Exploration of adjustment in hemodialysis patients: Qualitative content analysis

authors:

avatar Monir Nobahar , avatar Mohaddese Saffari , avatar Hassan Babamohamadi , * , avatar Nemat Sotodeh Asl

Koomesh: Vol.19, issue 1; 164-174
article type: Research Article
received: May 03, 2016
accepted: September 04, 2016

how to cite: Nobahar M, Saffari M, Babamohamadi H, Sotodeh Asl N. Exploration of adjustment in hemodialysis patients: Qualitative content analysis. koomesh. 2017;19(1):e151333. 

Abstract

Introduction: Patients in end stage renal disease are at risk of numerous complications. To support patients in order to achieve adjustment, several models including the Roy adaptation model (RAM) have been suggested. The aim of this study was to determine adjustment in hemodialysis patients based on the RAM. Materials and Methods: This qualitative study was conducted in 2015 with conventional content analysis approach. Sampling was purposeful with maximum variation, 16 participants of hemodialysis patients referred to Imam Khomeini (RA) Garmsar and Semnan Kosar hospitals (Iran)  participated in the study. Data were collected with structured interviews using demographic and RAM questionnaires. Data analysis was concurrent with data collection using conventional content analysis based on the five-step Granheim and Lundman (2004). Rigor of the study was conducted using measures of Lincoln and Guba. Results: Four main themes "facing physical challenges", "self-perception weakened," "inability to role function" and "passive dependence" was emerged from data analysis. Conclusion: The results obtained from this study explored adjustment responses in patients undergoing hemodialysis on the basis of the RAM. Findings of this study is valuable for patients, all those who are involved in the care of hemodialysis patients

References

  • 1.

    Parvan K, Ghoujazadeh M, Ahangar R. Stressors and methods of coping with stress in peritoneal dialysis patients. Nursing & Midwifery Journal of Tabriz University of Medical Sciences. 2010; 5(17): 34-41. (Persian).

  • 2.

    Ahmad MM, Al Nazly EK. Hemodialysis: stressors and coping strategies. Psychol Health Med 2015; 20: 477-487.

  • 3.

    Stengel B, Combe C, Jacquelinet C, Brianon S, Fouque D, Laville M, et al. The French chronic kidney disease-renal epidemiology and information network (CKD-REIN) cohort study. Nephrol Dial Transplant (NDT). 2014; 29: 1500-1507.

  • 4.

    Braz SH, Zarea K, Dashtbozorgi B. Comparing the effect of two educational programs on the Quality of life of hemodialysis patients in Iran. Iran Red Crescent Med J 2014; 16: e19368.

  • 5.

    Beladi-Mousavi SS, Alemzadeh-Ansari MJ, Alemzadeh-Ansari MH, Beladi-Mousavi M. Long-term survival of patients with End-stage renal disease on maintenance hemodialysis: A multicenter study in Iran. Iranian J Kidney Dis 2012; 6: 452-456.

  • 6.

    Hosseinpanah F, Kasraei F, Nassiri A, Azizi F. High prevalence of chronic kidney disease in Iran: a large population-based study. BMC Public Health 2009; 44: 1-8.

  • 7.

    Sakhai SH, Motearefi H, Khorami A, Habibpoor Z. A study about ferequency of stressors and coping confrontation styles hemodialysis pationts in khoy 2010. J Urmia Nurs Midwifery Fac 2014; 11: 998-1005. (Persian).

  • 8.

    Ahmadi F. Ghalyaf M, Rahimi A. Impact of Continuous care model on self-esteem in hemodialysis patients. J Zanjan Univ Med Sci 2006; 13: 16-21. (Persian).

  • 9.

    Scaife D. "What is the lived experience of the client with end stage renal disease on hemodialysis?" 2006; Theses and Dissertations. Paper 1382.

  • 10.

    Parvan K, Ahangar R, Hosseini F, Abdollahzadeh F, Ghojazadeh M, Jasemi M. Coping methods to stress among Patients on Hemodialysis and peritoneal dialysis. Saudi J Kidney Dis Transpl 2015; 26: 255-262.

  • 11.

    Vlez-Vlez E, Bosch RJ. Illness perception, coping and adherence to treatment among patients with chronic kidney disease. J Adv Nurs 2016; 72: 849-863.

  • 12.

    Nobahar M. Experiences of the hemodialysis patients and medical staff about regarding of nursing care: A content analysis. J Qual Res Health Sci 2016; 4: 472-483.

  • 13.

    Nobahar M. Factors affecting the safety of hemodialysis' patients in dialysis ward and their strengthening strategies. Koomesh 2016; 17: 547-562. (Persian).

  • 14.

    Ricci WF, Longley HS, Sagduyu K. Psychological aspects of dialysis: a case-based discussion. Mol Med 2014; 111: 516-520.

  • 15.

    Nobahar M, Tamadon MR. Barriers to and facilitators of care for hemodialysis patients; a qualitative study. J Renal Inj Prev 2016; 5: 39-44.

  • 16.

    Afrasiabifar A, Hasani P, Khoshkenab MF, Yaghamaei F. Models of adjustment to illness. Iran J Nurs Midwifery Res 2010; 19: 42-47. (Persian).

