Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
BMJ Open. 2021 Mar 4;11(3):e044059. doi: 10.1136/bmjopen-2020-044059.
To support the adaptation and translation of an evidence-based chronic kidney disease (CKD) self-management intervention to the Chinese context, we examined the beliefs, perceptions and needs of Chinese patients with CKD and healthcare professionals (HCPs) towards CKD self-management.
A basic interpretive, cross-sectional qualitative study comprising semistructured interviews and observations.
One major tertiary referral hospital in Henan province, China.
11 adults with a diagnosis of CKD with CKD stages G1-G5 and 10 HCPs who worked in the Department of Nephrology.
Four themes emerged: (1) CKD illness perceptions, (2) understanding of and motivation towards CKD self-management, (3) current CKD practice and (4) barriers, (anticipated) facilitators and needs towards CKD self-management. Most patients and HCPs solely mentioned medical management of CKD, and self-management was largely unknown or misinterpreted as adherence to medical treatment. Also, the majority of patients only mentioned performing disease-specific acts of control and not, for instance, behaviour for coping with emotional problems. A paternalistic patient-HCP relationship was often present. Finally, the barriers, facilitators and needs towards CKD self-management were frequently related to knowledge and environmental context and resources.
The limited understanding of CKD self-management, as observed, underlines the need for educational efforts on the use and benefits of self-management before intervention implementation. Also, specific characteristics and needs within the Chinese context need to guide the development or tailoring of CKD self-management interventions. Emphasis should be placed on role management and emotional coping skills, while self-management components should be tailored by addressing the existing paternalistic patient-HCP relationship. The use of electronic health innovations can be an essential facilitator for implementation.
为支持将基于证据的慢性肾脏病（CKD）自我管理干预措施改编并翻译为中文，我们调查了中国 CKD 患者和医疗保健专业人员（HCP）对 CKD 自我管理的信念、看法和需求。
一项基本的解释性、横断面定性研究，包括半结构化访谈和观察。
中国河南省一家主要的三级转诊医院。
11 名患有 CKD G1-G5 期的成年人和 10 名在肾脏病科工作的 HCP。
出现了 4 个主题：（1）CKD 疾病认知，（2）对 CKD 自我管理的理解和动力，（3）当前 CKD 实践，（4）CKD 自我管理的障碍、（预期）促进因素和需求。大多数患者和 HCP 仅提到 CKD 的医疗管理，而自我管理知之甚少或被误解为坚持医疗治疗。此外，大多数患者仅提到执行疾病特异性的控制行为，而不是例如应对情绪问题的行为。医患关系常常是家长式的。最后，CKD 自我管理的障碍、促进因素和需求常常与知识和环境背景以及资源有关。
所观察到的对 CKD 自我管理的理解有限，这强调了在干预实施之前需要进行有关自我管理的使用和益处的教育工作。此外，中国背景下的具体特征和需求需要指导 CKD 自我管理干预措施的制定或调整。应重点关注角色管理和情绪应对技能，同时通过解决现有的家长式医患关系来调整自我管理组件。电子健康创新的使用可以成为实施的重要促进因素。
