title: The peritoneal dialysis experience: insights from long-term patients.
abstract: This exploratory-descriptive study identifies dimensions of self-management demonstrated by patients with end stage renal disease (ESRD) who have been successfully treated with peritoneal dialysis (PD) for more than 4 years (range = 4.1 to 13.1 years, mean = 7.5 years). After IRB review, semi-structured interviews were conducted with 18 individuals, 10 male and 8 female; 11 Caucasian, 6 African-American, and 1 Hispanic. Respondents ranged in age from 33 to 86 years (mean = 54.4 years). Interviews were audio-recorded and verbatim transcriptions were analyzed according to a content analytic procedure, with movement from specific to general. Two broad domains of self-management were identified: autonomy/control in health care and normality in everyday life. Autonomy/control was comprised of three specific dimensions: partnership in care, self-care, and self-care self-efficacy. Normality in everyday life included the dimensions of flexibility/freedom, interpretation of illness severity, and perception of body image. Although the small sample size and methodology limit generalizability, insights into the lived self-management experience on PD were identified. Such insights lay the groundwork for development of interventions to facilitate informed decision-making regarding dialysis modality, to teach tactics for effective self-management on PD, and to help health care professionals to support the self-management efforts of patients on PD.
authors.affiliation: Medical Education Institute, Madison, WI, USA.
authors.forename: Roberta Braun
authors.initials: RB
authors.lastname: Curtin
authors.forename: H Keith
authors.initials: HK
authors.lastname: Johnson
authors.forename: Dorian
authors.initials: D
authors.lastname: Schatell
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001828:Body Image; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D010530:Peritoneal Dialysis / Q000523:psychology; D012648:Self Care; D020377:Self Efficacy