title: Adhering to behaviour change in older pre-dialysis populations--what do patients think? A qualitative study.
abstract: BACKGROUND
  Chronic Kidney Disease (CKD) is associated with the development of serious co-morbidities. Patients with CKD are encouraged to adhere to regimens to lower this risk. This study aimed to explore the experiences of patients attempting to integrate lifestyle changes into their lives.
  
  
  METHODS
  Face-to-face recorded interviews were conducted with nine consenting patients with CKD Stage 4 under the care of a consultant nephrologist. Each recording was analysed by two independent investigators using thematic analysis.
  
  
  RESULTS
  Five themes emerged: Self in relation to others, Control, Adherence, Beliefs about treatment and illness and Uncertainty. Participants highlighted the importance of personal support and recounted their sense of being a burden on close family. They described how they approached disclosure about their condition, their beliefs regarding treatment and their decision making processes and how these factors impacted on adherence to behaviour change.
  
  
  CONCLUSIONS
  Practical support from family and healthcare professionals, a willingness to disclose their condition and help to make good decisions in difficult circumstances were identified as important factors in supporting success with behaviour change.
authors.affiliation: Department of Nutrition and Dietetics, Royal Free Hampstead NHS Trust, London, UK. Rebecca.walker6@nhs.net
authors.forename: Rebecca
authors.initials: R
authors.lastname: Walker
authors.forename: Hayley
authors.initials: H
authors.lastname: James
authors.forename: Aine
authors.initials: A
authors.lastname: Burns
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D006801:Humans; D055809:Illness Behavior; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D036301:Qualitative Research; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D011795:Surveys and Questionnaires