Perceptions of rural Australian adults with chronic kidney disease stages 3 and 4 about the role of dietary intervention in their health and access to dietetic care

IF 2.9 3区 医学 Q3 NUTRITION & DIETETICS Journal of Human Nutrition and Dietetics Pub Date : 2024-12-01 DOI:10.1111/jhn.13400
Annette Shelley, Kerith Duncanson, Kelly Lambert
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Abstract

Background

Dietary modification is an important component of chronic kidney disease (CKD) management. The aim of this study was to explore the perceptions of people with earlier-stage CKD living in rural Australia about the role of dietary intervention in their health and access to dietetic care.

Methods

Semi-structured interviews were conducted with 14 people with stage 3–4 CKD living in a rural Australian health district. Interview questions were guided by the principles of the appreciative inquiry study methodology. The thematic analysis involved inductive coding of data, discussions of emerging themes between co-researchers as coding proceeded and thematic memoing to finalise the transformation of data into distinct themes.

Results

Three predominant themes were evident from the data. First, people with CKD expressed that ‘Dietary change empowers’ them in self-management. Second, ‘Dietetics is valued’ in achieving dietary change. Third, it was clear that nephrologists had a key role in determining service access through ‘Awareness and advocacy’ of renal dietetic services.

Conclusions

People with CKD living in rural Australia desire early, specialised renal dietetic care. The unexpectedly high acceptability of less resource-intensive technology for dietetic intervention suggests that there is an opportunity for service reorientation. Access to dietetic care could be enhanced by building on the key role of nephrologists in dietetic referral, service awareness and perception of value.

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澳大利亚农村慢性肾脏疾病3期和4期成人对饮食干预在其健康和获得饮食护理中的作用的看法
饮食调整是慢性肾脏疾病(CKD)治疗的重要组成部分。本研究的目的是探讨生活在澳大利亚农村的早期CKD患者对饮食干预在其健康和获得饮食保健方面的作用的看法。方法对居住在澳大利亚农村卫生区的14例3-4期CKD患者进行半结构化访谈。访谈问题以欣赏性探究研究方法论的原则为指导。主题分析包括数据的归纳编码,在编码过程中共同研究人员之间对新兴主题的讨论以及主题备忘录,以最终将数据转换为不同的主题。结果从数据中可以明显看出三个主要主题。首先,CKD患者表示,“饮食改变赋予”他们自我管理的能力。第二,在实现饮食改变方面,“营养学是有价值的”。第三,很明显,肾病学家在通过肾营养服务的“意识和倡导”来决定服务获取方面发挥了关键作用。结论生活在澳大利亚农村的CKD患者需要早期的、专门的肾脏营养护理。对较少资源密集的技术进行饮食干预的高接受度出乎意料,这表明有机会重新定位服务。通过建立肾病学家在饮食转诊、服务意识和价值感知方面的关键作用,可以提高获得饮食保健的机会。
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来源期刊
CiteScore
5.30
自引率
15.20%
发文量
133
审稿时长
6-12 weeks
期刊介绍: Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.
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