Patient Experiences of Dietary Management in Chronic Kidney Disease: A Focus Group Study

Jaimon T Kelly, Katrina L Campbell, Tammy Hoffmann, Dianne P Reidlinger

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

OBJECTIVE: People with chronic kidney disease (CKD) contend with complex dietary recommendations. The challenge in practice is for clinicians to provide individualized support with the frequency and consistency required to sustain dietary changes. This study aimed to describe the experiences of patients with managing dietary recommendations, including their perspectives on the potential to use telehealth to support dietary management in CKD.

DESIGN: Focus group study.

SUBJECTS: Twenty-one adult patients with CKD (nondialysis) and 3 caregivers (total N = 24) purposively sampled to achieve diverse demographic and clinical characteristics, from two nephrology units in Queensland, Australia.

METHODS: Five focus groups were conducted, audio recorded, and transcribed. Transcripts were analyzed using thematic analysis drawing on the principles of grounded theory.

MAIN OUTCOME MEASURE: Themes aligned with the research question.

RESULTS: We identified five themes: exasperating stagnancy (patronized by redundant advice, confused and unprepared for dietary change, inevitability of failure, and barriers to accessing dietetic services); supporting and sustaining change (receiving regular feedback, incremental and comprehendible modification, practical guidance on food, flexibility in monitoring schedule, and valuing peer advice); fostering ownership (seeking kidney diet information, enacting behavior change, making reminders, and tracking progress against targets); motivators and positive learning instruction (relying on reassurance, positive reinforcement, focusing on allowable foods, and involving family); threats and ambiguities of risk (sugar as the culprit, ubiquity of salt, illegible food labeling, avoiding processed foods, and questioning credibility of sources).

CONCLUSIONS: Patients with CKD desire a preventative approach to CKD progression and maintaining their health, however, are stymied by dietary restrictions and a lack of reliable dietetic advice. Easy-to-use telehealth options have the potential to overcome the shortcomings in current health service delivery which may be limiting factors to providing these approaches. They provide patients with pragmatic tools, comprehensible and consistent information which fosters ownership and self-monitoring.

Original languageEnglish
Pages (from-to)393-402
Number of pages10
JournalJournal of Renal Nutrition
Volume28
Issue number6
Early online date14 Nov 2017
DOIs
Publication statusPublished - 1 Nov 2018

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Focus Groups
Chronic Renal Insufficiency
Dietetics
Telemedicine
Ownership
Food
Food Labeling
Queensland
Foster Home Care
Nephrology
Caregivers
Health Services
Disease Progression
Appointments and Schedules
Salts
Demography
Learning
Diet
Kidney
Health

Cite this

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title = "Patient Experiences of Dietary Management in Chronic Kidney Disease: A Focus Group Study",
abstract = "OBJECTIVE: People with chronic kidney disease (CKD) contend with complex dietary recommendations. The challenge in practice is for clinicians to provide individualized support with the frequency and consistency required to sustain dietary changes. This study aimed to describe the experiences of patients with managing dietary recommendations, including their perspectives on the potential to use telehealth to support dietary management in CKD.DESIGN: Focus group study.SUBJECTS: Twenty-one adult patients with CKD (nondialysis) and 3 caregivers (total N = 24) purposively sampled to achieve diverse demographic and clinical characteristics, from two nephrology units in Queensland, Australia.METHODS: Five focus groups were conducted, audio recorded, and transcribed. Transcripts were analyzed using thematic analysis drawing on the principles of grounded theory.MAIN OUTCOME MEASURE: Themes aligned with the research question.RESULTS: We identified five themes: exasperating stagnancy (patronized by redundant advice, confused and unprepared for dietary change, inevitability of failure, and barriers to accessing dietetic services); supporting and sustaining change (receiving regular feedback, incremental and comprehendible modification, practical guidance on food, flexibility in monitoring schedule, and valuing peer advice); fostering ownership (seeking kidney diet information, enacting behavior change, making reminders, and tracking progress against targets); motivators and positive learning instruction (relying on reassurance, positive reinforcement, focusing on allowable foods, and involving family); threats and ambiguities of risk (sugar as the culprit, ubiquity of salt, illegible food labeling, avoiding processed foods, and questioning credibility of sources).CONCLUSIONS: Patients with CKD desire a preventative approach to CKD progression and maintaining their health, however, are stymied by dietary restrictions and a lack of reliable dietetic advice. Easy-to-use telehealth options have the potential to overcome the shortcomings in current health service delivery which may be limiting factors to providing these approaches. They provide patients with pragmatic tools, comprehensible and consistent information which fosters ownership and self-monitoring.",
author = "Kelly, {Jaimon T} and Campbell, {Katrina L} and Tammy Hoffmann and Reidlinger, {Dianne P}",
note = "Copyright {\circledC} 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.",
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Patient Experiences of Dietary Management in Chronic Kidney Disease : A Focus Group Study. / Kelly, Jaimon T; Campbell, Katrina L; Hoffmann, Tammy; Reidlinger, Dianne P.

