Understanding the Experience of stress on initiation of Haemodialysis: A Phenomenological Study
Background: Research evidence on stress among chronic kidney disease/end stage renal disease patients in India is sparse. Experience of stress is a subjective phenomenon. Hence qualitative research methodology helps to gain real insight about factors that cause stress among haemodialysis patients. The objective of this study was to understand the stressors experienced by patients on initiation of haemodialysis treatment.
Methods: A phenomenological approach was used to gain insight into the lived experience of stressors experienced by patientsâ€™ on haemodialysis treatment. The study was conducted in outpatient haemodialysis units of two private hospitals in Bangalore, India. Participants of the study consisted of six males and four females who were on haemodialysis for between 2 months to 36 months. Individual semi-structured interviews were conducted with all participants. All interviews were audio-taped and transcribed verbatim .
Results: Content analysis was used to analyze the data. Three main themes emerged namely â€˜Physical stress- orsâ€™, â€˜psychological stressorsâ€™ and â€˜Socioeconomic stressorsâ€™. Pain, tiredness and loss of appetite were the predominant physical stressors reported by participants. Shock and depression on diagnosis and initiation of dialysis, difficulty adhering to prescribed therapeutic regimen, feeling of being burden on family, fear of complications and uncertainty about life were the psychological stressors reported by participants. A range of socioeconomic stressors were reported by the participants which included; Loss of employment, financial problems, loss of ability to perform activities of daily living and limited social life.
Conclusion: Findings of this study can be utilized to design a pre-haemodialysis preparatory program which can be implemented for stage-4 chronic kidney disease patients to prepare them for haemodialysis.
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