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2017 ; 9
(1
): e1-e6
Nephropedia Template TP
gab.com Text
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English Wikipedia
Palliative care needs of patients living with end-stage kidney disease not
treated with renal replacement therapy: An exploratory qualitative study from
Blantyre, Malawi
#MMPMID28582995
Bates MJ
; Chitani A
; Dreyer G
Afr J Prim Health Care Fam Med
2017[May]; 9
(1
): e1-e6
PMID28582995
show ga
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.