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Introducción: En algunos casos la calidad de vida para el paciente en diálisis conlleva a la búsqueda de entornos domiciliarios. En otros, el entorno domiciliario puede suponer una barrera importante. El análisis del entorno para el tratamiento de diálisis está relacionado con la capacidad de autocontrol personal de los tratamientos y la enfermedad. Los planes enfermeros deben tener en cuenta de forma temprana cuando un entorno es adecuado y también el estilo de autocontrol fomentando un rol activo.
Objetivo: Conocer la experiencia vivida por el paciente en diálisis en relación con el autocontrol personal del tratamiento y el entorno donde se produce.
Material y Método: Estudio cualitativo descriptivo fenomenológico mediante entrevista a pacientes en diferentes programas de diálisis. Muestreo no probabilístico. Los resultados se obtienen mediante trascripción textual, método de comparación constante y cuaderno de campo de las entrevistas. Se analiza el discurso mediante triangulación y análisis temático inductivo iterativo.
Resultados: Veinticuatro personas fueron entrevistadas. Las categorías y códigos resultantes son los siguientes: a) Hospitalaria; a.a) salas de diálisis: Escasa intimidad, afrontamiento ineficaz, participación social, rol pasivo. b) Domiciliaria; b.a) Hemodiálisis domiciliaria: rol activo, barreras arquitectónicas, barreras familiares, b.b) Diálisis Peritoneal: pases diarios, cicladora nocturna, organización de espacios, rol activo.
Conclusiones: Parece evidenciarse que el entorno donde se produce el tratamiento de diálisis es un elemento de relevancia para las personas en tratamiento y está relacionado con la capacidad para aumentar el autocontrol. La enfermería debería consensuar una intervención temprana dirigida a conocer el impacto del entorno.
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Derechos de autor 2025 Miguel Ángel Escudero-López, Irene Marcilla-Toribio2, Raquel Bartolome-Gutierrez, María Martínez Andrés
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
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© Los autores ceden de forma no exclusiva los derechos de explotación de los trabajos publicados y consiente en que su uso y distribución se realice con la Licencia Creative Commons Atribución - No comercial 4.0 Internacional (CC BY-NC 4.0). Puede consultar desde aquí la versión informativa y el texto legal de la licencia. Esta circunstancia ha de hacerse constar expresamente de esta forma cuando sea necesario.
Referencias
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- Feng X, Hou N, Chen Z, Liu J., Li X, Sun X, et al. Secular trends of epidemiologic patterns of chronic kidney disease over three decades: an updated analysis of the Global Burden of Disease Study 2019. BMJ Open. 2023;13(3):e064540, https://doi.org/10.1136/bmjopen-2022-064540
- Jesky MD, Dutton M, Dasgupta I, Yadav P, Ng KP, Fenton A., et al. Health-related quality of life impacts mortality but not progression to end-stage renal disease in pre-dialysis chronic kidney disease: A prospective observational study. PLoS One. 2016, https://doi.org/10.1371/journal.pone.0165675
- Escudero López M, Martínez Andrés M, Marcilla Toribio I, Moratalla Cebrián ML, Pérez Moreno A, Bartolomé Gutiérrez R. Barriers and facilitators in self-care and management of chronic kidney disease in dialysis patients: A systematic review of qualitative studies. J Clin Nurs. 2024, https://doi.org/10.1111/jocn.17193
- Mesa-Gresa P, Avesani CM, Clyne N, García-Testal A, Kouidi E, Van Craenenbroeck AH, et al. Needs, barriers and facilitators for a healthier lifestyle in haemodialysis patients: The GoodRENal project. J Clin Nurs. 2023,
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- Fletcher BR, Damery S, Aiyegbusi OL, Anderson N, Calvert M, Cockwell P, et al. Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLoS Med. 2022, https://doi.org/10.1371/journal.pmed.1003954
- Elshahat S, Cockwell P, Maxwell AP, Griffin M, O’Brien T, O’Neill C. The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review. PLoS One. 2020, https://doi.org/10.1371/journal.pone.0230512
- Walker RC, Tipene-Leach D, Graham A, Palmer SC. Patients’ Experiences of Community House Hemodialysis: A Qualitative Study. Kidney Med. 2019;1(6):338-46,
- https://doi.org/10.1016/j.xkme.2019.07.010
- Hall PA, Fong GT. Temporal self-regulation theory: A model for individual health behavior. Health Psychol Rev. 2007;1(1):6-52, doi: 10.1080/17437190701492437.
- Hall PA, Fong GT. Temporal self-regulation theory: Integrating biological, psychological, and ecological determinants of health behavior performance. Social Neuroscience and Public Health: Foundations for the Science of Chronic Disease Prevention. Springer New York; 2013. p. 35-54.