In: Journal of Renal Nutrition, Vol. 28, No. 6, 01.11.2018, p. 393-402.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Patient Experiences of Dietary Management in Chronic Kidney Disease

T2 - A Focus Group Study

AU - Kelly, Jaimon T

AU - Campbell, Katrina L

AU - Hoffmann, Tammy

AU - Reidlinger, Dianne P

N1 - Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - OBJECTIVE: People with chronic kidney disease (CKD) contend with complex dietary recommendations. The challenge in practice is for clinicians to provide individualized support with the frequency and consistency required to sustain dietary changes. This study aimed to describe the experiences of patients with managing dietary recommendations, including their perspectives on the potential to use telehealth to support dietary management in CKD.DESIGN: Focus group study.SUBJECTS: Twenty-one adult patients with CKD (nondialysis) and 3 caregivers (total N = 24) purposively sampled to achieve diverse demographic and clinical characteristics, from two nephrology units in Queensland, Australia.METHODS: Five focus groups were conducted, audio recorded, and transcribed. Transcripts were analyzed using thematic analysis drawing on the principles of grounded theory.MAIN OUTCOME MEASURE: Themes aligned with the research question.RESULTS: We identified five themes: exasperating stagnancy (patronized by redundant advice, confused and unprepared for dietary change, inevitability of failure, and barriers to accessing dietetic services); supporting and sustaining change (receiving regular feedback, incremental and comprehendible modification, practical guidance on food, flexibility in monitoring schedule, and valuing peer advice); fostering ownership (seeking kidney diet information, enacting behavior change, making reminders, and tracking progress against targets); motivators and positive learning instruction (relying on reassurance, positive reinforcement, focusing on allowable foods, and involving family); threats and ambiguities of risk (sugar as the culprit, ubiquity of salt, illegible food labeling, avoiding processed foods, and questioning credibility of sources).CONCLUSIONS: Patients with CKD desire a preventative approach to CKD progression and maintaining their health, however, are stymied by dietary restrictions and a lack of reliable dietetic advice. Easy-to-use telehealth options have the potential to overcome the shortcomings in current health service delivery which may be limiting factors to providing these approaches. They provide patients with pragmatic tools, comprehensible and consistent information which fosters ownership and self-monitoring.

AB - OBJECTIVE: People with chronic kidney disease (CKD) contend with complex dietary recommendations. The challenge in practice is for clinicians to provide individualized support with the frequency and consistency required to sustain dietary changes. This study aimed to describe the experiences of patients with managing dietary recommendations, including their perspectives on the potential to use telehealth to support dietary management in CKD.DESIGN: Focus group study.SUBJECTS: Twenty-one adult patients with CKD (nondialysis) and 3 caregivers (total N = 24) purposively sampled to achieve diverse demographic and clinical characteristics, from two nephrology units in Queensland, Australia.METHODS: Five focus groups were conducted, audio recorded, and transcribed. Transcripts were analyzed using thematic analysis drawing on the principles of grounded theory.MAIN OUTCOME MEASURE: Themes aligned with the research question.RESULTS: We identified five themes: exasperating stagnancy (patronized by redundant advice, confused and unprepared for dietary change, inevitability of failure, and barriers to accessing dietetic services); supporting and sustaining change (receiving regular feedback, incremental and comprehendible modification, practical guidance on food, flexibility in monitoring schedule, and valuing peer advice); fostering ownership (seeking kidney diet information, enacting behavior change, making reminders, and tracking progress against targets); motivators and positive learning instruction (relying on reassurance, positive reinforcement, focusing on allowable foods, and involving family); threats and ambiguities of risk (sugar as the culprit, ubiquity of salt, illegible food labeling, avoiding processed foods, and questioning credibility of sources).CONCLUSIONS: Patients with CKD desire a preventative approach to CKD progression and maintaining their health, however, are stymied by dietary restrictions and a lack of reliable dietetic advice. Easy-to-use telehealth options have the potential to overcome the shortcomings in current health service delivery which may be limiting factors to providing these approaches. They provide patients with pragmatic tools, comprehensible and consistent information which fosters ownership and self-monitoring.

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