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Seabrook, Hannah
Languages: English
Types: Doctoral thesis
Subjects: RC, BF
There are 30,000 people in the UK who are on dialysis or that have received a\ud transplant for chronic kidney failure (Stein & Wilde, 2006). Those with a diagnosis\ud of End Stage Renal Failure (ESRF) face a gruelling treatment regimen with dialysis\ud providing only 5% of the function two healthy kidneys would supply (Stein &\ud Wilde, 2006). Patients face many changes to their lifestyle and these are often\ud difficult to manage. The treatment necessary for such a condition is complex and\ud includes restrictions to diet and fluid intake as well ingestion of medication and\ud attending dialysis. Many patients struggle with adhering to this treatment and it is\ud important to have an understanding of the psychological factors that contribute to\ud this issue. Understanding the experience of being diagnosed and treated for ESRF\ud for specific groups of patients is an important area of research if the best quality care\ud is to be provided. This thesis is made up of three chapters, the first two are a\ud literature review and an empirical paper that focus on two under-researched areas in\ud the field of ESRF.\ud Those with ESRF often struggle to adhere to prescribed medical treatments with\ud rates estimated to be between 50-80% (Christensen, 2000; Morgan, 2001). The\ud social and psychological effects of this diagnosis on adherence have been well\ud recognised by the research. Chapter one presents a critical review of the literature\ud that considers psychological factors of adherence to the treatment for ESRF in its\ud entirety (rather than dietary restrictions or medication intake alone) in the last ten\ud years. The review reveals a number of important psychological factors related to\ud adherence to ESRF treatment. The review finds evidence to support the argument\ud that psychological factors associated with adherence are an important consideration\ud for supporting this group. The review highlights many of the limitations of the\ud current literature and identifies directions for future research.\ud Chapter two presents an empirical study exploring working age men’s experiences\ud of ESRF and haemodialysis. There is a lack of research into the experiences of\ud specific groups with this diagnosis and treatment experience. This includes working\ud age men, and there are no qualitative studies of this group. The paper focuses on the\ud experience of diagnosis, treatment and coping using Interpretative\ud Phenomenological Analysis. Findings revealed three superordinate themes these\ud were: ‘The many sides of the HD treatment experience’, ‘Coping the best way you\ud can’ and their experience of ESRF as a ‘Hidden diagnosis’. Clinical implications and\ud directions for future research are then discussed.\ud Chapter three is a reflective paper highlighting some of the issues that arose for the\ud researcher during the research process. This paper considers the different roles of the\ud researcher within and outside the research context, how they have converged and the\ud impact they have had. They include reflections that may be beneficial to future\ud researchers in this area.
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