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支持慢性肾病患者自我管理其病情:了解他们的生活经历、需求和要求,以及障碍和促进因素。

Supporting people with chronic kidney disease to self-manage their condition: understanding the lived experiences, needs and requirements, and barriers and facilitators.

作者信息

Lightfoot Courtney J, Wilkinson Thomas J, Graham-Brown Matthew P M, Smith Alice C

机构信息

Leicester Kidney Lifestyle Team, Department of Population Health Sciences, University of Leicester, Leicester, UK.

NIHR Leicester Biomedical Research Centre, Leicester, UK.

出版信息

J Nephrol. 2025 Jul 12. doi: 10.1007/s40620-025-02349-8.

Abstract

BACKGROUND

Self-management has been identified as an essential component in the effective management of patients with chronic kidney disease (CKD). To effectively develop interventions that support patients with CKD to self-manage, it is crucial to understand their experiences and the factors that may influence their ability to self-manage. This study explored awareness, attitudes and participation with self-management in people living with non-dialysis CKD to understand factors influencing self-management behaviours.

METHODS

Semi-structured interviews were conducted with 22 individuals living with non-dialysis CKD. Topics explored included perspectives and experiences of self-management, health and lifestyle behaviours, healthcare professional support, and self-management support, including future interventional approaches. Data were audio recorded and transcribed verbatim. Thematic analysis was used to analyse the data and to identify and report themes.

RESULTS

Six themes were identified encompassing perspectives, barriers and facilitators of self-management: "perceptions and experiences of (self-)managing CKD", "perceived needs and requirements for self-management education and support", "knowledge and capability-related factors", "skills and opportunity-related factors", "confidence and motivational-related factors" and "social support".

CONCLUSION

Participants perceived that their CKD was not a significant problem, given the lack of concern from their doctor. Despite reporting a lack of awareness and understanding of CKD and its management, participants expressed interest in learning more and implementing appropriate self-management strategies. It was perceived that information and support were provided when it was almost too late, and not when it could potentially have the greatest impact. Perceived barriers and facilitators must be considered when developing interventions to support self-management for people with CKD.

摘要

背景

自我管理已被视为慢性肾脏病(CKD)患者有效管理的重要组成部分。为了有效制定支持CKD患者进行自我管理的干预措施,了解他们的经历以及可能影响其自我管理能力的因素至关重要。本研究探讨了非透析CKD患者对自我管理的认知、态度和参与情况,以了解影响自我管理行为的因素。

方法

对22名非透析CKD患者进行了半结构化访谈。探讨的主题包括自我管理的观点和经历、健康和生活方式行为、医疗专业人员的支持以及自我管理支持,包括未来的干预方法。数据进行了音频录制并逐字转录。采用主题分析法对数据进行分析,以识别和报告主题。

结果

确定了六个主题,涵盖自我管理的观点、障碍和促进因素:“(自我)管理CKD的认知和经历”、“自我管理教育和支持的感知需求和要求”、“与知识和能力相关的因素”、“与技能和机会相关的因素”、“与信心和动机相关的因素”以及“社会支持”。

结论

由于医生缺乏关注,参与者认为他们的CKD不是一个重大问题。尽管报告对CKD及其管理缺乏认识和了解,但参与者表示有兴趣了解更多并实施适当的自我管理策略。人们认为信息和支持是在几乎为时已晚时提供的,而不是在可能产生最大影响的时候提供。在制定支持CKD患者自我管理的干预措施时,必须考虑到感知到的障碍和促进因素。

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