- Hall PA, Fong GT. Temporal Self-Regulation theory: A neurobiologically informed model for physical activity behavior. Front Hum Neurosci. 2015;9(MAR), https://doi.org/10.3389/fnhum.2015.00117
- Giacomini MK, Cook DJ, for the Evidence-Based Medicine Working Group. Users’ Guides to the Medical Literature. JAMA. 2000;284(4), https://doi.org/10.1001/jama.284.4.478.
- Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6):349-57, https://doi.org/10.1093/intqhc/mzm042.
- Hong LI, Wang W, Chan EY, Mohamed F, Chen HC. Dietary and fluid restriction perceptions of patients undergoing haemodialysis: an exploratory study. J Clin Nurs. 2017;26(21-22):3664-76, https://doi.org/10.1111/jocn.13739.
- Lee EJ, Chang AK, Chung YC. Socioecological Factors Affecting Fluid Restriction Adherence Among Korean Patients Receiving Hemodialysis: A Qualitative Study. Journal of Transcultural Nursing. 2021;32(3):239-47, https://doi.org/10.1177/1043659620919162
- Mailani F, Muthia R, Herien Y, Huriani E, Chan CM., Abdullah KL. ORIGINAL RESEARCH The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study. Nurse Media Journal of Nursing. 2021;11(3):389-403, https://doi.org/10.14710/nmjn.v11i3.38838
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- Kilonzo KG, Ghosh S, Temu SA, Maro V, Callegari J, Carter M, et al. Outcome of acute peritoneal dialysis in Northern Tanzania. Peritoneal Dialysis International. 2012;32(3):261-6, https://doi.org/10.3747/pdi.2012.00083
- Lillebuen L, Schick-Makaroff K, Thompson S, Molzahn A. Facilitators and Barriers to Care in Rural Emergency Departments in Alberta for Patients on Peritoneal Dialysis (PD): An Interpretive Descriptive Study. Can J Kidney Health Dis. 2020;7, https://doi.org/10.1177/2054358120970098
- Clark-Cutaia MN, Sevick MA, Thurheimer-Cacciotti J, Hoffman LA, Snetselaar L, Burke LE, et al. Perceived Barriers to Adherence to Hemodialysis Dietary Recommendations. Clin Nurs Res. 2019;28(8):1009-29, https://doi.org/10.1177/1054773818773364
- Phillips Salimi CR, Haase JE, Kooken WC. Connectedness in the context of patient–provider relationships: a concept analysis. J Adv Nurs. 2012;68(1):230-45, https://doi.org/10.1111/j.1365-2648.2011.05763.x
- Ladeiras-Lopes R, Baciu L, Grapsa J, Sohaib A, Vidal Pérez R, Bohm A, et al. Social media in cardiovascular medicine: A contemporary review. European Heart Journal - Digital Health. 2020:10-9, https://doi.org/10.1093/ehjdh/ztaa004
Referencias
García GG., Iyengar A, Kaze F, Kierans C, Padilla-Altamira C, Luyckx VA. Sex and gender differences in chronic kidney disease and access to care around the globe. Semin Nephrol. 2022:101-13, https://doi.org/10.1016/j.semnephrol.2022.04.001
Feng X, Hou N, Chen Z, Liu J., Li X, Sun X, et al. Secular trends of epidemiologic patterns of chronic kidney disease over three decades: an updated analysis of the Global Burden of Disease Study 2019. BMJ Open. 2023;13(3):e064540, https://doi.org/10.1136/bmjopen-2022-064540
Jesky MD, Dutton M, Dasgupta I, Yadav P, Ng KP, Fenton A., et al. Health-related quality of life impacts mortality but not progression to end-stage renal disease in pre-dialysis chronic kidney disease: A prospective observational study. PLoS One. 2016, https://doi.org/10.1371/journal.pone.0165675
Escudero López M, Martínez Andrés M, Marcilla Toribio I, Moratalla Cebrián ML, Pérez Moreno A, Bartolomé Gutiérrez R. Barriers and facilitators in self-care and management of chronic kidney disease in dialysis patients: A systematic review of qualitative studies. J Clin Nurs. 2024, https://doi.org/10.1111/jocn.17193
Mesa-Gresa P, Avesani CM, Clyne N, García-Testal A, Kouidi E, Van Craenenbroeck AH, et al. Needs, barriers and facilitators for a healthier lifestyle in haemodialysis patients: The GoodRENal project. J Clin Nurs. 2023,
https://doi.org/10.1111/jocn.16910
Fletcher BR, Damery S, Aiyegbusi OL, Anderson N, Calvert M, Cockwell P, et al. Symptom burden and health-related quality of life in chronic kidney disease: A global systematic review and meta-analysis. PLoS Med. 2022, https://doi.org/10.1371/journal.pmed.1003954
Elshahat S, Cockwell P, Maxwell AP, Griffin M, O’Brien T, O’Neill C. The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review. PLoS One. 2020, https://doi.org/10.1371/journal.pone.0230512
Walker RC, Tipene-Leach D, Graham A, Palmer SC. Patients’ Experiences of Community House Hemodialysis: A Qualitative Study. Kidney Med. 2019;1(6):338-46,
https://doi.org/10.1016/j.xkme.2019.07.010
Hall PA, Fong GT. Temporal self-regulation theory: A model for individual health behavior. Health Psychol Rev. 2007;1(1):6-52, doi: 10.1080/17437190701492437.
