Akpakli Addo Joana, Senoo-Dogbey Vivian Efua
Department of Nephrology, University of Ghana Medical Center, Accra, Ghana.
Faculty of Nephrology Nursing, Ghana College of Nurses and Midwives, Accra, Ghana.
SAGE Open Nurs. 2025 Jun 20;11:23779608251350750. doi: 10.1177/23779608251350750. eCollection 2025 Jan-Dec.
Chronic kidney disease has become a significant global public health burden due to its increasing incidence, prevalence, and impact on quality of life. Worldwide, conservative management, kidney transplantation, and renal replacement therapy are employed to manage chronic kidney disease. However, in Ghana, conservative management and hemodialysis predominate, focusing on prolonging life while neglecting other supportive care needs. This study explored nurses' knowledge of kidney supportive care and the measures they adopt to identify and manage the psychological needs of patients with chronic kidney disease.
Exploratory descriptive qualitative design was employed. Eighteen nurses from a tertiary hospital dialysis unit in Ghana were purposively recruited. Face-to-face interviews were conducted using a semistructured guide, and thematic analysis was performed using Braun and Clarke's six-step qualitative data analysis method.
Nurses' practices were categorized into two main themes: awareness and emotional/psychological practices. The Awareness theme comprised five subthemes: expert communication, interdisciplinary teams, symptom management, realities, and management challenges. The emotional/psychological practices theme included three subthemes: establishing relationships, identifying needs, and addressing psychological issues.
The study revealed that while nurses in Ghanaian dialysis units possess some awareness of kidney support care, their practices are primarily centered on prolonging life rather than addressing holistic patient needs. Psychological and emotional support for chronic kidney disease patients is often informal and lacks structured guidelines. Limited resources and interdisciplinary collaboration hinder comprehensive kidney support care implementation. Strengthening nurses' knowledge and integrating formal psychological support frameworks are crucial for improving patient-centred care in chronic disease management.
慢性肾脏病因其发病率、患病率不断上升以及对生活质量的影响，已成为全球重大的公共卫生负担。在全球范围内，保守治疗、肾移植和肾脏替代疗法被用于管理慢性肾脏病。然而，在加纳，保守治疗和血液透析占主导地位，侧重于延长生命，而忽视了其他支持性护理需求。本研究探讨了护士对肾脏支持性护理的知识，以及他们为识别和管理慢性肾脏病患者心理需求所采取的措施。
采用探索性描述性定性设计。从加纳一家三级医院透析科有目的地招募了18名护士。使用半结构化指南进行面对面访谈，并采用布劳恩和克拉克的六步定性数据分析方法进行主题分析。
护士的实践分为两个主要主题：认知与情感/心理实践。认知主题包括五个子主题：专业沟通、跨学科团队、症状管理、现实情况和管理挑战。情感/心理实践主题包括三个子主题：建立关系、识别需求和解决心理问题。
该研究表明，虽然加纳透析科的护士对肾脏支持性护理有一定认识，但他们的实践主要集中在延长生命上，而非满足患者的整体需求。对慢性肾脏病患者的心理和情感支持往往是非正式的，缺乏结构化指南。资源有限和跨学科协作阻碍了全面肾脏支持性护理的实施。加强护士知识并整合正式的心理支持框架对于改善慢性病管理中以患者为中心的护理至关重要。