  • 17.

    Hassani P, Otaghi M, Zagheri-Tafreshi M, Nekbakhat-Nasrabadi A. The Facilitators of the Transition to Heamodialysis. Iran J Nurs (IJN) 2013; 25: 14-23.

  • 18.

    Lin CC, Han CY, Pan IJ. A qualitative approach of psychosocial adaptation process in patients undergoing long-term hemodialysis. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9: 35-41.

  • 19.

    Alimohammadi N, Maleki B, Shahriari M. Effect of a care plan based on Roy adaptation model biological dimension on stroke patients physiologic adaptation level. IJNMR 2015; 20: 275-281.

  • 20.

    Frazo CM, Dantas de S J, Medeiros AB. The adaptation problems of patients undergoing hemodialysis: socio-economic and clinical aspects. Rev Lat Am Enfermagem 2014; 22: 966-972.

  • 21.

    Hassani P, Otaghi M. Roy Adaption Model in Hemodialysis Patient: A mixed method research. J Urmia Nurs Midwifery Fac 2012; 10: 610-620. (Persian).

  • 22.

    Frazo CM, Medeiros AB, Paiva MG. Nursing diagnoses and adaptation problems among chronic renal patients. Invest Educ Enferm 2015; 33: 119-127.

  • 23.

    Bayhakki, Hatthakit U. Lived experiences of patients on hemodialysis: a meta-synthesis. Nephrol Nurs J 2012; 39: 295-304.

  • 24.

    Asgari MR, Mohammadi E, Fallahi Khoshknab M, Tamadon MR. Hemodialysis patients' perception from nurses' role in their adjustment with hemodialysis: A qualitative study. Koomesh 2010; 12: 385-395. (Persian).

  • 25.

    Tu HY, Shao JH, Wu FJ, Chen SH, Chuang YH. Stressors and coping strategies of 20-45-year-old hemodialysis patients. Collegian 2014; 21: 185-192.

  • 26.

    Keen M, Breckenridge D, Frauman AC, Hartigan MF, Smith L, Butera E, et al. Nursing assessment and intervention for adult hemodialysis patients: application of Roy's Adaptation Model. ANNA J 1998; 25: 311-319.

  • 27.

    Granheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004; 24: 105-112.

  • 28.

    Hekari D, Mohammadzadeh R. The assessment of adaptation rate of coronary artery disease female patients according to quadruple aspects of physiologic, self perception, role playing and independence/dependence in Tabriz, 1386-87. Islamic Azad Tehran Med Unit 2008; 18: 187-193. (Persian).

  • 29.

    Lincoln Y, Guba E. Naturalistic inquiry. California: Sage publication; 1985.

  • 30.

    Streubert Speziale H, Streubert H, Rinaldi Carpenter D. Qualitative research in nursing: advancing the humanistic imperative. Philadelphia: Lippincott Williams & Wilkins; 2011.

  • 31.

    Flythe JE, Powell JD, Poulton CJ, Westreich KD, Handler L, Reeve BB, et al. Patient-reported outcome instruments for physical symptoms among patients receiving maintenance dialysis: a systematic review. Am J Kidney Dis 2015; 66: 1033-1046.

  • 32.

    Gurkan A, Pakyuz S, Demir T. Stress coping strategies in hemodialysis and kidney transplant patients. Transplant Proc 2015; 47: 1392-1397.

  • 33.

    Krueger L. Experiences of hmong patients on hemodialysis and the nurses working with Them. J Nephrol Nurs 2009; 36: 379-388.

  • 34.

    Dehkordi LM, Shahgholian N. An investigation of coping styles of hemodialysis patients. Iran J Nurs Midwifery Res 2013; 18: 42-46. (Persian).

  • 35.

    Baraz S, Mohammadi E, Broumand B. The effect of self-care educational program on decreasing the problems and improving the quality of life of dialysis patients. Sci J Kurdistan Univ Med Sci 2006; 10: 69-79. (Persian).

  • 36.

    Tayyebi A, Salimi SH, Mahmoudi H. Comparison of quality of life in hemodialysis and renal transplantation patients. Iran J Crit Care Nurs 2010; 3: 19-22.

  • 37.

    Al Nazly E, Ahmad M, Musil C, Nabolsi M. Hemodialysis stressors and coping strategies among Jordanian patients on hemodialysis: a qualitative study. Nephrol Nurs J 2013; 40: 321-327.

  • 38.

    Shahgholian N, Tajdari S, Nasiri M. Reviewing and comparing self-concept in patients undergoing hemodialysis and peritoneal dialysis. Iran J Nurs Midwifery Res 2012; 17: S85-S90.

  • 39.

    Small LF. Quality-of-life experiences from the perspective of patients receiving hemodialysis for chronic renal failure. J Interdisciplinary Health Sci 2010; 15: 1-7.

  • 40.

    Asgari MR, Mohammadi E, Fallahi Khoshknab M, Tamadon MR. The perception of chronic renal failure patients from advocacy resources in adjustment with hemodialysis: A qualitative study. Iranian J Crit Care Nurs 2011; 4: 133-144.##.