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Experiences of carers supporting dying renal patients managed without dialysis.
- Source :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.); Aug2013, Vol. 69 Issue 8, p1829-1839, 11p, 2 Charts
- Publication Year :
- 2013
-
Abstract
- Aim To explore the impact of being a family carer to patients with stage 5 chronic kidney disease managed without dialysis. Background Increasing numbers of patients with renal disease worldwide are making the decision not to embark on dialysis. This group has significant physical and psychological symptom burdens similar to or greater than those in advanced cancer patients. Little is known about the impact on family carers. Design Exploratory, qualitative design. Methods The study was undertaken with 19 carers caring for patients managed in a Renal Supportive Care Service in the UK between 2006-2008. Sixty-one semi-structured interviews and detailed field notes inform the analysis. Findings 'Caring from diagnosis to death' was the overarching theme illustrated by three sub-themes: (i) Caregiver's plight - making sense of the disease and potential deterioration; (ii) Having to care indefinitely; and (iii) Avoiding talk of death. 'Caring from diagnosis to death' coincides with an original concept analysis of renal supportive care, which is considered an adjunct to the management of patients with renal disease at all stages of their illness. Conclusion There is a clear need for further research internationally and theory-based nursing interventions to support carers of patients managed without dialysis. The development of a holistic, integrated care pathway based on carer perspectives, which includes identification of information needs related to original diagnosis, associated comorbidities, treatment options, prognosis, and assistance in developing strategies to manage communication with patients as the end of life approaches, is required. [ABSTRACT FROM AUTHOR]
- Subjects :
- PSYCHOLOGICAL adaptation
CAREGIVERS
CHRONIC kidney failure
EMPLOYMENT
FAMILIES
HOME nursing
INTERVIEWING
RESEARCH methodology
PALLIATIVE treatment
RESEARCH
RESEARCH funding
STATISTICAL sampling
TERMINALLY ill
ADVANCE directives (Medical care)
QUALITATIVE research
ATTITUDES toward death
THEMATIC analysis
DATA analysis software
SYMPTOMS
Subjects
Details
- Language :
- English
- ISSN :
- 03092402
- Volume :
- 69
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 88979720
- Full Text :
- https://doi.org/10.1111/jan.12049