性主题分析法对数据进行分析:丹麦南部两家医院接受血液透析和高磷血症治疗的患者(n = 14):分析得出一个总主题:社交聚会中的分离,以及两个副主题:新的社交准则和我的食物与他们的食物。参与者在日常生活中,尤其是在社交聚会中,很难将饮食和药物结合起来。当有人为他们提供特殊菜单时,他们感到与他人有隔阂;当他们在高磷酸盐和低磷酸盐食物之间做出选择时,他们感到很纠结。他们对自己和他人有了新的认识,尤其是他们在家人和朋友中的地位,以及他们如何向他人展示自己和自己的社会身份。同样,一种新的社会规范也显现出来,让人难以接受。大多数参与者认为,饮食和药物治疗伴随着一种道德责任,即是否接受含磷量高的熟食,这影响了他们的共处:结论:在社交聚会中,患者往往不坚持高磷血症治疗。高磷血症的治疗导致了新的社会身份和新的社会规范,患者对此难以接受。
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来源期刊
Journal of renal care
Journal of renal care Nursing-Advanced and Specialized Nursing
CiteScore
3.50
自引率
5.30%
发文量
36
期刊介绍: The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.
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