A Qualitative Study of Facilitators and Barriers to Self-Management of CKD.

TitleA Qualitative Study of Facilitators and Barriers to Self-Management of CKD.
Publication TypeJournal Article
Year of Publication2022
AuthorsSchrauben SJ, Rivera E, Bocage C, Eriksen W, Amaral S, Dember LM, Feldman HI, Barg FK
JournalKidney Int Rep
Volume7
Issue1
Pagination46-55
Date Published2022 Jan
ISSN2468-0249
Abstract

Introduction: Self-management is an integral component of CKD treatment. Nevertheless, many patients with CKD do not adequately engage in self-management behaviors, and little is known on the underlying reasons. We aimed to identify and describe the factors that influence self-management behaviors from the perspective of adults with CKD.

Methods: We conducted 30 semistructured interviews with adults with CKD stage 3 or 4 from an academic nephrology clinic in the United States. Interviews were analyzed thematically.

Results: The following are the 3 key phases of CKD self-management behavior engagement identified: (i) prioritization, (ii) performance, and (iii) maintenance. Prioritization was favorably influenced by optimism, stress management, and patient-provider communication and hampered by fatalism and competing priorities. Behavior performance was facilitated by motivating factors, self-efficacy, and support resources and impeded by comorbid conditions that caused treatment burden and adverse symptoms. Behavior maintenance relied on effective routines, influenced by similar factors as behavior performance, and reinforced by memory aids, goal setting, self-monitoring, and proactive preparation.

Conclusion: We identified modifiable facilitators and barriers that influence the incorporation of CKD self-management into daily life. Our findings have important implications for the care of patients with CKD by providing a framework for providers to develop effective, tailored approaches to promote self-management engagement.

DOI10.1016/j.ekir.2021.10.021
Alternate JournalKidney Int Rep
PubMed ID35005313
PubMed Central IDPMC8720654