Bulathwatta Darshika Thejani, Rudnik Agata, Borchet Judyta, Zelechowska Sonia, Treppner Małgorzata, Ruszkowski Jakub, Zakrzewska Agnieszka, Dębska-Ślizien Alicja M, Biedunkiewicz Bogdan, Tylicki Leszek, Bidzan Mariola
Department of Psychology and Counseling, Faculty of Health Sciences, The Open University of Sri Lanka, Colombo, Sri Lanka.
Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdansk, Poland.
SAGE Open Nurs. 2025 Jul 31;11:23779608251360594. doi: 10.1177/23779608251360594. eCollection 2025 Jan-Dec.
End-stage kidney disease (ESKD) represents the final stage of chronic kidney disease, profoundly impacting patients and their caregivers through a wide range of physical, psychological, and social challenges. Cultural values and healthcare system disparities often shape these experiences, but comparative cross-cultural perspectives remain limited.
This study explores the psychosocial experiences and treatment processes of individuals with ESKD and their caregivers in Sri Lanka and Poland, focusing on cultural, systemic, and personal influences on wellbeing.
An exploratory qualitative design was employed, utilizing semistructured interviews with 27 participants, including 18 individuals undergoing hemodialysis (10 from the Sri Lankan sample and eight from the Polish sample) and nine caregivers (five from the Sri Lankan sample and four from the Polish sample). The interviews were analyzed using conventional qualitative content analysis, identifying thematic similarities and differences across the two cultural contexts.
Three interconnected themes emerged: quality of life, coping strategies, and medical experiences. In Poland, the "Power of (My)Self" reflected individual resilience and personal agency as dominant factors influencing wellbeing. In contrast, the Sri Lankan context was shaped by the "Power of Tradition," with cultural practices, religious rituals, and communal values playing pivotal roles. Participants in Sri Lanka faced significant resource limitations and infrastructural challenges, while Polish participants benefited from more comprehensive healthcare systems but reported challenges such as depression and emotional isolation.
The findings highlight the profound impact of cultural frameworks and systemic disparities on the lives of individuals with ESKD and their caregivers. While Polish participants emphasized autonomy and self-management, Sri Lankan participants relied heavily on traditional and familial support systems. The proposed conceptual model encapsulates these dynamics, providing a framework for culturally sensitive interventions that address both universal and context-specific needs.
终末期肾病（ESKD）是慢性肾病的最后阶段，通过一系列身体、心理和社会挑战对患者及其照顾者产生深远影响。文化价值观和医疗保健系统差异常常塑造这些经历，但跨文化比较视角仍然有限。
本研究探讨斯里兰卡和波兰ESKD患者及其照顾者的心理社会经历和治疗过程，重点关注文化、系统和个人对幸福感的影响。
采用探索性定性设计，对27名参与者进行半结构化访谈，其中包括18名接受血液透析的个体（10名来自斯里兰卡样本，8名来自波兰样本）和9名照顾者（5名来自斯里兰卡样本，4名来自波兰样本）。使用常规定性内容分析法对访谈进行分析，确定两种文化背景下的主题异同。
出现了三个相互关联的主题：生活质量、应对策略和医疗经历。在波兰，“（我）自身的力量”反映出个人复原力和个人能动性是影响幸福感的主导因素。相比之下，斯里兰卡的情况则受“传统的力量”塑造，文化习俗、宗教仪式和社区价值观发挥着关键作用。斯里兰卡的参与者面临重大资源限制和基础设施挑战，而波兰的参与者受益于更全面的医疗保健系统，但报告了诸如抑郁和情感孤立等挑战。
研究结果凸显了文化框架和系统差异对ESKD患者及其照顾者生活的深远影响。波兰参与者强调自主性和自我管理，而斯里兰卡参与者严重依赖传统和家庭支持系统。所提出的概念模型概括了这些动态，为满足普遍和特定背景需求的文化敏感干预措施提供了一个框架。
