Patients' and healthcare professionals' beliefs, perceptions and needs towards chronic kidney disease self-management in China: a qualitative study. Issue 3 (4th March 2021)

• Record Type: Journal Article
• Authors: Shen, Hongxia; van der Kleij, Rianne M J J; van der Boog, Paul J M; Wang, Wenjiao; Song, Xiaoyue; Li, Zhengyan; Lou, Xiaoping; Chavannes, Niels
• Is Part Of: BMJ open. Volume 11:Issue 3(2021)
• Publication Date: 2021-03-04
• Subjects: public health -- chronic renal failure -- qualitative research; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-044059
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To support the adaptation and translation of an evidence-based chronic kidney disease (CKD) self-management intervention to the Chinese context, we examined the beliefs, perceptions and needs of Chinese patients with CKD and healthcare professionals (HCPs) towards CKD self-management. Design: A basic interpretive, cross-sectional qualitative study comprising semistructured interviews and observations. Setting: One major tertiary referral hospital in Henan province, China. Participants: 11 adults with a diagnosis of CKD with CKD stages G1–G5 and 10 HCPs who worked in the Department of Nephrology. Results: Four themes emerged: (1) CKD illness perceptions, (2) understanding of and motivation towards CKD self-management, (3) current CKD practice and (4) barriers, (anticipated) facilitators and needs towards CKD self-management. Most patients and HCPs solely mentioned medical management of CKD, and self-management was largely unknown or misinterpreted as adherence to medical treatment. Also, the majority of patients only mentioned performing disease-specific acts of control and not, for instance, behaviour for coping with emotional problems. A paternalistic patient–HCP relationship was often present. Finally, the barriers, facilitators and needs towards CKD self-management were frequently related to knowledge and environmental context and resources. Conclusions: The limited understanding of CKD self-management, as observed, underlines the need for educational efforts on the use and benefits of self-management before intervention implementation. Also, specific characteristics and needs within the Chinese context need to guide the development or tailoring of CKD self-management interventions. Emphasis should be placed on role management and emotional coping skills, while self-management components should be tailored by addressing the existing paternalistic patient–HCP relationship. The use of electronic health innovations can be an essential facilitator for implementation.