Radmore Nicole M T, Hyrkäs Kristiina
Clinical Nurse II, Maine Medical Center, Portland, Maine, 04102, USA.
Director, Center for Nursing Research and Quality Outcomes, Maine Medical Center, Portland, Maine, 04102, USA.
J Ren Care. 2019 Sep;45(3):159-170. doi: 10.1111/jorc.12291. Epub 2019 Jul 11.
People with end-stage kidney disease (ESKD) receiving peritoneal dialysis (PD) have been found to alter their adherence to the renal therapeutic regimen following their initial teaching by PD nurses. Since alterations of adherence have been associated with poor health outcomes, this study focuses on persons receiving PD who rely on support and re-education from their nurses.
To explore the teaching-learning partnership between people receiving PD and PD nurses, and to compare and contrast shared perspectives.
The study consisted of individual semi-structured interviews of four people receiving PD and three PD nurses, using qualitative content analysis.
Four shared themes and nine sub-themes emerged: "motivation" was characterised by perceptions of "staying healthy to avoid peritonitis pain and to qualify for a transplant". One sub-theme emerged exclusively in the interviewed people receiving PD: "motivation" to initiate PD through "finding meaning in life and situation". The theme "acceptance" was comprised "of diagnosis and choosing to initiate PD" and the "modification and integration into daily life". The presence of "support" arose from "personal support from family and friends", "professional care and understanding of the individual" and "professional customised and re-iterative education". The evolving "partnership" was comprised of "exposure", "personal rapport", and the "necessity of working together" in order to maintain positive health outcomes.
The partnership between the PD nurse and people receiving PD for ESKD is crucial for successful health outcomes. Each partnership is unique and evolves over time. A successful partnership requires nurses to modify the educational content and teaching style to best meet the needs of people receiving PD and, most importantly, allow them to feel cared for and supported.
研究发现，接受腹膜透析（PD）的终末期肾病（ESKD）患者在接受PD护士的初始指导后，会改变其对肾脏治疗方案的依从性。由于依从性的改变与不良健康结局相关，本研究聚焦于依赖护士支持和再教育的接受PD治疗的患者。
探讨接受PD治疗的患者与PD护士之间的教学伙伴关系，并比较和对比双方的共同观点。
该研究采用定性内容分析法，对4名接受PD治疗的患者和3名PD护士进行了个体半结构化访谈。
出现了4个共同主题和9个子主题：“动机”的特点是“保持健康以避免腹膜炎疼痛并符合移植条件”的认知。一个子主题仅出现在接受PD治疗的受访者中：通过“在生活和处境中找到意义”来启动PD的“动机”。“接受”主题包括“对诊断的接受和选择开始PD治疗”以及“调整并融入日常生活”。“支持”来自“家人和朋友的个人支持”、“专业护理人员对个体的关心和理解”以及“专业的个性化和反复教育”。不断发展的“伙伴关系”包括“接触”、“个人融洽关系”以及为保持良好健康结局而“共同合作的必要性”。
PD护士与接受ESKD - PD治疗的患者之间的伙伴关系对于取得成功的健康结局至关重要。每一种伙伴关系都是独特的，且会随着时间发展。成功的伙伴关系要求护士调整教育内容和教学方式，以最好地满足接受PD治疗患者的需求，最重要的是，让他们感到被关心和支持。
