Social Support in the Peritoneal Dialysis Experience: A Qualitative Descriptive Study

Abstract

Background: People with end-stage kidney disease can either pursue conservative (palliative) management or kidney replacement therapy. Although transplant is preferred, there is a limited number of organs available rendering the majority of patients treated with some form of dialysis. Hemodialysis and peritoneal dialysis are equivalent regarding clinical outcomes, but peritoneal dialysis is much less costly to provide. Peritoneal dialysis is most often done in the home by the patient or a support person and carries a self-care burden on patients and families. Social support is important for patients receiving peritoneal dialysis and in sustaining peritoneal dialysis therapy. Few studies have comprehensively explored social support in the context of peritoneal dialysis. Objective: To explore how patients, family members, and nurses view social support. Design: Qualitative, descriptive study. Setting: An outpatient peritoneal dialysis clinic in Western Canada. Participants: Patients, family members, and nurses. Methods: Patients (n = 15), family members (n = 6), and nurses (n = 11) were interviewed between January and May 2018. Content analysis was undertaken using 4 attributes of social support (ie, emotional support, instrumental support, informational support, and appraisal support) as an analytic framework. Results: Themes related to the 4 attributes of social support were identified: addressing emotional needs and managing emotion (emotional support); peritoneal dialysis tasks and life tasks (instrumental support); accessing information, receiving information, and learning (informational support); and affirmation/external reassurance and self-confidence (appraisal support). The social support needs of both patients and family members varied and were dependent on their existing support networks and individual perspectives of support. Limitations: It is possible that some of the study findings were gender-bound as well as context-specific. The study findings could be different if the patient and caregiver sample were more balanced based on sex. There are also unique attributes of each peritoneal dialysis program that may impact the transferability of these findings to other practice settings. Conclusion: Home-based peritoneal dialysis has potential benefit to patients and health care systems. However, receiving peritoneal dialysis requires support. If health care providers wish to promote this treatment, they must also understand how to best support patients and their family members. Trial Registration: Not applicable.

The availability of support and peritoneal dialysis survival: A cohort study

“…Support people do more than instrumental tasks for people on PD including developing confidence with self-care, 24 improving treatment- and medication-adherence, as well as providing nutritional support. 25,26 It is also possible that our findings are not reflective of support ‘tasks’, but rather reflect the impact of isolation on PD survival.…”

Evolving peritoneal dialysis care in Chinese mainland from 2010 to 2020: Comparison data from two surveys

“…Physicians and PD nurses are the key players in predialysis counseling, catheter implantations, individualized PD prescription, and management of complications 20,21 . Dieticians and social workers are also important for the PD program as dietary interventions and psychosocial assessment and support are beneficial for PD patients 22–24 . Of note, APD accessibility was increased and expanded to both secondary and tertiary centers.…”

“…assessment and support are beneficial for PD patients. [22][23][24] Of note, APD accessibility was increased and expanded to both secondary and tertiary centers. Whether the increased APD accessibility could translate into better clinically meaningful outcome warrants further study.…”

Experiences and perception of character strengths among patients with breast cancer in China: a qualitative study

“…Discussion continued until a consensus was reached among the co-researchers. 33 Open dialogue and careful probing were used during the interviews to ensure that the information was reliable. To enhance transferability, 34 we continued interviews until data saturation occurred, made clear and distinct descriptions of the content and presented rich information from the findings.…”

“…To increase the credibility of our findings, we used a peer checking process. Discussion continued until a consensus was reached among the co-researchers 33. Open dialogue and careful probing were used during the interviews to ensure that the information was reliable.…”