Lindqvist R, Carlsson M, Sjödén P O
Department of Public Health and Caring Sciences, Uppsala University, Sweden.
Nephrol Nurs J. 2000 Jun;27(3):291-7; discussion 298.
This study describes the perceived consequences of illness and treatment among end stage renal disease (ESRD) patients. A qualitative, explorative-descriptive design was used, which included continuous ambulatory peritoneal dialysis (CAPD) (n = 26), hemodialysis (HD) (n = 30), and transplantation (n = 30) patients. Data collection was performed using unstructured interviews, mostly in the patients' homes. All interviews were tape-recorded with permission from the informants, transcribed verbatim, and analyzed by content analysis. An overall theme was identified, "Wishes for independence and normality." Four main categories emerged: "Wish for normality," "Wish to manage one's own life," "Deprivation of one's normal life," and "Concerns." Interview statements were classified in 11 subcategories: live as usual, keep up appearances, social comparison, hope/fulfilled dreams, freedom/lack of freedom, control/lack of control, losses, dependence on others, physical problems, disgusted with oneself, and broodings. The perceived consequences of being an ESRD patient are multidimensional and involve several aspects of everyday life. It is important for nurses to appreciate the patient's view of illness as well as the patient's perceived stressors and expectations. It may help to direct the focus of nursing assessment in planning and implementing nursing care.
本研究描述了终末期肾病（ESRD）患者对疾病及治疗的认知后果。采用了定性的探索性描述性设计，纳入了持续性非卧床腹膜透析（CAPD）患者（n = 26）、血液透析（HD）患者（n = 30）以及肾移植患者（n = 30）。数据收集通过非结构化访谈进行，大多在患者家中。所有访谈均在获得受访者许可的情况下进行录音，逐字转录，并采用内容分析法进行分析。确定了一个总体主题，即“对独立和正常生活的渴望”。出现了四个主要类别：“对正常生活的渴望”、“希望掌控自己的生活”、“正常生活的丧失”以及“担忧”。访谈陈述被归类为11个子类别：照常生活、维持表象、社会比较、希望/实现的梦想、自由/缺乏自由、掌控/缺乏掌控、损失、依赖他人、身体问题、自我厌恶以及沉思。作为一名ESRD患者，其认知后果是多维度的，涉及日常生活的多个方面。护士了解患者对疾病的看法以及患者感知到的压力源和期望非常重要。这可能有助于在规划和实施护理时引导护理评估的重点。
