Exploring Patients' Perceptions About Chronic Kidney Disease and Their Treatment: A Qualitative Study.

Autor: Meuleman Y; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands. Y.Meuleman@lumc.nl., van der Bent Y; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands., Gentenaar L; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands., Caskey FJ; Population Health Sciences, University of Bristol, Bristol, UK., Bart HA; Dutch Kidney Patients Association, Bussum, the Netherlands., Konijn WS; Dutch Kidney Patients Association, Bussum, the Netherlands., Bos WJW; Department of Nephrology, Leiden University Medical Centre, Leiden, the Netherlands.; Department of Internal Medicine, St Antonius Hospital, Nieuwegein, the Netherlands., Hemmelder MH; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.; CARIM School for Cardiovascular Research, University Maastricht, Maastricht, the Netherlands., Dekker FW; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands.
Jazyk: angličtina
Zdroj: International journal of behavioral medicine [Int J Behav Med] 2024 Apr; Vol. 31 (2), pp. 263-275. Date of Electronic Publication: 2023 May 24.
DOI: 10.1007/s12529-023-10178-x
Abstrakt: Background: Unhelpful illness perceptions can be changed by means of interventions and can lead to improved outcomes. However, little is known about illness perceptions in patients with chronic kidney disease (CKD) prior to kidney failure, and no tools exist in nephrology care to identify and support patients with unhelpful illness perceptions. Therefore, this study aims to: (1) identify meaningful and modifiable illness perceptions in patients with CKD prior to kidney failure; and (2) explore needs and requirements for identifying and supporting patients with unhelpful illness perceptions in nephrology care from patients' and healthcare professionals' perspectives.
Methods: Individual semi-structured interviews were conducted with purposive heterogeneous samples of Dutch patients with CKD (n = 17) and professionals (n = 10). Transcripts were analysed using a hybrid inductive and deductive approach: identified themes from the thematic analysis were hereafter organized according to Common-Sense Model of Self-Regulation principles.
Results: Illness perceptions considered most meaningful are related to the seriousness (illness identity, consequences, emotional response and illness concern) and manageability (illness coherence, personal control and treatment control) of CKD. Over time, patients developed more unhelpful seriousness-related illness perceptions and more helpful manageability-related illness perceptions, caused by: CKD diagnosis, disease progression, healthcare support and approaching kidney replacement therapy. Implementing tools to identify and discuss patients' illness perceptions was considered important, after which support for patients with unhelpful illness perceptions should be offered. Special attention should be paid towards structurally embedding psychosocial educational support for patients and caregivers to deal with CKD-related symptoms, consequences, emotions and concerns about the future.
Conclusions: Several meaningful and modifiable illness perceptions do not change for the better by means of nephrology care. This underlines the need to identify and openly discuss illness perceptions and to support patients with unhelpful illness perceptions. Future studies should investigate whether implementing illness perception-based tools will indeed improve outcomes in CKD.
(© 2023. The Author(s).)
Databáze: MEDLINE
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