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Coping with kidney disease - qualitative findings from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study.
BMC Nephrol. 2017 04 03; 18(1):119.BN

Abstract

BACKGROUND

The highly burdensome effects of kidney failure and its management impose many life-altering changes on patients. Better understanding of successful coping strategies will inform patients and help health care providers support patients' needs as they navigate these changes together.

METHODS

A qualitative, cross-sectional study involving semi-structured telephone interviews including open- and closed-ended questions, with 179 U.S. patients with advanced chronic kidney disease (CKD), either not yet on dialysis ([CKD-ND], n = 65), or on dialysis (hemodialysis [HD], n = 76; or peritoneal dialysis [PD], n = 38) recruited through social media and in-person contacts from June to December 2013. Themes identified through content analysis of interview transcripts were classified based on the Coping Strategies Index (CSI) and compared across groups by demographics, treatment modality, and health status.

RESULTS

Overall, more engagement than disengagement strategies were observed. "Take care of myself and follow doctors' orders," "accept it," and "rely on family and friends" were the common coping themes. Participants often used multiple coping strategies. Various factors such as treatment modality, time since diagnosis, presence of other chronic comorbidities, and self-perceived limitations contributed to types of coping strategies used by CKD patients.

CONCLUSIONS

The simultaneous use of coping strategies that span different categories within each of the CSI subscales by CKD patients reflects the complex and reactive response to the variable demands of the disease and its treatment options on their lives. Learning from the lived experience of others could empower patients to more frequently use positive coping strategies depending on their personal context as well as the stage of the disease and associated stressors. Moreover, this understanding can improve the support provided by health care systems and providers to patients to better deal with the many challenges they face in living with kidney disease.

Authors+Show Affiliations

Arbor Research Collaborative for Health, 340 E. Huron, Suite 300, Ann Arbor, MI, 48104, USA. lalita.subramanian@arborresearch.org.The Center for Managing Chronic Disease, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.Arbor Research Collaborative for Health, 340 E. Huron, Suite 300, Ann Arbor, MI, 48104, USA.The Center for Managing Chronic Disease, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.Arbor Research Collaborative for Health, 340 E. Huron, Suite 300, Ann Arbor, MI, 48104, USA.Arbor Research Collaborative for Health, 340 E. Huron, Suite 300, Ann Arbor, MI, 48104, USA. Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28372582

Citation

Subramanian, Lalita, et al. "Coping With Kidney Disease - Qualitative Findings From the Empowering Patients On Choices for Renal Replacement Therapy (EPOCH-RRT) Study." BMC Nephrology, vol. 18, no. 1, 2017, p. 119.
Subramanian L, Quinn M, Zhao J, et al. Coping with kidney disease - qualitative findings from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study. BMC Nephrol. 2017;18(1):119.
Subramanian, L., Quinn, M., Zhao, J., Lachance, L., Zee, J., & Tentori, F. (2017). Coping with kidney disease - qualitative findings from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study. BMC Nephrology, 18(1), 119. https://doi.org/10.1186/s12882-017-0542-5
Subramanian L, et al. Coping With Kidney Disease - Qualitative Findings From the Empowering Patients On Choices for Renal Replacement Therapy (EPOCH-RRT) Study. BMC Nephrol. 2017 04 3;18(1):119. PubMed PMID: 28372582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coping with kidney disease - qualitative findings from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study. AU - Subramanian,Lalita, AU - Quinn,Martha, AU - Zhao,Junhui, AU - Lachance,Laurie, AU - Zee,Jarcy, AU - Tentori,Francesca, Y1 - 2017/04/03/ PY - 2016/12/19/received PY - 2017/03/24/accepted PY - 2017/4/5/entrez PY - 2017/4/5/pubmed PY - 2017/11/29/medline KW - CKD KW - CSI KW - Coping strategies KW - Hemodialysis KW - Peritoneal dialysis SP - 119 EP - 119 JF - BMC nephrology JO - BMC Nephrol VL - 18 IS - 1 N2 - BACKGROUND: The highly burdensome effects of kidney failure and its management impose many life-altering changes on patients. Better understanding of successful coping strategies will inform patients and help health care providers support patients' needs as they navigate these changes together. METHODS: A qualitative, cross-sectional study involving semi-structured telephone interviews including open- and closed-ended questions, with 179 U.S. patients with advanced chronic kidney disease (CKD), either not yet on dialysis ([CKD-ND], n = 65), or on dialysis (hemodialysis [HD], n = 76; or peritoneal dialysis [PD], n = 38) recruited through social media and in-person contacts from June to December 2013. Themes identified through content analysis of interview transcripts were classified based on the Coping Strategies Index (CSI) and compared across groups by demographics, treatment modality, and health status. RESULTS: Overall, more engagement than disengagement strategies were observed. "Take care of myself and follow doctors' orders," "accept it," and "rely on family and friends" were the common coping themes. Participants often used multiple coping strategies. Various factors such as treatment modality, time since diagnosis, presence of other chronic comorbidities, and self-perceived limitations contributed to types of coping strategies used by CKD patients. CONCLUSIONS: The simultaneous use of coping strategies that span different categories within each of the CSI subscales by CKD patients reflects the complex and reactive response to the variable demands of the disease and its treatment options on their lives. Learning from the lived experience of others could empower patients to more frequently use positive coping strategies depending on their personal context as well as the stage of the disease and associated stressors. Moreover, this understanding can improve the support provided by health care systems and providers to patients to better deal with the many challenges they face in living with kidney disease. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/28372582/Coping_with_kidney_disease___qualitative_findings_from_the_Empowering_Patients_on_Choices_for_Renal_Replacement_Therapy__EPOCH_RRT__study_ L2 - https://www.biomedcentral.com/1471-2369/18/119 DB - PRIME DP - Unbound Medicine ER -