Patients’ Lived Experiences of Self-Management in Chronic Kidney Disease Undergoing Hemodialysis: A Qualitative Study
DOI:
https://doi.org/10.30994/jnp.v10i1.1189Keywords:
chronic kidney disease, hemodialysis, lived experience, qualitative study, self-managementAbstract
Background: Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) face complex multidimensional challenges that profoundly affect self-management capacity and quality of life.
Purpose: To explore the lived experiences of CKD patients undergoing HD, focusing on self-management practices, perceived barriers and benefits, and educational needs within the Health Belief Model (HBM) framework.
Methods: A qualitative exploratory study was conducted at the Hemodialysis Unit of one of the hospitals in Bukittinggi, West Sumatera, Indonesia. Twenty CKD patients undergoing routine HD were selected using purposive sampling technique. In-depth semi structured interviews were conducted individually (20–45 minutes). Data were analyzed using Braun and Clarke's reflexive thematic analysis approach. Trustworthiness was ensured through source triangulation, member checking, audit trail, and peer debriefing.
Results: Nine themes emerged: (1) physical burden of fatigue, cramps, and activity limitation; (2) psychological adaptation from fear and shock to acceptance; (3) social role disruption and community participation; (4) perceived susceptibility and severity; (5) self-management challenges in diet, fluid restriction, and medication adherence; (6) perceived benefits of adherence; (7) barriers of transportation, economic burden, and vascular access complications; (8) self-efficacy and family support as motivational pillars; and (9) educational needs favoring interactive and personalized approaches.
Conclusion: Patients’ self-management experiences are shaped by intersecting physical, psychological, social, and educational dimensions, providing a critical empirical foundation for developing a structured HBM-based Self-Management Education model for the Indonesian hemodialysis context.
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