Coping with kidney disease – qualitative findings from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study

Abstract

BackgroundThe highly burdensome effects of kidney failure and its management impose many life-altering changes on patients. Better understanding of successful coping strategies will inform patients and help health care providers support patients’ needs as they navigate these changes together.MethodsA qualitative, cross-sectional study involving semi-structured telephone interviews including open- and closed-ended questions, with 179 U.S. patients with advanced chronic kidney disease (CKD), either not yet on dialysis ([CKD-ND], n = 65), or on dialysis (hemodialysis [HD], n = 76; or peritoneal dialysis [PD], n = 38) recruited through social media and in-person contacts from June to December 2013. Themes identified through content analysis of interview transcripts were classified based on the Coping Strategies Index (CSI) and compared across groups by demographics, treatment modality, and health status.ResultsOverall, more engagement than disengagement strategies were observed. “Take care of myself and follow doctors’ orders,” “accept it,” and “rely on family and friends” were the common coping themes. Participants often used multiple coping strategies. Various factors such as treatment modality, time since diagnosis, presence of other chronic comorbidities, and self-perceived limitations contributed to types of coping strategies used by CKD patients.ConclusionsThe simultaneous use of coping strategies that span different categories within each of the CSI subscales by CKD patients reflects the complex and reactive response to the variable demands of the disease and its treatment options on their lives. Learning from the lived experience of others could empower patients to more frequently use positive coping strategies depending on their personal context as well as the stage of the disease and associated stressors. Moreover, this understanding can improve the support provided by health care systems and providers to patients to better deal with the many challenges they face in living with kidney disease.

Interpretative Phenomenological Analysis of the Lived Experiences of Older Adults Regarding Their Functional Activities in Ghana

“…Previous studies also identified family and friends as a great support system. 45,46 Additionally, participants used comparison and acceptance to manage their difficulties. Possessing the ability to accept difficulties is a powerful coping strategy 47 because it gives older adults a tool to develop new perspectives on life and promotes psychological well-being.…”

Passive Coping Strategies Are Associated With More Impairment In Quality Of Life In Patients With Fibrous Dysplasia

“…The observation that patients with FD reported more active coping than patients with chronic pain, could potentially be explained by the fact that in the reference group of patients with chronic pain due to an unknown cause, the pain was localized in the hip and/or knee and was reported to have occurred on at least three occasions over the previous month [ 9 ], whereas not all patients with FD have complaints of pain (58%). Furthermore, no difference in coping behavior was found between FD patients with and FD patients without pain (data not shown).…”

The Correlation Between Anxiety and Coping Mechanisms in Patients with Renal Failure Undergoing Hemodialysis

“…The results of the study showed that patients undergoing hemodialysis have surrendered to God and seek social support as a coping strategy [16]. From other studies, it was indicated that hemodialysis patients do not know what to do unless they undergo hemodialysis routinely [17].…”