A qualitative study exploring self-management behavior of patients with chronic kidney disease during COVID-19

Abstract

Chronic kidney disease (CKD) is a significant public health issue. COVID-19 immensely affects people with chronic diseases, including patients with CKD. We aimed to explore the factors that might impact the self-management of patients receiving haemodialysis (HD) and patients with kidney transplants (KTx) during COVID-19 using the Health Belief Model (HBM). A qualitative phenomenological research design was used to build evidence on the effects of the COVID-19 pandemic on the self-management behavior of patients with CKD. Data were analyzed using framework analysis to identify critical factors influencing patients- perceptions regarding the selfmanagement of their conditions during COVID-19. Eighteen patients with KTx and seven with HD were interviewed during the lockdown. Having CKD was discussed as a major factor contributing to the perception of susceptibility. The fear of death expressed by the participants had a profound impact on self-management. Delays in check-ups and monitoring, staying at home, the financial burden of treatment, lack of trusted information, safety of test sites, and fatalistic attitudes of patients were identified as barriers to the selfmanagement behaviors of patients. External and internal triggers were the motivators of adopting self-management behavior. This study provides an in-depth view of factors impacting the adoption of self-management behavior of patients with CKD during COVID-19 and may offer healthcare providers and policymakers knowledge about factors contributing towards compromised patient care.