Diet and fluid restriction experiences of patients on hemodialysis: a meta-synthesis study
Keywords:
hemodialysis patients, experience, qualitative metasynthesis, renal diet, fluid restriction
Abstract
Introduction: Non-compliance with diet and fluid restriction is an important and common health behavior problem in the hemodialysis population and is associated with increased morbidity and mortality. Therefore, investigating the perceptions and experiences of patients undergoing hemodialysis regarding diet and fluid restriction is very important in terms of achieving the management of diet and fluid restriction. Methods: This is a meta-synthesis study. CINAHL, MEDLINE, PubMed, Web of Science, OVID, and Scopus electronic databases were utilized for the literature review. Studies were critically evaluated using the Joanna Briggs critical appraisal tool. Qualitative data were extracted, meta-summarized, and then meta-synthesized. The thematic analysis method was used in the analysis of the data. Results: This review consisted of 23 qualitative studies. The experiences of patients undergoing hemodialysis about diet and fluid restriction were classified into three main themes, namely, “the meaning of diet and fluid restriction for the patient”, “perceived barriers”, and “patient’s own management strategies for diet and fluid restriction”. Conclusion: The results of the synthesis in our study indicated that patients undergoing hemodialysis perceived diet and fluid restriction as a complex and challenging process involving a constant struggle. Some personal, social, and systemic barriers perceived by the patients made compliance with diet and fluid restriction even more difficult. More importantly, it was determined that most of the patients were not supported enough in the management of diet and fluid restriction and that they had developed strategies in their own right. In line with these results, we recommend that individual counseling services for diet-fluid restriction of patients undergoing hemodialysis should be increased, the obstacles perceived by the patient should be considered while planning patients’ diet-fluid restriction, and that the planning should be realistic and feasible.
References
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3) Lambert K, Mullan J, Mansfield K. An integrative review of the methodology and findings regarding dietary adherence in end stage kidney disease. BMC Nephrol. 2017;18(1):318. doi: 10.1186/s12882-017-0734-z.
4) Murali KM, Mullan J, Roodenrys S, Hassan HC, Lambert K, Lonergan M. Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials. PLoS One. 2019;14(1):e0211479. doi: 10.1371/journal.pone.0211479.
5) Opiyo RO, Nyasulu PS, Olenja J, Zunza M, Nguyen KA, Bukania Z, et al. Factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis in national referral hospitals in Kenya: a mixed-methods survey. Renal Replace Ther. 2019;5(1):41. doi: 10.1186/s41100-019-0237-4.
6) Gebrie MH, Ford J. Depressive symptoms and dietary non-adherence among end stage renal disease patients undergoing hemodialysis therapy: systematic review. BMC Nephrol. 2019;20(1):429. doi: 10.1186/s12882-019-1622-5.
7) Geldine CG, Bhengu B, Manwere A. Adherence of adult chronic kidney disease patients with regard to their dialysis, medication, dietary and fluid restriction. Res J Health Sci. 2017;5(1):3-17. doi: 10.4314/rejhs.v5i1.2.
8) Clark S, Farrington K, Chilcot J. Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants. Semin Dial. 2014;27(1):42-9. doi: 10.1111/sdi.12159.
9) Ibrahim S, Hossam M, Belal D. Study of non-compliance among chronic hemodialysis patients and its impact on patients' outcomes. Saudi J Kidney Dis Transpl. 2015;26(2):243-9. doi: 10.4103/1319-2442.152405.
10) Chazot C, Wabel P, Chamney P, Moissl U, Wieskotten S, Wizemann V. Importance of normohydration for the long-term survival of haemodialysis patients. Nephrol Dial Transplant. 2012;27(6):2404-10. doi: 10.1093/ndt/gfr678.
11) Covic A, Rastogi A. Hyperphosphatemia in patients with ESRD: assessing the current evidence linking outcomes with treatment adherence. BMC Nephrol. 2013;14:153. doi: 10.1186/1471-2369-14-153.
12) McDonald TJ, Oram RA, Vaidya B. Investigating hyperkalaemia in adults. BMJ. 2015;351:h4762. doi: 10.1136/bmj.h4762.
13) Malterud K. Qualitative metasynthesis: a research method for medicine and health sciences. 1th ed. New York: Routledge, 2019.
14) Paterson BL. The shifting perspectives model of chronic illness. J Nurs Scholarsh. 2001;33(1):21-6. doi: 10.1111/j.1547-5069.2001.00021.x.
15) Sandelowski M, Barroso J. Handbook for synthesizing qualitative research. New York: Springer, 2006.
16) Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al.; PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. doi: 10.1186/2046-4053-4-1.
17) Aromataris E, Munn Z (editors). JBI Manual for Evidence Synthesis [Internet]. JBI: 2020. Disponible en:
18) Hannes K, Lockwood C, Pearson A. A comparative analysis of three online appraisal instruments' ability to assess validity in qualitative research. Qual Health Res. 2010;20(12):1736-43. doi: 10.1177/1049732310378656.
19) Cervantes L, Jones J, Linas S, Fischer S. Qualitative interviews exploring palliative care perspectives of latinos on dialysis. Clin J Am Soc Nephrol. 2017;12(5):788-798. doi: 10.2215/CJN.10260916.
20) Griva K, Ng HJ, Loei J, Mooppil N, McBain H, Newman SP. Managing treatment for end-stage renal disease--a qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence. Psychol Health. 2013;28(1):13-29. doi: 10.1080/08870446.2012.703670.
21) 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. doi: 10.1111/jocn.13739.
