Identifying Needs for Self-management Interventions for Adults With CKD and Their Caregivers: A Qualitative Study

• DOI: 10.1053/j.ajkd.2019.02.006
• Publication Date: 2019-04-02T18:52:22Z
• Authors: Maoliosa Donald; Heather Beanlands; Sharon Straus; Paul Ronksley; Helen Tam-Tham; Juli Finlay; Jennifer MacKay; Meghan Elliott; Gwen Herrington; Lori Harwood; Chantel A. Large; Claire L. Large; Blair Waldvogel; Dwight Sparkes; Maria Delgado; Allison Tong; Allan Grill; Marta Novak; Matthew T. James; K. Scott Brimble; Susan Samuel; Brenda R. Hemmelgarn
• Keywords: Adult; Aged, 80 and over; Male; Canada; Health Services Needs and Demand; Self-Management; Focus Groups; Middle Aged; 16. Peace & justice; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Caregivers; Humans; Female; Renal Insufficiency, Chronic; 10. No inequality; Qualitative Research; Aged

Fostering the ability of patients to self-manage their chronic kidney disease (CKD), with support from caregivers and providers, may slow disease progression and improve health outcomes. However, little is known about such patients' needs for self-management interventions. We aimed to identify and describe the needs of adults with CKD and informal caregivers for CKD self-management support.Descriptive qualitative study using semi-structured interviews and focus groups.6 focus groups (37 participants) and 11 telephone interviews with adults with CKD (stages 1-5, not on renal replacement therapy) and informal caregivers from across Canada.Thematic analysis.3 major themes were identified: (1) empowerment through knowledge (awareness and understanding of CKD, diet challenges, medication and alternative treatments, attuning to the body, financial implications, mental and physical health consequences, travel and transportation restrictions, and maintaining work and education), (2) activation through information sharing (access, meaningful and relevant, timing, and amount), and (3) tangible supports for the health journey (family, community, and professionals).Participants were primarily white, educated, married, and English speaking, which limits generalizability.There are opportunities to enhance CKD self-management support by addressing knowledge pertinent to living well with CKD and priority areas for sharing information and providing tangible support. Future efforts may consider the development of innovative CKD self-management support interventions based on the diverse patient and caregiver needs identified in this study.