Living Well with End Stage Renal Disease: Patients' Narratives Interpreted from a Virtue Perspective

Abstract

Over the last few decades there has been a revival of interest in virtue ethics, with the emphasis on the virtuous caregiver. This paper deals with the 'virtuous patient', specifically the patient with End Stage Renal Disease (ESRD). We believe that a virtue approach provides insights not available to current methods of studying coping styles and coping strategies. Data are derived from seven semi-structured in-depth interviews. The transcripts of the interviews were subjected to an Interpretative Phenomenological Analysis (IPA). The focus of the analysis was on 'living well with chronic illness.' It appears that the moral challenges faced by patients with ESRD are manifold. When they are invited to tell the story of their illness, they do not explicitly speak of virtues, but they often refer to moral qualities, and to attitudes that can be regarded as virtuous. We identify several such concepts in the narratives of patients with ESRD. We conclude that the Aristotelian model of virtue ethics is particularly descriptively (and possibly also normatively) relevant to the explanation of the life narratives and the moral challenges of patients with an ESRD.

The Lived Experience of Patients Receiving Hemodialysis Treatment for End-Stage Renal Disease

“…This finding is consistent with the findings of studies of patients with ESRD on HD in the United States, Greece, Hong Kong, Australia, and the Netherlands (Al-Arabi, 2006;Dekker et al, 2005;Kaba et al, 2007;Suet-Ching, 2001). The researchers in these previous studies reported that the most troublesome restrictions that patients with ESRD experienced were physical limitations that adversely affected their QOL, followed by dependence on others, loss of familiar role functions, changes in lifestyle, lowered self-esteem, feelings of helplessness, and alterations in family dynamics.…”

“…Many qualitative studies have described the experiences of living with ESRD (Al-Arabi, 2006;Dekker et al, 2005;Kaba et al, 2007;Suet-Ching, 2001). It has been reported that patients with ESRD worry about the integrity of their vascular access (Gokal & Hutchison, 2002;Lindqvist, Carlsson, & Sjö dén, 1998;Polaschek, 2003).…”

“…Although these qualitative studies provide an initial understanding of the impact of HD dependence, the impact of having strict dietary and fluid restrictions, the need to spend considerable time on treatment, and the effect of ESRD on other life dimensions are issues that have not yet been thoroughly explored (Dekker, Uerz, & Wils, 2005;Hagren, Pettersen, Severinsson, Lü tzén, & Clyne, 2001;Kaba et al, 2007).…”

Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies

“… 61 152 To demonstrate resilience, some patients tried to maintain a sense of normalcy, integrating the dialysis community into their social network. 42 139 210 260 …”

Problems experienced by haemodialysis patients in Greece

“…Hagren et al (2001Hagren et al ( , 2005 interviewed Swedish ESRD patients and identified the existing struggle imposed by prolonged haemodialysis treatment, including the negative impact of life restrictions and use of time. Dekker et al (2005) described the moral challenges of living with ESRD for Dutch patients, and Lin et al (2005) explored the process of decision-making regarding haemodialysis for 12 Taiwanese individuals. Only the latter study actively considered the impact of culture and the haemodialysis experience.…”