Perspectives on peritoneal dialysis at home: an ethnographic study.
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Background: Peritoneal dialysis is a daily, life-saving treatment for end-stage renal disease, performed at home by patients and their relatives. Increasing numbers of patients are requiring treatment for this disease and therefore clinicians are calling for more patients to use peritoneal dialysis. However, the literature revealed only a small number of qualitative studies that considered patients’ experiences of their treatment, while a dearth of studies that explored relatives’ perspectives was noted. Aim and research questions: The study aimed to explore the experiences of patients and their families living with peritoneal dialysis. The specific research questions were: • What influences patients’ decisions to choose peritoneal dialysis? • How does peritoneal dialysis impact on life and the home environment? • How is peritoneal dialysis managed at home and integrated into everyday life? • How do families perceive having a relative with peritoneal dialysis at home and what contribution do they make to the process? Methodology and methods: The study employed ethnographic methodology and the methods included in-depth interviews and ethnographic observations with sixteen patients using peritoneal dialysis at home in Wales, and their relatives. Additionally seven specialist nephrology healthcare professionals were interviewed, who provided contextualising information about the care they give to patients and their families. The data were analysed thematically using Wolcott’s (1994) approach of description, analysis and interpretation. Findings: The sociological theory of illness trajectories was adopted as a conceptual framework, which guided the analysis and presentation of study findings. Participants reflected on the difficult process of choosing peritoneal dialysis, which was influenced by a preference for home, aversion to hospital and hope for control. The challenges of living with the treatment were described and observed, including medicalisation of the home, while participants tried to minimise their disrupted lives through creativity and flexibility. The future was associated with fear and uncertainty about deterioration, although participants maintained hope that they might receive a kidney transplant. Conclusions: Through the use of ethnography, this study revealed the challenges of living with peritoneal dialysis, but also the ability of families to integrate the treatment into everyday life. The study also demonstrated the usefulness of ethnographic methodology to explore how patients and their families live with home medical treatments.
|Item Type:||Thesis (PhD)|
|Subjects:||R Medicine > RT Nursing|
|Uncontrolled Keywords:||Ethnography; Peritoneal dialysis; Patient; Family Nursing|
|Funders:||Research Capacity Building Collaboration (RCBC) Wales|
|Last Modified:||26 May 2014 09:22|
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