J Acad Nutr Diet. 2019 Aug;119(8):1362-1374. doi: 10.1016/j.jand.2019.01.023. Epub 2019 Apr 9.
Dietary behavior change interventions for the self-management of chronic kidney disease (CKD) have the potential to slow disease progression and reduce metabolic complications. Telehealth-delivered dietary interventions may assist in the self-management of CKD, although their acceptability by patients is unknown.
This study aims to describe the acceptability and experiences of a telehealth coaching intervention that utilized telephone calls and tailored text messages to improve diet quality in patients with stage 3 to 4 CKD.
Semistructured interview study of adults with CKD.
PARTICIPANTS/SETTING: Adults with stage 3 to 4 CKD (n=21) aged 28 to 78 (mean 62) years, who completed a 12-week telehealth-delivered dietary intervention in Queensland, Australia, were interviewed from March to July 2017.
Interviews were transcribed verbatim and analyzed thematically.
Five themes were identified: valuing relationships (receiving tangible and perceptible support, building trust and rapport remotely, motivated by accountability, readily responding to a personalized approach, reassured by health professional expertise); appreciating convenience (integrating easily into lifestyle, talking comfortably in a familiar environment, minimizing travel and wait time burden); empowered with actionable knowledge (comprehending diet-disease mechanisms, practical problem solving for sustainable dietary behavior); increasing diet consciousness (learning from recurrent feedback, prompted by reiteration of messages); making sense of complexity (contextualizing and prioritizing comorbidities, gaining confidence to make dietary decisions, setting and achieving realistic goals).
Among adults with stage 3 to 4 CKD, individualized telehealth coaching for improving diet quality was convenient for patients, and they felt supported and empowered to navigate recommendations and prioritize dietary behavior changes. Telehealth-delivered dietary interventions appear to be well accepted by patients as a way of providing regular, tailored contact with a health professional to support dietary management in CKD.
针对慢性肾脏病（CKD）自我管理的饮食行为改变干预措施有可能减缓疾病进展并减少代谢并发症。远程医疗提供的饮食干预措施可能有助于 CKD 的自我管理，尽管患者对其接受程度尚不清楚。
本研究旨在描述一种远程健康教练干预措施的可接受性和体验，该措施利用电话和个性化短信来提高 3 至 4 期 CKD 患者的饮食质量。
对患有 CKD 的成年人进行半结构式访谈研究。
参与者/设置：2017 年 3 月至 7 月，在澳大利亚昆士兰州接受为期 12 周远程医疗提供的饮食干预的 21 名年龄在 28 至 78 岁（平均 62 岁）的 3 至 4 期 CKD 成年人接受了访谈。
访谈记录逐字转录并进行主题分析。
确定了五个主题：重视人际关系（获得有形和可感知的支持，远程建立信任和融洽关系，通过问责制激励，轻松响应个性化方法，由健康专业人员的专业知识感到放心）；欣赏便利性（轻松融入生活方式，在熟悉的环境中舒适地交谈，最大限度地减少旅行和等待时间负担）；通过可操作的知识赋予权力（理解饮食与疾病的关系，为可持续的饮食行为提供实际问题解决方案）；提高饮食意识（从反复反馈中学习，通过重复消息提示）；理解复杂性（根据共病情况进行调整和优先排序，获得信心做出饮食决策，设定和实现现实目标）。
在 3 至 4 期 CKD 成年人中，改善饮食质量的个性化远程健康教练对患者来说很方便，他们感到受到支持和赋权，可以指导建议并优先考虑饮食行为的改变。远程医疗提供的饮食干预措施似乎被患者很好地接受，因为它提供了与健康专业人员定期、个性化的联系，以支持 CKD 的饮食管理。
