title: Exploring the process of adjusting to diabetic kidney disease.
abstract: The psychological process of adjusting to diabetic kidney disease (DKD) has been afforded little attention within previous literature. This study aimed to explore the process of adjusting to DKD as a secondary condition to type 1 diabetes. A qualitative method was used in the study design. Eleven participants were interviewed using a semi-structured and exploratory approach. Through inductive thematic analysis, three super-ordinate themes were identified from the data: coming to an understanding over time, managing the impact of DKD and facing the future. The themes demonstrate that the DKD population has complex physical and psychological needs at all stages of their condition. Making sense of kidney disease as a secondary condition and integration of this information with existing beliefs was integral to the adjustment process. Attempts to manage uncertainty and change included asserting control of the situation and use of cognitive strategies. The results support the use of psychological models of adjustment in conceptualising the 'process' of adjustment and suggest the need for psychological interventions to support this population.
authors.affiliation: Gloucestershire Royal Hospital, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK. katiereid@nhs.net
authors.forename: Katherine
authors.initials: K
authors.lastname: Reid
authors.forename: Marianne
authors.initials: M
authors.lastname: Morris
authors.forename: Margaret
authors.initials: M
authors.lastname: Cormack
authors.forename: Karen
authors.initials: K
authors.lastname: Marchant
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003928:Diabetic Nephropathies / Q000523:psychology*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support; D055815:Young Adult