Mbeje Pretty N, Chironda Geldine, Mtshali Ntombifikile G
College of Health Sciences, School of Nursing and Public Health, 5th floor Desmond Clarence Building, Howard College Campus, University of KwaZulu-Natal, Durban, 4041, South Africa.
Seed Global Health, St John of God University, Mzuzu, Malawi.
Heliyon. 2024 Sep 16;10(19):e37842. doi: 10.1016/j.heliyon.2024.e37842. eCollection 2024 Oct 15.
Chronic kidney disease (CKD) is one non-communicable disease mainly caused by comorbid of diabetes and hypertension, thus compromising quality of life for the patients. Few rigorous Quality of Life frameworks on chronic kidney disease (CKD) have been reported in low-middle income countries including South Africa. Therefore, the study aimed at developing a Conceptual Framework to improve the Quality of Life in Patients with CKD on Dialysis in KwaZulu Natal Province, South Africa. A Mixed method sequential explanatory design which entails collection of quantitative data, followed by qualitative. A purposive sampling of 316 CKD patients for quantitative was initially selected. For qualitative, 17 healthcare professionals were theoretically sampled until data saturation. A structured questionnaire (WHO HRQOL-BREF) was utilized to collect numerical data for quantitative phase, while focus group discussions provided qualitative insights. The quantitative results indicated low quality of life (QoL) in several dimensions: economic (98 %), psychological (95 %), physical (70 %), and social (55 %). Grounded theory analysis of the qualitative data identified key predictors of QoL as the patients' geographic location, accessibility to haemodialysis centres, their ability to adapt and accept the condition, self-management practices, support from family members and caregivers including the presence of well-trained nursing staff. A comprehensive conceptual framework was developed through identifying contextual factors, interventions and outcomes that is expected to improve the QOL. The study recommends the immediate intervention of the policy makers and health care providers in drafting and implementing policies to improve the QOL in patients with CKD.
慢性肾脏病（CKD）是一种主要由糖尿病和高血压合并症引起的非传染性疾病，从而影响患者的生活质量。在包括南非在内的中低收入国家，很少有关于慢性肾脏病（CKD）的严格生活质量框架的报道。因此，该研究旨在制定一个概念框架，以提高南非夸祖鲁-纳塔尔省接受透析的慢性肾脏病患者的生活质量。采用混合方法顺序解释性设计，即先收集定量数据，然后收集定性数据。最初选取了316名慢性肾脏病患者进行定量研究的目的抽样。对于定性研究，理论上抽取了17名医疗保健专业人员，直至数据饱和。定量阶段使用结构化问卷（世界卫生组织生活质量简表）收集数值数据，而焦点小组讨论提供定性见解。定量结果表明，在几个维度上生活质量较低：经济维度（98%）、心理维度（95%）、身体维度（70%）和社会维度（55%）。对定性数据的扎根理论分析确定，生活质量的关键预测因素包括患者的地理位置、血液透析中心的可及性、他们适应和接受病情的能力、自我管理实践、家庭成员和护理人员的支持，包括训练有素的护理人员的配备情况。通过确定预期能改善生活质量的背景因素、干预措施和结果，制定了一个全面的概念框架。该研究建议政策制定者和医疗保健提供者立即采取干预措施，起草和实施政策，以改善慢性肾脏病患者的生活质量。
