Psychosocial consequences of gastrointestinal symptoms and dietary changes in people receiving automated peritoneal dialysis

• Published in: Journal of renal care 2019-03, Vol.45 (1), p.41-50
• Main Authors: Duncanson, Emily, Chur‐Hansen, Anna, Jesudason, Shilpanjali
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Caregivers - psychology; Diet; Diet Therapy - psychology; Diet Therapy - standards; Digestive system; Eating behavior; Eating disorders; Female; Food; Gastrointestinal Diseases - complications; Gastrointestinal Diseases - psychology; Gastrointestinal symptoms; Humans; Interviews as Topic - methods; Male; Mind body relationship; Nursing; Peritoneal dialysis; Peritoneal Dialysis - psychology; Peritoneal Dialysis - standards; Personal Autonomy; Personal relationships; Qualitative research; Quality of life; Sleep; South Australia; Wellbeing
• ISSN: 1755-6678; 1755-6686
• DOI: 10.1111/jorc.12265

SUMMARY Background Gastrointestinal (GI) symptoms are associated with poor psychosocial wellbeing among people receiving peritoneal dialysis (PD). The mind‐gut axis represents one possible explanatory mechanism for this relationship. Despite existing evidence, the individual's experience of GI symptoms and their potential psychosocial consequences have not been explored. Objective To understand the experiences of people receiving peritoneal dialysis regarding their gastrointestinal health and psychosocial wellbeing. Method Ten people undergoing automated PD (five females, five males) aged 31–77 years (Mean = 59.3, SD = 15.67) participated in a single one‐on‐one qualitative interview. Interviews ceased at thematic saturation. Transcripts were analysed using the framework approach. Results A central theme of Autonomy emerged from the data representing participants’ experiences of the psychosocial consequences of dialysis, GI symptoms, and dietary changes. This overarched two main themes: 1) Loss of Autonomy [Sub‐themes: Interference to Daily Life (Dialysis process and sleep, Impacts on relationships), Powerlessness, Frustration, Food Aversion, and Restriction (Friendships and social life, Impacts on partner)] and 2) Attempts to Gain Autonomy (Sub‐themes: Coping Well, Pragmatism, and Maintaining Normality). A related sub‐theme of Partner as a Carer emerged as part of Loss of Autonomy. Conclusion GI symptoms and diet and fluid restrictions have psychosocial consequences resulting in multiple losses of autonomy for people receiving PD, who employ strategies to attempt to regain autonomy in the face of these issues. Dietary and GI symptom management advice should aim to enhance patient autonomy within the confines of PD therapy and thus reduce its psychosocial impacts.