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Exploring symptoms in patients managed without dialysis: a qualitative research study
Helen Noble1, Professor Julienne Meyer, Dr Jackie Bridge
1School of Community and Health Sciences, City University, Philpot Street, London, United Kingdom. helen.noble.1@city.ac.uk
Journal of Renal Care
|March 11, 2010
Summary
Patients not on dialysis experience many symptoms, including breathlessness and pain. As death nears, symptoms like fluid overload worsen, signaling the end of life and requiring appropriate renal supportive care.
Area of Science:
- Nephrology
- Palliative Care
- Symptom Management
Background:
- Limited understanding of symptom burden in patients managed without dialysis.
- Focus on end-of-life trajectories in this patient group.
- Exploration of patient experiences within a Renal Supportive Care Service.
Purpose of the Study:
- To investigate the prevalence and burden of symptoms in patients receiving renal supportive care without dialysis.
- To identify key symptoms impacting daily living and end-of-life trajectories.
- To inform clinical practice regarding symptom management and end-of-life care.
Main Methods:
- Analysis of data from 30 patients referred to a Renal Supportive Care Service.
- Retrospective review of symptoms reported at first consultation.
- Qualitative assessment of symptom impact on daily living and proximity to death.
Main Results:
- High prevalence of symptoms, with 30 different symptoms reported at initial consultation.
- Commonly reported symptoms include breathlessness, edema, pruritus, nausea, vomiting, and pain.
- Worsening and difficult-to-treat symptoms like fluid overload and lethargy indicate approaching death.
Conclusions:
- Effective identification and management of symptoms are crucial for patients managed without dialysis.
- Symptom burden significantly impacts daily living and end-of-life experiences.
- Understanding symptom escalation aids in determining proximity to death for appropriate supportive care.
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