Enduring hardship to live day by day : fatigue experience of ESRD patients commencing continuous ambulatory peritoneal dialysis

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Enduring hardship to live day by day : fatigue experience of ESRD patients commencing continuous ambulatory peritoneal dialysis


Author: Lin, Wai-ting
Title: Enduring hardship to live day by day : fatigue experience of ESRD patients commencing continuous ambulatory peritoneal dialysis
Degree: M.Sc.
Year: 2010
Subject: Hong Kong Polytechnic University -- Dissertations
Chronic renal failure -- Patients -- Physiology
Department: School of Nursing
Pages: x, 113 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2399221
URI: http://theses.lib.polyu.edu.hk/handle/200/5910
Abstract: Background: Fatigue is reported to be one of the most common and distressing symptoms among patients with end-stage renal disease (ESRD) affecting their physical and psychosocial wellbeing. Previous studies related to fatigue among patients with ESRD were primarily focused on its prevalence and associated factors by using survey studies. Using qualitative research to explicate how fatigue affects patients' different aspects of life is rare. Patients on peritoneal dialysis (PD) reported the highest level of fatigue among different renal replacement therapies (RRT), yet no study related to fatigue of PD patients was reported so far. Aims: This study aimed to uncover how fatigue was experienced by patients on commencement of self-administered continuous ambulatory peritoneal dialysis (CAPD) and over a period of two months thereafter.
Method: This is a qualitative study using phenomenological approach. Eleven patients on their commencement of self-administered CAPD were recruited. Data was collected through semi-structured interviews. Each participant was interviewed three times so as to fully unfold the fatigue experience along the course of treatment. Benner's interpretative method was used to analyze the data. This method involved three strategies: thematic analysis, analysis of exemplars and searching for paradigm cases. Findings: All participants expressed a high level of perceived fatigue on commencing CAPD. They described experiencing fatigue acts as a kind of hardship they encounter when living along. Enduring hardship to live day by day is the main theme of this study. Majority of them indicated a desire to ease the fatigue. Whether perceived fatigue level could be improved was dependent on how successful they dealt and coped with it. Three more themes emerged under the main themes: (i) negotiating normal activities with physical limits, (ii) engaging with non-voluntary dependence, and (iii) changing attribution of role responsibility. Two subthemes were emerged under each of these three themes. These subthemes present the factors contributing to their changes in fatigue levels after commencing CAPD over a period of two months. Conclusions: The study findings provide nurses an understanding about how the patients experience and endure fatigue on commencing CAPD. Contributory factors to alleviate fatigue from the patient's point of view are delineated. Appropriate and effective nursing interventions can be implemented at earlier stage so as to alleviate their suffering.

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