Exploring the bio-psychosocial effects of renal replacement therapy amongst patients in a state hospital in South Africa

Abstract

This article described a qualitative study that investigated the bio-psychosocial effects of renal replacement therapy on patients in a state hospital in South Africa. The study aimed to investigate the level of debility experienced by patients undergoing haemodialysis (HD)and continuous ambulatory peritoneal dialysis (CAPD) and to explore how this debility affects their bio-psychosocial functioning. Respondents comprised a small sample of HD and CAPD patients. Using an interview schedule as the research tool allowed rich data to be uncovered. Content analysis and reducing data into themes facilitated data analysis. Although the study was not quantitative and thus did not allow for comparative analysis,themes regarding the levels of stress emerged amongst participants. The HD group voiced greater concerns regarding the degree of debility and psychosocial distress than the CAPD group. Governmental support for holistic kidney disease treatment and careful teaming of key role players to reduce the severity and far-reaching bio-psychosocial effects of HD and CAPD treatment are recommended.<p><strong>Opsomming</strong></p><p>Hierdie artikel beskryf ‘n kwalitatiewe studie wat die bio-psigososiale effekte van niervervangingsterapie op pasiënte in ‘n staatshospitaal in Suid-Afrika ondersoek het. Die studie is gemotiveer deur die mate van debiliteit van pasiënte wat hemodialise (HD) en kontinue ambulatoriese peritoneale dialise (KAPD) ondergaan en wat oënskynlik verder strek as bloot die fisieke aspekte van die siekte en die behandeling daarvan. Respondente het bestaan uit ‘n klein groep HD- en KAPD-pasiënte. Deur ‘n onderhoudskedule as die navorsingsinstrument te gebruik, is ryk data onthul. Inhoudanalise en die redusering van data tot temas het die data-analise gefasiliteer. Alhoewel die studie nie kwantitatief was nie en vergelykende analise dus nie moontlik was nie, het temas van spanning onder die respondente voorgekom. Dit was duidelik uit die onderhoude met albei pasiëntgroepe en inhoudanalise dat die HD-groep meer bekommernis oor die graad van debiliteit en psigososiale stres getoon het as die KAPD-groep.Regeringsondersteuning vir holistiese nierbehandeling en versigtige samestelling van ‘n span sleutelrolspelers vir die vermindering van die erns en verreikende gevolge van HD en KAPD word voorgestel.</p><strong>How to cite this article:</strong> Harilall, B. & Kasiram,M., 2011, ‘Exploring the bio-psychosocial effects of renal replacement therapy amongst patients in a state hospital in South Africa’,<em>Health SA Gesondheid</em> 16(1), Art. #497, 10 pages. doi:10.4102/hsag.v16i1.49

Perceptions of caregivers regarding engagement with integrated management of chronic kidney disease patients in selected public hospitals of KwaZulu-Natal region, South Africa

“…Social support of friends and family has been found to influence the integrated management of CKD patients (Karamanidou et al 2008). However, CKD and its complex integrated management restrict daily activities, employment, family life and social relationships (Harilall & Kasiram 2011;Subhashini & Indira 2016). The burden of care placed on caregivers who need to assume multiple roles that need attention as burnout and compassion fatigue (Mashayekhi, Pilevarzadeh & Rafati 2015), is likely to affect the quality of care for CKD patients.…”

“…Subhashini and Indira (2016) confirmed the findings of the study. Harilall and Kasiram (2011) further stated that CKD patients find it difficult to integrate the requirements of the dialysis regimen into their daily schedules.…”

“…These findings are corroborated by the results of Assounga et al (2012) and Subhashini and Indira (2016) who cited unemployment as a core stressor among caregivers and CKD patients. However, a study, conducted by Harilall and Kasiram (2011), showed some CKD patients were able to work and remain economically productive with support from health advisors to keep up supporting their caregivers. They were employed, because they were able to integrate their CKD regimen into their work schedules.…”