Dietary Needs, Barriers, and Facilitators Among Patients on Hemodialysis and Their Caregivers: The GoodRENal Project in Spain.

Abstract

Objective: Dietary restrictions are common in patients undergoing hemodialysis (HD). These restrictions result in a complex diet that becomes difficult for patients to understand and to follow. Therefore, we aimed to identify dietary needs, barriers, and facilitators that influence the adherence to dietary recommendations as perceived by patients on HD and their caregivers.

Methods: Seventy-two Spanish patients on HD and 57 caregivers participated in this explorative study by replying a questionnaire consisting of 20 and 10 questions respectively. The responses were assessed using a Likert scale varying from 1 to 5 (strongly agree, agree, neither disagree or disagree, disagree, strongly disagree, respectively) to evaluate the perception of patients and caregivers regarding dietary needs, barriers, and facilitators to adhere to the recommended diet. For analysis purposes, the responses were grouped in 3 categories (agree, neither agree or disagree, disagree).

Results: Seventy percent of the patients agreed that knowing the food sources of potassium, protein and phosphate was a need for them to know to be able to adhere to the dietary recommendations. Moreover, patients stated that not being able to eat what they liked, and feeling thirsty, were important barriers. For caregivers, the support of a renal dietitian was mentioned as an important facilitator to assist those they cared for to adhere to the diet.

Conclusions: Knowing food sources of potassium, phosphate, and protein, exploring foods patients like to eat and adjusting fluid intake to avoid feeling thirsty were identified as important by the patients. These findings can be used to develop strategies and educational material to improve the dietary adherence in patients undergoing HD. Moreover, the presence of a renal dietitian was identified as an important resource by the caregivers.