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晚期慢性肾脏病老年患者及其照顾者的生活经历:一项揭示风险与复原力动态的定性研究

Lived Experiences of Older Adults with Advanced CKD and Their Caregivers: A Qualitative Study Uncovering Risk and Resilience Dynamics.

作者信息

Cameranesi Margherita, Mollard Rebecca, Harasemiw Oksana, Curtis Sarah, Iman Yasmin, Buenafe Jeann, Protudjer Jennifer L P, Tangri Navdeep, MacKay Dylan

机构信息

Department of Foods and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada.

出版信息

Kidney360. 2025 May 1;6(5):754-762. doi: 10.34067/KID.0000000723. Epub 2025 Feb 4.

Abstract

KEY POINTS

Older adults with advanced CKD and their caregivers experience a variety of stressors that substantially affect their well-being. These families use a set of interpersonal and ecological coping mechanisms to deal with the challenges they face. More research on the lived experiences of this marginalized population is needed to identify the mechanisms that promote resilience in these families.

BACKGROUND

To date, very little is known about the lived experiences of families affected by CKD, especially regarding the adaptive coping strategies these families use to successfully cope with the chronic stress they must face because of CKD.

METHODS

An exploratory qualitative descriptive study was conducted by recruiting a subsample of adults with advanced CKD participating in the Canadian Frailty Observation and Interventions Trial study and some of their caregivers. As part of this ongoing larger study, 12 adults with advanced CKD and seven of their caregivers (=19) completed one focus group discussion that explored topics related to their unique lived experiences as individuals affected by CKD. Narrative data were analyzed using a three-step inductive thematic analysis process.

RESULTS

Three themes that portray participants' lived experiences were identified, including () experiencing chronic stress because of CKD, () coping successfully with the stress caused by CKD, and () recommendations to improve family well-being.

CONCLUSIONS

Social and health services for families affected by CKD may be more effective in promoting the health, well-being, and quality of life of both adults with CKD and their caregivers if they acknowledge the chronic stressors these families face daily and provide support strategies that help them successfully cope with such stressors.

摘要

关键点

患有晚期慢性肾脏病(CKD)的老年人及其照料者会经历各种压力源,这些压力源会严重影响他们的幸福感。这些家庭采用一系列人际和生态应对机制来应对所面临的挑战。需要对这一边缘化人群的生活经历进行更多研究,以确定促进这些家庭恢复力的机制。

背景

迄今为止,对于受CKD影响的家庭的生活经历知之甚少,尤其是关于这些家庭用来成功应对因CKD而必须面对的慢性压力的适应性应对策略。

方法

通过招募参与加拿大虚弱观察与干预试验研究的晚期CKD成年人及其部分照料者的子样本,进行了一项探索性定性描述性研究。作为这项正在进行的更大规模研究的一部分,12名晚期CKD成年人及其7名照料者(共19人)完成了一次焦点小组讨论,探讨了与他们作为受CKD影响的个体的独特生活经历相关的话题。使用三步归纳主题分析过程对叙事数据进行分析。

结果

确定了描绘参与者生活经历的三个主题,包括()因CKD经历慢性压力,()成功应对CKD造成的压力,以及()改善家庭幸福感的建议。

结论

如果社会和卫生服务机构承认受CKD影响的家庭每天面临的慢性压力源,并提供帮助他们成功应对此类压力源的支持策略,那么这些服务可能会更有效地促进患有CKD的成年人及其照料者的健康、幸福感和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c3f/12136632/9fc0f6c818a1/kidney360-6-754-g001.jpg

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