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dc.contributor.authorStevenson, J
dc.contributor.authorTong, A
dc.contributor.authorGutman, T
dc.contributor.authorCampbell, KL
dc.contributor.authorCraig, JC
dc.contributor.authorBrown, MA
dc.contributor.authorLee, VW
dc.date.accessioned2019-06-10T01:32:59Z
dc.date.available2019-06-10T01:32:59Z
dc.date.issued2018
dc.identifier.issn1051-2276
dc.identifier.doi10.1053/j.jrn.2018.02.005
dc.identifier.urihttp://hdl.handle.net/10072/384085
dc.description.abstractObjectives: Diet and fluid management can reduce mortality, serious comorbidities, and debilitating symptoms in patients on hemodialysis, but restrictions may also be a major burden, and nonadherence remains high. We aimed to describe the perspectives and experiences of patients on hemodialysis regarding their dietary management to understand both facilitators and barriers to adherence and to identify strategies to improve care. Design and methods: Semi-structured interviews were conducted with 35 people on maintenance hemodialysis from six dialysis units in New South Wales, Australia. Transcripts were thematically analyzed using principles of grounded theory. Results: We identified 5 major themes. Two themes reflect barriers to dietary change: exacerbating disruption (adding to treatment burden, contradicting healthy eating, confused by fragmented advice, conflicting cultural norms, changing appetite and palate, isolation from family and friends) and losing control (crises derailing discipline, frustrated by failure, combating bodily need for hydration). Three themes represent enablers for dietary change: attaining health benefits (avoiding medical catastrophes, enhancing benefits of dialysis, alleviating and managing symptoms, improving health), achieving treatment goals (building familiarity and acceptance, flexibility and moderation, taking personal responsibility), and succeeding with support (leaning on family for strength, trusting expert guidance, empowered with flexible and practical advice, relying on reminders and cues, motivation through shared experience). Conclusions: Patients on hemodialysis believe dietary control helps to reduce symptom burden and enhance general health and well-being, but competing medical and social issues coupled with contradictory and/or irrelevant dietary advice prevents them from implementing diet and fluid restrictions. Interventions involving collaborative multidisciplinary care including clinicians with dietetic expertise, and consistent information that addresses cultural and personal circumstances, may support adherence to dietary recommendations and improve outcomes.
dc.description.peerreviewedYes
dc.languageeng
dc.relation.ispartofpagefrom411
dc.relation.ispartofpageto421
dc.relation.ispartofissue6
dc.relation.ispartofjournalJournal of Renal Nutrition
dc.relation.ispartofvolume28
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchNutrition and Dietetics
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1111
dc.titleExperiences and Perspectives of Dietary Management Among Patients on Hemodialysis: An Interview Study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorCampbell, Katrina


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