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Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study

OBJECTIVE: To outline the facilitators and barriers to patients’ self-management of predialysis chronic kidney disease (CKD). DESIGN: Qualitative. SETTING: Three polyclinics in a public primary care institution in Singapore. PARTICIPANTS: 20 patients entered and completed the study. Inclusion criter...

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Autores principales: Hwang, Sun Joon, Tan, Ngiap Chuan, Yoon, Sungwon, Ramakrishnan, Chandrika, Paulpandi, Muthulakshmi, Gun, Shihying, Lee, Jia Ying, Chang, Zi Ying, Jafar, Tazeen H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569996/
https://www.ncbi.nlm.nih.gov/pubmed/33067304
http://dx.doi.org/10.1136/bmjopen-2020-041788
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author Hwang, Sun Joon
Tan, Ngiap Chuan
Yoon, Sungwon
Ramakrishnan, Chandrika
Paulpandi, Muthulakshmi
Gun, Shihying
Lee, Jia Ying
Chang, Zi Ying
Jafar, Tazeen H
author_facet Hwang, Sun Joon
Tan, Ngiap Chuan
Yoon, Sungwon
Ramakrishnan, Chandrika
Paulpandi, Muthulakshmi
Gun, Shihying
Lee, Jia Ying
Chang, Zi Ying
Jafar, Tazeen H
author_sort Hwang, Sun Joon
collection PubMed
description OBJECTIVE: To outline the facilitators and barriers to patients’ self-management of predialysis chronic kidney disease (CKD). DESIGN: Qualitative. SETTING: Three polyclinics in a public primary care institution in Singapore. PARTICIPANTS: 20 patients entered and completed the study. Inclusion criteria were: (1) English speaking, (2) aged 40 years and above, (3) identified by clinical coding as ‘DM (diabetes mellitus) nephropathy-overt’ and ‘DM nephropathy-incipient’, by their physicians in the polyclinic, with an estimated glomerular filtration rate of less than 60 mL/min/1.73 m(2) (based on electronic health records) and (4) aware of their CKD illness. Exclusion criteria were: (1) receiving dialysis or had received a kidney transplant, (2) suffered from any visual, auditory or cognitive impairment which could hinder their ability to participate in the study or (3) pregnant. RESULTS: We found that the major barriers to CKD management were a lack of knowledge and awareness of CKD, a passive attitude toward self-management and insufficient patient-physician communication. Major facilitators included patient trust and satisfaction with the physician and family support. Many patients reported that there was an overload of information and too little guidance on how to manage their condition, especially regarding dietary recommendations. CONCLUSION: We identified several barriers and facilitators to the management of predialysis CKD among patients. A multi-pronged approach for raising CKD awareness is required: improving patient-physician communication, implementing CKD workshops and home-visits and disseminating accurate online information about CKD. Strategies should also focus on increasing patient engagement and optimising family support by involving family members in patients’ care. Furthermore, clear dietary recommendations and patient-specific advice are needed to empower patients to manage their own condition.
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spelling pubmed-75699962020-10-21 Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study Hwang, Sun Joon Tan, Ngiap Chuan Yoon, Sungwon Ramakrishnan, Chandrika Paulpandi, Muthulakshmi Gun, Shihying Lee, Jia Ying Chang, Zi Ying Jafar, Tazeen H BMJ Open Renal Medicine OBJECTIVE: To outline the facilitators and barriers to patients’ self-management of predialysis chronic kidney disease (CKD). DESIGN: Qualitative. SETTING: Three polyclinics in a public primary care institution in Singapore. PARTICIPANTS: 20 patients entered and completed the study. Inclusion criteria were: (1) English speaking, (2) aged 40 years and above, (3) identified by clinical coding as ‘DM (diabetes mellitus) nephropathy-overt’ and ‘DM nephropathy-incipient’, by their physicians in the polyclinic, with an estimated glomerular filtration rate of less than 60 mL/min/1.73 m(2) (based on electronic health records) and (4) aware of their CKD illness. Exclusion criteria were: (1) receiving dialysis or had received a kidney transplant, (2) suffered from any visual, auditory or cognitive impairment which could hinder their ability to participate in the study or (3) pregnant. RESULTS: We found that the major barriers to CKD management were a lack of knowledge and awareness of CKD, a passive attitude toward self-management and insufficient patient-physician communication. Major facilitators included patient trust and satisfaction with the physician and family support. Many patients reported that there was an overload of information and too little guidance on how to manage their condition, especially regarding dietary recommendations. CONCLUSION: We identified several barriers and facilitators to the management of predialysis CKD among patients. A multi-pronged approach for raising CKD awareness is required: improving patient-physician communication, implementing CKD workshops and home-visits and disseminating accurate online information about CKD. Strategies should also focus on increasing patient engagement and optimising family support by involving family members in patients’ care. Furthermore, clear dietary recommendations and patient-specific advice are needed to empower patients to manage their own condition. BMJ Publishing Group 2020-10-16 /pmc/articles/PMC7569996/ /pubmed/33067304 http://dx.doi.org/10.1136/bmjopen-2020-041788 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Renal Medicine
Hwang, Sun Joon
Tan, Ngiap Chuan
Yoon, Sungwon
Ramakrishnan, Chandrika
Paulpandi, Muthulakshmi
Gun, Shihying
Lee, Jia Ying
Chang, Zi Ying
Jafar, Tazeen H
Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study
title Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study
title_full Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study
title_fullStr Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study
title_full_unstemmed Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study
title_short Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study
title_sort perceived barriers and facilitators to chronic kidney disease care among patients in singapore: a qualitative study
topic Renal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569996/
https://www.ncbi.nlm.nih.gov/pubmed/33067304
http://dx.doi.org/10.1136/bmjopen-2020-041788
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