Study Develops Framework to Engage Chronic Kidney Disease (CKD) Patients with their Integrated Management
UKZN PhD graduate Dr Geldine Chironda has ensured that Chronic Kidney Disease (CKD) patients adequately manage their condition.
‘Effective management of CKD entails patients engaging with their dialysis plan, medication, fluid and dietary restriction to reduce complications and progression of the disease to end of life stages,’ said Chironda.
In this regard, she developed a framework which would facilitate engagement of CKD patients with their integrated management in selected tertiary hospitals in the eThekwini District. ‘The study used a sequential explanatory mixed method design where quantitative data was collected and analysed first, followed by the collection and analysis of qualitative data,’ she said.
‘Firstly, the level of engagement with integrated management was established using descriptive cross sectional design. Thereafter, participants with the highest and lowest level of engagement, including their respective caregivers and healthcare workers, were selected to reveal the motivators of and barriers to engagement with integrated management using qualitative case study. Findings from the quantitative and qualitative phases were converged to develop a framework for engagement of CKD patients with their integrated management.’
According to Chironda, there is a new discovery associated with the study. ‘New information on varying engagement behaviours and the reasons were discovered from the South African context. Further, a comprehensive framework that will promote patient engagement was developed using results from the quantitative and qualitative phase.
‘The care of CKD is complex as it requires different people to co-ordinate the care of these patients, that is why the perceptions of caregivers and healthcare professionals regarding the integrated management of CKD patients were included in the study.’
Chironda says resource constraints regarding CKD treatment in public hospitals in South Africa results in issues of distributive justice. ‘Hence the strict selection criteria introduced by the Department of Health as a legal measure to aid in selection of CKD patients. The criterion for admission of CKD patients to the CKD programme is eligibility for a kidney transplant and this directly impacts on those CKD patients who do not match the criteria as well as their respective families and communities in society.’
‘Kidney transplant is acknowledged as a major advance of modern medicine which provides high-quality years to patients with irreversible kidney failure. Although a successful renal transplant is advantageous in terms of patient quality of life, a shortage of donor organs has resulted in dialysis becoming the dominating treatment. Hence, the study recommended media engagement in educating the society about CKD, such as advertising a low-salt diet and healthy living behaviours, and creating awareness about organ donation to increase the number of kidneys for transplantation in healthcare settings.’
She thanked the Dean of Research in the College of Health Sciences, Professor Moses Chimbari, for his assistance and support, and her supervisor, Professor Busi Bhengu, for her untiring guidance and encouragement.
Chironda works for the Human Resources for Health (HRH) programme as a training specialist at the University of New York’s Rory Meyers College of Nursing. At present she is at the University of Rwanda’s School of Medicine and Health Sciences where she is a training specialist.