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An interpretive description of the experience of end stage renal disease as perceived by persons with diabetes mellitus Ravenscroft, Eleanor Fay

Abstract

I designed this study to explore the experience of end stage renal disease (ESRD) from the perspective of people with diabetes. My intent was to increase the knowledge, awareness, and understanding of the experience of ESRD for individuals with diabetes. I used the qualitative research approach, interpretive description, described by Thorne, Reimer Kirkham, and MacDonald-Emes (1997), as my research method as it was appropriate to answering the research question, "How do individuals with diabetes experience ESRD?" The data were collected by means of in-depth interviews with a total of 7 participants ranging in age from 35 to 87 years. All of the participants had been receiving dialysis treatments for at least 2 years prior to this study. The interview transcripts constituted the bulk of the data. Inductive data analysis was ongoing throughout the data collection process. The cumulative analytic findings informed and guided the data collection process enabling the construction of the interpretive description. The narratives constructed through the research interviews revealed three dominant themes within the participants' perception of the experience of diabetes and ESRD. These were the experience of diagnosis, the experience of illness intrusion, and the experience of interactions with health care providers. Further, in describing how they engaged with the illness experience, participants described how they sought and maintained control over the illness experience as they adjusted to living with ESRD. Participants adjusted to living with ESRD by learning to manage through minimizing illness intrusion, thinking positively, learning to manage diabetes with ESRD, and learning by experience. In addition, participants described how they sought to find a balance between the illness and normalcy and reached an acceptance of illness through hope. The findings of this study support the existing understanding of the experience of ESRD as relevant to persons with diabetes and ESRD. However, the findings also strengthen the argument for individualized care based on the lived experience of the individual. Implications for future nursing research include further exploration of selected issues that emerged from the findings and evaluation of care delivery within hemodialysis programs.

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