Developing a theory to help guide End‐Stage Renal Disease Patients to adapt to Peritoneal Dialysis: A grounded theory study

Abstract

Aim and objectives:The aim of this study was to develop a theory to help guide patients with end-stage renal disease to adapt to peritoneal dialysis.Background: Taiwan ranks first worldwide in end-stage renal disease incidence and dialysis prevalence. Many patients cannot accept long-term dialysis treatment and thus face several physical and psychological suffering. No theory has yet been developed to help guide patients with end-stage renal disease to adapt to peritoneal dialysis.Design: A grounded theory approach was used in this study. Methods:A theoretical sampling was performed after interviewing 25 patients who had adapted to peritoneal dialysis at a medical centre in Taiwan from January 2018 to September 2018; data saturation was achieved. Data were analysed using open, axial and selective coding and while using the constant comparison technique. COREQ reporting guidelines were utilised.Results: A substantive theory was developed to help guide patients with end-stage renal disease to adapt to peritoneal dialysis. The core category that emerged from the data collected was 'Confronting peritoneal dialysis to live and co-exist with peritoneal dialysis'. Other key categories linked to and embraced in this core category were as follows: positive self-regulation, regulation of daily life and the process of adaptation to dialysis method. Conclusion:The results could help healthcare professionals to better understand the process of end-stage renal disease patients' adaptation to peritoneal dialysis, thereby facilitating patients' adaptation to dialysis in their daily life, enhancing their quality of life and improving the quality of medical care.Relevance to clinical practice: Healthcare professionals could use this theory as reference when providing care for peritoneal dialysis patients to assist them in adapting to life with peritoneal dialysis as soon as possible through positive self-regulation, daily life adjustments and the process of adapting to the dialysis method.

Patient perspectives on peritoneal dialysis (PD) and the PD catheter: Strategies and Solutions

“…18,33 Consistent with the biopsychosocial model for relating patient life-experience to health outcomes, 34,35 patient behavioural responses to physical, emotional, interpersonal and environmental challenges were crucial for success. Frameworks related to PD adaptation theory, 36 motivation, 37 learning theories such as a growth mindset 38,39 and emotional intelligence, or the ability to understand and problem solve with emotional information, 40 could support behavioural interventions to reduce PD drop-out.…”

Living normally without being oneself: A qualitative study on the experience of living with advanced chronic kidney disease

“…Adaptation is one of the strategies that enables them to live with the disease and not just live for the disease [ 30 ]. People with CKD employ strategies to adapt to peritoneal dialysis, such as positive self-regulation, adjustments to reduce the impact of treatment on their lives, and changes in the dialysis method [ 17 ]. One study found that for people with CKD, adapting their routines to dialysis treatment allowed them to maintain their family relationships [ 44 ].…”

“…Having to visit the hospital three times a week for hemodialysis; having to change peritoneal fluid daily; being subject to significant dietary, social and leisure restrictions and the loss of independence significantly reduce people’s quality of life [ 15 , 16 ]. Therefore, when choosing a therapy, one of the main considerations of people in the final stages of CKD is maintaining the highest possible quality of life [ 17 , 18 ].…”

“…Peritoneal dialysis patients report how the inconvenience disrupts their daily activities due to the peritoneal catheter. Some effects include longer showers, having to replace the dressing immediately to prevent infection and being limited in their clothing options [ 17 ]. In order to overcome these restrictions and inconveniences, patients carry out strategies that they feel add to their workload [ 27 ].…”