Hall PA, Fong GT. Temporal self-regulation theory: Integrating biological, psychological, and ecological determinants of health behavior performance. Social Neuroscience and Public Health: Foundations for the Science of Chronic Disease Prevention. Springer New York; 2013. p. 35-54.
Hall PA, Fong GT. Temporal Self-Regulation theory: A neurobiologically informed model for physical activity behavior. Front Hum Neurosci. 2015;9(MAR), https://doi.org/10.3389/fnhum.2015.00117
Giacomini MK, Cook DJ, for the Evidence-Based Medicine Working Group. Users’ Guides to the Medical Literature. JAMA. 2000;284(4), https://doi.org/10.1001/jama.284.4.478.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6):349-57, https://doi.org/10.1093/intqhc/mzm042.
Hong LI, Wang W, Chan EY, Mohamed F, Chen HC. Dietary and fluid restriction perceptions of patients undergoing haemodialysis: an exploratory study. J Clin Nurs. 2017;26(21-22):3664-76, https://doi.org/10.1111/jocn.13739.
Lee EJ, Chang AK, Chung YC. Socioecological Factors Affecting Fluid Restriction Adherence Among Korean Patients Receiving Hemodialysis: A Qualitative Study. Journal of Transcultural Nursing. 2021;32(3):239-47, https://doi.org/10.1177/1043659620919162
Mailani F, Muthia R, Herien Y, Huriani E, Chan CM., Abdullah KL. ORIGINAL RESEARCH The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study. Nurse Media Journal of Nursing. 2021;11(3):389-403, https://doi.org/10.14710/nmjn.v11i3.38838
Stevenson J, Tong A, Gutman T, Campbell KL, Craig JC, Brown MA, et al. Experiences and Perspectives of Dietary Management Among Patients on Hemodialysis: An Interview Study. Journal of Renal Nutrition. 2018;28(6):411-21, https://doi.org/10.1053/j.jrn.2018.02.005.
Sciberras A, Scerri J. Facilitators and barriers to treatment with haemodialysis among persons in mid-adulthood: an interpretative phenomenological analysis. Scand J Caring Sci. 2017;31(4):695-701, https://doi.org/10.1111/scs.12381.
Årestedt L, Martinsson C, Hjelm C, Uhlin F, Eldh AC. Context Factors Facilitating and Hindering Patient Participation in Dialysis Care: A Focus Group Study With Patients and Staff. Worldviews Evid Based Nurs. 2020;17(6):457-64, https://doi.org/10.1111/wvn.12452
Alcalde Bezhold G, Alcázar Arroyo R, Angoso de Guzmán M, Arenas MD, Arias Guillén M, Arribas-Cobo P, et al. Guía de unidades de hemodiálisis 2020. Nefrología. 2021;41:1-77, https://doi.org/10.1016/j.nefro.2021.07.011
Kilonzo KG, Ghosh S, Temu SA, Maro V, Callegari J, Carter M, et al. Outcome of acute peritoneal dialysis in Northern Tanzania. Peritoneal Dialysis International. 2012;32(3):261-6, https://doi.org/10.3747/pdi.2012.00083
Lillebuen L, Schick-Makaroff K, Thompson S, Molzahn A. Facilitators and Barriers to Care in Rural Emergency Departments in Alberta for Patients on Peritoneal Dialysis (PD): An Interpretive Descriptive Study. Can J Kidney Health Dis. 2020;7, https://doi.org/10.1177/2054358120970098
Clark-Cutaia MN, Sevick MA, Thurheimer-Cacciotti J, Hoffman LA, Snetselaar L, Burke LE, et al. Perceived Barriers to Adherence to Hemodialysis Dietary Recommendations. Clin Nurs Res. 2019;28(8):1009-29, https://doi.org/10.1177/1054773818773364
Phillips Salimi CR, Haase JE, Kooken WC. Connectedness in the context of patient–provider relationships: a concept analysis. J Adv Nurs. 2012;68(1):230-45, https://doi.org/10.1111/j.1365-2648.2011.05763.x
Ladeiras-Lopes R, Baciu L, Grapsa J, Sohaib A, Vidal Pérez R, Bohm A, et al. Social media in cardiovascular medicine: A contemporary review. European Heart Journal - Digital Health. 2020:10-9, https://doi.org/10.1093/ehjdh/ztaa004