The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study

Abstract

Background: Fluid management can reduce mortality, severe comorbidities, and debilitating symptoms in patients on hemodialysis. Therefore, a restricted fluid intake plan is crucial for patients with chronic kidney disease (CKD). Little evidence has been found to date on exploring the experience in fluid management of CKD patients in Indonesia.Purpose: This study aimed to explore the fluid management experience of adults with chronic kidney disease participating in hemodialysis treatment in Indonesia.Methods: A qualitative study with a phenomenological approach was conducted. Purposive sampling was used to recruit 14 adults patients with chronic kidney disease undergoing hemodialysis in a tertiary hospital in Padang between July and September 2020. Manual content analysis using the Colaizzi approach was used to identify themes.Results: Data analysis revealed four themes with 12 sub-themes. The four major themes include the challenge of thirst control, fluid/diet restriction management, inadequate information, and the support system.Conclusions: The result showed the severe suffering and sadness experienced by CKD patients who conform to fluid restrictions. It is important to provide clear information on the fluid prescription or the exact consumable amount per day. Structured education with a personal approach is recommended to ensure detailed information regarding "fluid prescribing". The support obtained from family, friends, and dialysis staff is a significant factor in promoting acceptance and adherence.

The relationship between fatigue, pruritus, and thirst distress with quality of life among patients receiving hemodialysis: a mediator model to test concept of treatment adherence

“…Physiological symptoms such as TD and mouth dryness are one of the major barriers to adherence to fluid restriction 25 . Therefore, improving adherence to fluid restriction can reduce the overconsumption of fluids and weight gain between hemodialysis sessions and thereby, can maintain electrolyte balance and improve treatment outcomes 103 . Besides, adherence to dietary regimens, such as limited salt intake, can reduce TD which is a major contributing factor to fluid overconsumption 39 (Hypothesis-7).…”

Dializuojamų Pacientų Patirtys Laikantis Mitybos Principų

“…F. Mailani ir kt. (2021) įrodė, kad tie pacientai, kurie labiau motyvuoti laikytis dietos rekomendacijų, rečiau patenka į ligoninę, pagerėja jų išgyvenamumas ir geresni klinikiniai rezultatai [14]. Dializuojami pacientai patiria fizinių ir psichologinių sunkumų, susijusių su liga, dializėmis bei mitybos ribojimais.…”

“…Fiziniai simptomaiskausmas, mėšlungis, nuovargis, niežulys, edemos, troškulys, galvos svaigimas riboja pacientų galimybes tinkamai maitintis. Kyla ir psichologinių problemų -beviltiškumo jausmas, jautrumas, socialinė izoliacija, nerimas, baimė, stresas [15][16]. Įvairūs veiksniai gali sutrikdyti mitybos režimo laikymąsi, o tai gali pabloginti klinikinę baigtį.…”

Pengalaman Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisis dalam Mengikuti Asupan Diet dan Cairan: Studi Fenomenologi

“…Hal ini dilakukan untuk mengurangi asupan dan memastikan asupan cairan sesuai dengan yang dianjurkan. Sejalan dengan penelitian Mailani et al, (2021), menemukan bahwa sebagian besar pasien HD melakukan modifikasi untuk pengurangan rasa haus ialah dengan meminum minuman hangat atau panas. Cara lain yang dilakukan oleh partisipan untuk mengatur asupan cairannya ialah dengan melakukan berbagai aktivitas, melakukan olahraga, bersauna agar keringat keluar lebih banyak.…”