Self-management action and motivation of Pacific adults in New Zealand with end-stage renal disease

English version

Autoři: Jacqueline Schmidt-Busby ^aff001; Janine Wiles ^aff002; Daniel Exeter ^aff003; Timothy Kenealy ^aff004
Působiště autorů: Counties Manukau Health, Middlemore Hospital, Auckland, New Zealand ^aff001; Department of Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ^aff002; Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ^aff003; School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand ^aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222642

Souhrn

Aims

To explore actions and motivations for self-management practices of Pacific adults following diagnosis of end stage renal disease (ESRD).

Methods

Focused ethnography using in-depth interviews with 16 Pacific people on haemodialysis for diabetic ESRD, in Auckland, New Zealand. Study participants were of Samoan, Cook Islander, Tongan, Niuean, or Tokelauan ethnicity and aged between 30 to 69 years old. Thematic analysis was used to code and identify emergent themes.

Results

All participants assumed active responsibility for their self-management following their diagnosis of ESRD. They reported positive differences in their current self-management behaviours, compared to pre-ESRD diagnosis. In the face of their terminal diagnosis, participant’s motivations to self-manage their health were fuelled by hope; the hope to live long enough to change their family legacy of diabetes and ESRD. To achieve this, there was a dependency upon family members as a resource for self-management support. Yet at the same time, family members also had health concerns (including diabetes), and several participants themselves were carers for sick or elderly family members.

Conclusion

The growing number of members (within family units) progressing from moderate to late-stage diabetes raises concerns about the sustainability of future family support in Pacific families in New Zealand with histories of diabetes, ESRD, and other chronic diseases. While the burden upon informal carers (family) has been well documented throughout the past few decades, the dynamics of bi-directional carer support between (two or more) sick family members and their families have had less exposure. This has potentially significant implications for Pacific peoples in New Zealand, considering the increases in diabetes prevalence within their families.

Klíčová slova:

Human families – Behavior – Emotions – New Zealand – Chronic kidney disease – Medical dialysis – Cardiovascular diseases

Zdroje

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