Key result
Gastrointestinal symptoms and dietary restrictions in automated peritoneal dialysis prompt a loss of patient autonomy.
Why the study?
GI symptoms are associated with poor psychosocial wellbeing in peritoneal dialysis, but individual experiences of these symptoms and their psychosocial consequences had not been explored.
GI symptoms and dietary restrictions in peritoneal dialysis patients lead to a significant loss of autonomy, highlighting the need for management strategies that enhance patient autonomy.
Patient autonomy concerns in peritoneal dialysis warrant clinical attention; leaves open optimal management strategies pending further research.
BACKGROUND: Gastrointestinal (GI) symptoms are associated with poor psychosocial wellbeing among people receiving peritoneal dialysis (PD). The mind-gut axis represents one possible explanatory mechanism for this relationship. Despite existing evidence, the individual's experience of GI symptoms and their potential psychosocial consequences have not been explored. OBJECTIVE: To understand the experiences of people receiving peritoneal dialysis regarding their gastrointestinal health and psychosocial wellbeing. METHOD: Ten people undergoing automated PD (five females, five males) aged 31-77 years (Mean = 59.3, SD = 15.67) participated in a single one-on-one qualitative interview. Interviews ceased at thematic saturation. Transcripts were analysed using the framework approach. RESULTS: A central theme of Autonomy emerged from the data representing participants' experiences of the psychosocial consequences of dialysis, GI symptoms, and dietary changes. This overarched two main themes: 1) Loss of Autonomy [Sub-themes: Interference to Daily Life (Dialysis process and sleep, Impacts on relationships), Powerlessness, Frustration, Food Aversion, and Restriction (Friendships and social life, Impacts on partner)] and 2) Attempts to Gain Autonomy (Sub-themes: Coping Well, Pragmatism, and Maintaining Normality). A related sub-theme of Partner as a Carer emerged as part of Loss of Autonomy. CONCLUSION: GI symptoms and diet and fluid restrictions have psychosocial consequences resulting in multiple losses of autonomy for people receiving PD, who employ strategies to attempt to regain autonomy in the face of these issues. Dietary and GI symptom management advice should aim to enhance patient autonomy within the confines of PD therapy and thus reduce its psychosocial impacts.
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Duncanson et al. (2018) studied Automated peritoneal dialysis (n=10). Gastrointestinal symptoms and dietary changes was evaluated on Psychosocial consequences (themes of Autonomy). Gastrointestinal symptoms and dietary restrictions in people receiving automated peritoneal dialysis resulted in multiple losses of autonomy, prompting strategies to attempt to regain it.
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