Perceptions of peritonitis risk, prevention, diagnosis and stigma: Findings from a mixed methods study with patients and relatives using peritoneal dialysis

IF 1.5 4区 医学 Q3 NURSING
Jessica Baillie BN (Hons), PhD, RN, Paul Gill BSc (Hons), PhD, RN, Molly Courtenay BSc (Hons), PhD, RGN
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引用次数: 0

Abstract

Background

Peritonitis is the main treatment-related complication of peritoneal dialysis and a primary concern for patients and their relatives. Therefore, understanding their perceptions of peritonitis is important.

Objectives

To explore patients' and relatives' perceptions of peritoneal dialysis-associated peritonitis risk, prevention measures and experiences of diagnosis, and experience of perceived stigma.

Design

A sequential mixed methods study design was used, including a questionnaire and semi-structured interviews.

Participants

Patients using peritoneal dialysis and relatives (n = 75) from six National Health Service organisations from the United Kingdom.

Measurements

A structured questionnaire was administered with patients and relatives (n = 75) using peritoneal dialysis; data were analysed using descriptive statistics. Thirty questionnaire respondents were then purposively sampled and interviewed in-depth; data were analysed thematically. Data were collected 2017−2018. Ethical and governance approvals were gained.

Results

Qualitative and quantitative analyses were integrated and three themes presented:

  • Perceptions of risk: participants assessed their risk of developing peritonitis and possible implications on their health and relatives. Participants felt greatly responsible for preventing infection.

  • Preventing peritonitis: participants reported similar and some differing measures to minimise their risk of developing peritonitis. Participants wanted to be seen as “clean”.

  • Diagnosis of peritonitis: peritonitis diagnosis was embarrassing and stigmatising for many individuals. This was influenced by the response of healthcare professionals and the cause of peritonitis.

Conclusions

It is important that healthcare professionals are aware of how responsible patients and relatives feel about preventing peritonitis, the emotional effect of this responsibility and crucially the impact this may have on seeking help.

对腹膜炎风险、预防、诊断和耻辱的看法:对使用腹膜透析的患者和亲属进行的混合方法研究结果。
背景:腹膜炎是腹膜透析治疗相关的主要并发症,也是患者及其亲属最关心的问题。因此,了解他们对腹膜炎的看法非常重要:目的:探讨患者及其亲属对腹膜透析相关腹膜炎风险、预防措施和诊断经验的看法,以及对耻辱感的感受:采用顺序混合法研究设计,包括问卷调查和半结构化访谈:参与人员:使用腹膜透析的患者及其亲属(n = 75),他们来自英国的六个国民健康服务机构:对使用腹膜透析的患者和亲属(n = 75)进行结构化问卷调查;使用描述性统计对数据进行分析。然后有目的地抽取 30 名问卷调查对象进行深入访谈;对数据进行专题分析。数据收集时间为 2017-2018 年。结果:综合定性和定量分析,提出了三个主题:- 对风险的认知:参与者评估了自己患腹膜炎的风险以及对其健康和亲属可能造成的影响。参与者认为自己对预防感染负有重大责任。- 预防腹膜炎:参与者报告了类似和一些不同的措施,以最大限度地降低其患腹膜炎的风险。与会者希望自己被视为 "干净 "的人。- 腹膜炎的诊断:腹膜炎的诊断让许多人感到尴尬和耻辱。这受到医护人员的反应和腹膜炎病因的影响:医护人员必须意识到患者和亲属在预防腹膜炎方面的责任感、这种责任感所带来的情绪影响,以及最重要的是这种影响可能对寻求帮助产生的影响。
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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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