Kpekura Stephen, Shan Yan, Yiryuo Lilian, Myers-Hansen Gustavus Adolphus, Parvin Shahinur
School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.
The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
J Nephrol. 2025 May 2. doi: 10.1007/s40620-025-02242-4.
In Ghana, the prevalence of chronic kidney disease was 12% in 2017. Global data show that about 70% of people living on kidney replacement therapy are on haemodialysis. Selfcare among haemodialysis patients is important to counteract the multiple difficulties encountered. However, patients on haemodialysis often do not engage enough in selfcare and need the help of "informal", usually family caregivers. The purpose of this study was to explore the challenges experienced by caregivers in contributing to the management of haemodialysis patients in Ghana.
Descriptive qualitative research design was employed in this study. The study was conducted at the Tamale Teaching Hospital and the 37 Military Hospital in Ghana. Fourteen caregivers of adult haemodialysis patients who received care at the nephology department of the setting were recruited through purposive sampling, according to the inclusion criteria. The sample size was defined by data saturation. Informal caregivers were interviewed face-to-face using a semi-structured interview, between April and May 2024. Data were analysed manually employing Braun and Clark's six-steps of thematic analysis.
Two main themes were identified with seven subthemes, namely, deficit of knowledge on kidney disease and its treatment (poor disease knowledge, poor knowledge on side effects of medications on fistula management, on blood pressure parameters, and on food requirements) and patients' non- adherence (resistance to food and fluid restrictions).
Supportive intervention programs may provide both patients and their caregivers with the knowledge and skills required to enable them to contribute effectively to the care of patients undergoing haemodialysis.
2017年，加纳慢性肾脏病的患病率为12%。全球数据显示，接受肾脏替代治疗的人群中约70%采用血液透析。血液透析患者的自我护理对于应对所遇到的多重困难至关重要。然而，血液透析患者往往在自我护理方面做得不够，需要“非正式”护理人员（通常是家庭护理人员）的帮助。本研究的目的是探讨加纳护理人员在协助管理血液透析患者过程中所面临的挑战。
本研究采用描述性定性研究设计。研究在加纳的塔马利教学医院和37军医院开展。根据纳入标准，通过目的抽样法招募了14名在上述医院肾病科接受护理的成年血液透析患者的护理人员。样本量由数据饱和确定。2024年4月至5月期间，采用半结构化访谈对非正式护理人员进行了面对面访谈。采用布劳恩和克拉克的主题分析六步法对数据进行人工分析。
确定了两个主要主题及七个子主题，即肾病及治疗知识不足（疾病知识匮乏、对药物副作用、内瘘管理、血压参数及食物需求的知识了解不足）和患者不依从（抗拒食物和液体限制）。
支持性干预项目可为患者及其护理人员提供必要的知识和技能，使他们能够有效地协助护理接受血液透析的患者。
