TY - JOUR
T1 - A longitudinal qualitative study to explore and optimize self-management in mild to end stage chronic kidney disease patients with limited health literacy
T2 - Perspectives of patients and health care professionals
AU - Boonstra, Marco D
AU - Reijneveld, Sijmen A
AU - Westerhuis, Ralf
AU - Tullius, Janne M
AU - Vervoort, Johanna P M
AU - Navis, Gerjan
AU - de Winter, Andrea F
N1 - Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - OBJECTIVES: Limited health literacy (LHL) is associated with faster kidney deterioration. Health care professionals (HCPs) promote self-management to maintain kidney function, which is difficult for patients with LHL. Evidence lacks on perceived barriers and best strategies to optimize their self-management. Our study aims to explore experiences with and barriers for self-management from the perspectives of LHL patients and HCPs to identify strategies to optimize self-management.METHODS: We performed a longitudinal qualitative study with semi-structured in-depth interviews and focus group discussions among CKD patients and LHL (n = 24) and HCPs (n = 37) from general practices and hospitals.RESULTS: Four themes arose among patients: (1) CKD elusiveness, (2) suboptimal intake of knowledge (3) not taking a front-seat role, and (4) maintaining change. Among HCPs, three themes emerged: (1) not recognizing HL problems, (2) lacking effective strategies, and (3) health care barriers.CONCLUSION: We suggest three routes to optimize self-management: providing earlier information, applying person-centered strategies to maintain changes, and improving competencies of HCPs.PRACTICE IMPLICATIONS: HCPs need to explain CKD self-management better to prevent kidney deterioration. New interventions, based on behavioral approaches, are needed to optimize self-management. HCPs need training to improve recognition and support of LHL patients.
AB - OBJECTIVES: Limited health literacy (LHL) is associated with faster kidney deterioration. Health care professionals (HCPs) promote self-management to maintain kidney function, which is difficult for patients with LHL. Evidence lacks on perceived barriers and best strategies to optimize their self-management. Our study aims to explore experiences with and barriers for self-management from the perspectives of LHL patients and HCPs to identify strategies to optimize self-management.METHODS: We performed a longitudinal qualitative study with semi-structured in-depth interviews and focus group discussions among CKD patients and LHL (n = 24) and HCPs (n = 37) from general practices and hospitals.RESULTS: Four themes arose among patients: (1) CKD elusiveness, (2) suboptimal intake of knowledge (3) not taking a front-seat role, and (4) maintaining change. Among HCPs, three themes emerged: (1) not recognizing HL problems, (2) lacking effective strategies, and (3) health care barriers.CONCLUSION: We suggest three routes to optimize self-management: providing earlier information, applying person-centered strategies to maintain changes, and improving competencies of HCPs.PRACTICE IMPLICATIONS: HCPs need to explain CKD self-management better to prevent kidney deterioration. New interventions, based on behavioral approaches, are needed to optimize self-management. HCPs need training to improve recognition and support of LHL patients.
KW - health literacy
KW - health personnel/education
KW - humans
KW - qualitative research
KW - renal insufficiency, chronic/therapy
KW - self-management
KW - gezondheidsgeletterdheid
KW - gezondheidspersoneel/educatie
KW - mensen
KW - kwalitatief onderzoek
KW - nierinsufficiëntie, chronisch/therapie
KW - zelfmanagement
U2 - 10.1016/j.pec.2021.05.016
DO - 10.1016/j.pec.2021.05.016
M3 - Article
C2 - 34024670
SN - 0738-3991
VL - 105
SP - 88
EP - 104
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 1
ER -