St. Mary's Medical Center, Long Beach, CA, USA.
Sydney School of Public Health, 4334The University of Sydney, New South Wales, Australia.
Perit Dial Int. 2021 Sep;41(5):484-493. doi: 10.1177/0896860820970064. Epub 2020 Nov 11.
Peritoneal dialysis (PD) can offer patients more autonomy and flexibility compared with in-center hemodialysis (HD). However, burnout - defined as mental, emotional, or physical exhaustion that leads to thoughts of discontinuing PD - is associated with an increased risk of transfer to HD. We aimed to describe the perspectives of burnout among patients on PD and their caregivers.
In this focus group study, 81 patients and 45 caregivers participated in 14 focus groups from 9 dialysis units in Australia, Hong Kong, and the United States. Transcripts were analyzed thematically.
We identified two themes. contributed to burnout, as patients and caregivers felt overwhelmed by the daily regimen, perceived their life to be coming to a halt, tolerated the PD regimen for survival, and had to bear the burden and uncertainty of what to expect from PD alone. against burnout encompassed establishing a new normal, drawing inspiration and support from family, relying on faith and hope for motivation, and finding meaning in other activities.
For patients on PD and their caregivers, burnout was intensified by perceiving PD as an unrelenting, isolating responsibility that they had no choice but to endure, even if it held them back from doing other activities in life. More emphasis on developing strategies to adapt and build resilience could prevent or minimize burnout.
与中心血液透析(HD)相比,腹膜透析(PD)可为患者提供更大的自主权和灵活性。然而,倦怠——定义为导致停止 PD 治疗想法的精神、情绪或身体疲惫——与增加转至 HD 的风险相关。我们旨在描述 PD 患者及其护理人员的倦怠观点。
在这项焦点小组研究中,来自澳大利亚、中国香港和美国的 9 个透析单位的 81 名患者和 45 名护理人员参加了 14 个焦点小组。对转录本进行了主题分析。
我们确定了两个主题。 导致倦怠,因为患者和护理人员感到日常治疗方案负担过重,感到他们的生活停滞不前,为了生存而忍受 PD 治疗方案,并且不得不独自承担对 PD 的期望的负担和不确定性。 对抗倦怠包括建立新的常态,从家人那里获得灵感和支持,依靠信仰和希望获得动力,以及在其他活动中找到意义。
对于 PD 患者及其护理人员来说,将 PD 视为一种无情、孤立的责任,他们别无选择,只能忍受,即使这阻碍了他们在生活中进行其他活动,这会加剧倦怠。更加强调制定适应和建立韧性的策略可以预防或最小化倦怠。