Self-care in end-stage renal disease patients who refused dialysis in Uttaradit Province

Abstract

Currently, conservative management for end-stage renal disease patients who refused dialysis is lacking in patients' understanding of non-medical dimensions. In order to achieve a holistic goal, this study aimed to understand patients’ self-care and the relevant context. A qualitative study was then conducted based on semi-structure in-depth interviews and non-participatory observation with 40 end-stage renal disease patients who refused dialysis in Renal Disease Center at Uttaradit Hospital during March to September 2019. These data were examined using content analysis. The results revealed that most patients could perceive their health status. They understood and took care of themselves in terms of physical, emotional, drug use, diet control and manage with effortlessly complications. The internal factors influencing self-care were physical condition, emotional state, understanding of disease and care, illness representations, experiences and beliefs. The external factors included caregivers, family supports, socio-economic status, health facility and channels for information perception. Therefore, the multidisciplinary team should understand the patients in all dimensions, develop good patient-team relationship, give appropriate and clear suggestions according to the context, promote the use of social media and join with their family to participate in the treatment plans to promote self-care and improve quality of life.