title: Dietary and fluid restriction perceptions of patients undergoing haemodialysis: an exploratory study.
abstract: OBJECTIVE
  To explore the perspectives of patients undergoing haemodialysis in Singapore on an imposed dietary and fluid restriction regime.
  
  
  BACKGROUND
  Adherence to prescribed dietary and fluid restriction constructs the fundamental basis of self-care with improved morbidity and mortality. However, most patients have struggled to adhere in this aspect. Existing studies have presented limited understanding on the facilitators and barriers of dietary and fluid adherence among haemodialysis patients.
  
  
  METHODS
  An exploratory qualitative study.
  
  
  METHODS
  A purposive sample of 14 patients undergoing haemodialysis was recruited from a renal unit of a tertiary hospital in Singapore. Data were collected through face-to-face individual interviews and subsequently analysed by thematic analysis.
  
  
  RESULTS
  Four themes emerged: (1) Pessimism, (2) Existing struggles, (3) Perceived quality of support, and (4) Immensity of self-discipline.
  
  
  CONCLUSIONS
  The imposed dietary and fluid restriction is a constant struggle and a cause of suffering among haemodialysis patients in Singapore. Nonetheless, they are generally submissive to their fluid restrictions for the sake of survival or to meet the expectations of their loved ones. The imposed dietary restrictions are generally neglected.
  
  
  CONCLUSIONS
  The findings from this study can provide useful information in reviewing existing educational strategies, policies and nursing care. This is especially important because most patients exhibit high reliance on healthcare professionals.
authors.affiliation: Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Leting Isabella
authors.initials: LI
authors.lastname: Hong
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Wenru
authors.identifier: http://orcid.org/0000-0002-0265-8215
authors.initials: W
authors.lastname: Wang
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.|Department of Nursing Service, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Ee Yuee
authors.initials: EY
authors.lastname: Chan
authors.affiliation: Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Fatimah
authors.initials: F
authors.lastname: Mohamed
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Hui-Chen
authors.identifier: http://orcid.org/0000-0002-4026-2414
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D004035:Diet Therapy / Q000523:psychology*; D005260:Female; D005440:Fluid Therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D006435:Renal Dialysis / Q000451:nursing / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D057566:Self Report; D012846:Singapore; D062606:Tertiary Care Centers; D000074822:Treatment Adherence and Compliance / Q000523:psychology*
keywords: adherence; dietary restriction; fluid restriction; haemodialysis; qualitative study