How do patients cope with chronic kidney disease?

Kidney failure has a serious impact on the lives of patients, who have to deal with many long-term physical and mental stressors. However, there are no established standards for addressing stressors and supporting effective coping strategies for patients dealing with kidney failure. Using qualitative interview data from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) Study, researchers investigated how patients cope with kidney disease, with the goal of improving support for patients.

Investigators analyzed responses from 179 patients who were asked “How do you cope or deal with your kidney problems?” to identify coping techniques used. Using the Coping Strategies Inventory (CSI) framework, they classified the coping techniques as either engagement or disengagement strategies. Engagement strategies involve confronting stressors and are believed to reduce the impact of long-term stress. Disengagement strategies rely on avoiding undesirable stressors; these strategies often have short-term benefits, but might cause longer-term problems.

Participants often used multiple coping techniques but overall mentioned engagement strategies more frequently than disengagement strategies. The results suggest that although there were some commonly used coping techniques, other techniques were particular to each group of patients (those that had not started dialysis, those on hemodialysis, and those on peritoneal dialysis). Differences in time since diagnosis of kidney disease, presence of other health issues, and self-perceived health status were also associated with variations in types of coping strategies used.

“Dealing with a chronic condition is tough,” said lead author Dr. Lalita Subramanian. “As one participant put it, ‘So it’s just the- the fact that this thing won’t go away, it’s my whole life, it’s always there.’ I found it inspiring to learn of the resilience and fortitude with which people are grappling and engaging with the challenges they face on a daily basis.”

Understanding the complexity of how patients with kidney disease cope when left to deal with their challenges on their own could help health care providers identify opportunities where targeted support would be most beneficial to patients. Wisdom from those who have successfully coped with their disease could also be helpful for others in similar circumstances.

Dr. Subramanian added, “I hope that this study provides some insight that empowers patients and leads to better support and understanding from their health care teams and health systems in negotiating the challenges of living with chronic kidney disease.” 

CITATION:Subramanian L, Quinn M, Zhao J, LaChance L, Zee J, Tentori F. Coping with Kidney Disease - Qualitative Findings from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) Study. BMC Nephrol. In Press.
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