22) Lee EJ, Chang AK, Chung YC. Socioecological factors affecting fluid restriction adherence among korean patients receiving hemodialysis: a qualitative study. J Transcult Nurs. 2021;32(3):239-47. doi: 10.1177/1043659620919162.
23) Smith K, Coston M, Glock K, Elasy TA, Wallston KA, Ikizler TA, et al. Patient perspectives on fluid management in chronic hemodialysis. J Ren Nutr. 2010;20(5):334-41. doi: 10.1053/j.jrn.2009.09.001.
24) Stevenson J, Tong A, Gutman T, Campbell KL, Craig JC, Brown MA, Lee VW. Experiences and perspectives of dietary management among patients on hemodialysis: an interview study. J Ren Nutr. 2018;28(6):411-21. doi: 10.1053/j.jrn.2018.02.005.
25) Tovazzi ME, Mazzoni V. Personal paths of fluid restriction in patients on hemodialysis. Nephrol Nurs J. 2012;39(3):207-15.
26) 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. doi: 10.1177/1054773818773364.
27) Flythe JE, Dorough A, Narendra JH, Forfang D, Hartwell L, Abdel-Rahman E. Perspectives on symptom experiences and symptom reporting among individuals on hemodialysis. Nephrol Dial Transplant. 2018;33(10):1842-52. doi: 10.1093/ndt/gfy069.
28) Lambert K, Mansfield K, Mullan J. How do patients and carers make sense of renal dietary advice? A qualitative exploration. J Ren Care. 2018;44(4):238-50. doi: 10.1111/jorc.12260.
29) Morris A, Lycett D. Experiences of the dietary management of serum potassium in chronic kidney disease: interviews with UK adults on maintenance hemodialysis. J Ren Nutr. 2020;30(6):556-60. doi: 10.1053/j.jrn.2020.01.025.
30) Oka M, Yoneda K, Moriyama M, Takahashi S, Bull C, Chaboyer W. The dietary patterns of japanese hemodialysis patients: a focused ethnography. Glob Qual Nurs Res. 2019;6:2333393619878150. doi: 10.1177/2333393619878150.
31) Tarakji AR, Surette M, Frotten R, Wilson K, Morley C. Experiences of people of Acadian descent receiving hemodialysis in southwest Nova Scotia. Can J Diet Pract Res. 2014;75(2):e342-45. doi: 10.3148/75.2.2014.e342.
32) Urquhart-Secord R, Craig JC, Hemmelgarn B, Tam-Tham H, Manns B, Howell M, et al. Patient and Caregiver Priorities for Outcomes in Hemodialysis: An International Nominal Group Technique Study. Am J Kidney Dis. 2016;68(3):444-54. doi: 10.1053/j.ajkd.2016.02.037.
33) Cubillo B, McCartan J, West C, Brimblecombe J. A Qualitative analysis of the accessibility and connection to traditional food for aboriginal chronic maintenance hemodialysis patients. Curr Dev Nutr. 2020;4(4):nzaa036. doi: 10.1093/cdn/nzaa036.
34) de las Heras Mayoral MT, Martínez Rincón C. Conocimiento y percepción nutricional en diálisis: su influencia en la transgresión y adherencia; estudio inicial. Nutr Hosp. 2014;31(3):1366-75. doi: 10.3305/nh.2015.31.3.7942.
35) Aker S, Yüksel S. Determining the factors that determine treatment compliance among hypertensive patients undergoing hemodialysis: A qualitative study. J Hum Sci. 2016;13(3):4389-404. doi:10.14687/jhs.v13i3.3940.
36) de Brito-Ashurst I, Perry L, Sanders TA, Thomas JE, Yaqoob MM, Dobbie H. Barriers and facilitators of dietary sodium restriction amongst Bangladeshi chronic kidney disease patients. J Hum Nutr Diet. 2011;24(1):86-95. doi: 10.1111/j.1365-277X.2010.01129.x.
37) Fakih El Khoury C, Karavetian M, Halfens RJG, Crutzen R, El Chaar D, Schols JMGA. Dietary application for the management of patients with hemodialysis: a formative development study. Healthc Inform Res. 2019;25(4):262-73. doi: 10.4258/hir.2019.25.4.262.
38) Glyde M, Keane D, Dye L, Sutherland E. Patients' perceptions of their experience, control and knowledge of fluid management when receiving haemodialysis. J Ren Care. 2019;45(2):83-92. doi: 10.1111/jorc.12275.
39) Karamanidou C, Weinman J, Horne R. A qualitative study of treatment burden among haemodialysis recipients. J Health Psychol. 2014;19(4):556-69. doi: 10.1177/1359105313475898.
40) Ng MSN, Wong CL, Ho EHS, Hui YH, Miaskowski C, So WKW. Burden of living with multiple concurrent symptoms in patients with end-stage renal disease. J Clin Nurs. 2020;29(13-14):2589-601. doi: 10.1111/jocn.15282.
41) Yu J, Ng HJ, Nandakumar M, Griva K. The management of food cravings and thirst in hemodialysis patients: A qualitative study. J Health Psychol. 2016;21(2):217-27. doi: 10.1177/1359105314525066.
42) Elliott JO, Ortman C, Almaani S, Lee YH, Jordan K. Understanding the associations between modifying factors, individual health beliefs, and hemodialysis patients' adherence to a low-phosphorus diet. J Ren Nutr. 2015;25(2):111-20. doi: 10.1053/j.jrn.2014.08.006.
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Published
2022-03-15
How to Cite
1.
Özkan İlknur, Taylan S. Diet and fluid restriction experiences of patients on hemodialysis: a meta-synthesis study. Rev Nefrol Dial Traspl. [Internet]. 2022Mar.15 [cited 2024Dec.25];42(1):22-0. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/754
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