Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi
Background: The burden of end-stage kidney disease (ESKD) in sub-Saharan Africa is increasing rapidly but the palliative care needs of patients living with ESKD are not well described. Resource limitations at both health system and patient level act as major barriers to patients receiving renal repl...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2017-05-01
|
| Series: | African Journal of Primary Health Care & Family Medicine |
| Subjects: | |
| Online Access: | https://phcfm.org/index.php/phcfm/article/view/1376 |
| _version_ | 1818366942276222976 |
|---|---|
| author | Maya J. Bates Alex Chitani Gavin Dreyer |
| author_facet | Maya J. Bates Alex Chitani Gavin Dreyer |
| author_sort | Maya J. Bates |
| collection | DOAJ |
| description | Background: The burden of end-stage kidney disease (ESKD) in sub-Saharan Africa is increasing rapidly but the palliative care needs of patients living with ESKD are not well described. Resource limitations at both health system and patient level act as major barriers to patients receiving renal replacement therapy (RRT) in the form of dialysis. We undertook an exploratory qualitative study to describe the palliative care needs of patients with ESKD who were not receiving RRT, at a government teaching hospital in Blantyre, Malawi.
Methods: A qualitative, explorative and descriptive design was used. Study participants were adults aged > 18 years with an estimated glomerular filtration rate < 15 ml/min on two separate occasions, three months apart, who either chose not to have or were not deemed suitable for RRT. Data were collected by means of semi-structured interviews.
Results: In October and November 2013, interviews were conducted with 10 adults (7 women with median age of 60.5 years). All were hypertensive and four were on treatment for HIV. Four themes emerged from the data: changes in functional status because of physical symptoms, financial challenges impacting hospital care, loss of role within the family and the importance of spiritual and cultural beliefs.
Conclusion: This study reports on four thematic areas which warrant further quantitative and qualitative studies both in Malawi and other low-resource settings, where a growing number of patients with ESKD unable to access RRT will require palliative care in the coming years. |
| first_indexed | 2024-12-13T22:44:10Z |
| format | Article |
| id | doaj.art-4138b4e9c26c4d1496a7368f5c6249e9 |
| institution | Directory Open Access Journal |
| issn | 2071-2928 2071-2936 |
| language | English |
| last_indexed | 2024-12-13T22:44:10Z |
| publishDate | 2017-05-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Primary Health Care & Family Medicine |
| spelling | doaj.art-4138b4e9c26c4d1496a7368f5c6249e92022-12-21T23:28:47ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362017-05-0191e1e610.4102/phcfm.v9i1.1376453Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, MalawiMaya J. Bates0Alex Chitani1Gavin Dreyer2College of Medicine, BlantyreMinistry of Health, BlantyreBarts Health NHS Trust, LondonBackground: The burden of end-stage kidney disease (ESKD) in sub-Saharan Africa is increasing rapidly but the palliative care needs of patients living with ESKD are not well described. Resource limitations at both health system and patient level act as major barriers to patients receiving renal replacement therapy (RRT) in the form of dialysis. We undertook an exploratory qualitative study to describe the palliative care needs of patients with ESKD who were not receiving RRT, at a government teaching hospital in Blantyre, Malawi. Methods: A qualitative, explorative and descriptive design was used. Study participants were adults aged > 18 years with an estimated glomerular filtration rate < 15 ml/min on two separate occasions, three months apart, who either chose not to have or were not deemed suitable for RRT. Data were collected by means of semi-structured interviews. Results: In October and November 2013, interviews were conducted with 10 adults (7 women with median age of 60.5 years). All were hypertensive and four were on treatment for HIV. Four themes emerged from the data: changes in functional status because of physical symptoms, financial challenges impacting hospital care, loss of role within the family and the importance of spiritual and cultural beliefs. Conclusion: This study reports on four thematic areas which warrant further quantitative and qualitative studies both in Malawi and other low-resource settings, where a growing number of patients with ESKD unable to access RRT will require palliative care in the coming years.https://phcfm.org/index.php/phcfm/article/view/1376palliative careend stage kidney diseaseMalawi |
| spellingShingle | Maya J. Bates Alex Chitani Gavin Dreyer Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi African Journal of Primary Health Care & Family Medicine palliative care end stage kidney disease Malawi |
| title | Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi |
| title_full | Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi |
| title_fullStr | Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi |
| title_full_unstemmed | Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi |
| title_short | Palliative care needs of patients living with end-stage kidney disease not treated with renal replacement therapy: An exploratory qualitative study from Blantyre, Malawi |
| title_sort | palliative care needs of patients living with end stage kidney disease not treated with renal replacement therapy an exploratory qualitative study from blantyre malawi |
| topic | palliative care end stage kidney disease Malawi |
| url | https://phcfm.org/index.php/phcfm/article/view/1376 |
| work_keys_str_mv | AT mayajbates palliativecareneedsofpatientslivingwithendstagekidneydiseasenottreatedwithrenalreplacementtherapyanexploratoryqualitativestudyfromblantyremalawi AT alexchitani palliativecareneedsofpatientslivingwithendstagekidneydiseasenottreatedwithrenalreplacementtherapyanexploratoryqualitativestudyfromblantyremalawi AT gavindreyer palliativecareneedsofpatientslivingwithendstagekidneydiseasenottreatedwithrenalreplacementtherapyanexploratoryqualitativestudyfromblantyremalawi |