From Impact to Meaning Reconstruction: A Qualitative Study of the Illness Trajectory in Chronic Kidney Disease...

Living with non-dialysis chronic kidney disease is a complex experience that extends beyond clinical markers. While the physical aspects of the disease are well-documented, a deeper understanding of the patient's subjective journey is needed to inform person-centered care.

This study aimed to develop a conceptual understanding of the lived trajectory of patients with non-dialysis chronic kidney disease to identify specific psychological shifts and management challenges.

This is an interview-based qualitative study.

A purposive sample of 13 patients with non-dialysis chronic kidney disease was recruited from a tertiary hospital in Shenzhen, China.

Data were collected using in-depth, semi-structured interviews and were analyzed using content analysis, guided by the Illness Trajectory Framework.

The analysis generated three central themes that defined the patient's illness trajectory: (1) Cognitive and Emotional Impact, an initial phase characterized by confusion, negative emotions, and identity conflict following diagnosis; (2) Dilemmas in Disease Management, a protracted period of struggle with treatment adherence, conflicting medical advice, and a lack of support; and (3) Adaptation and Meaning Reconstruction, an emergent phase wherein patients began to accept their condition and rebuild a purposeful life.

The illness experience in non-dialysis chronic kidney disease is a dynamic trajectory composed of distinct, identifiable phases. The resulting three-phase framework offers a valuable conceptual tool for practitioners to better anticipate and address the evolving psychosocial and practical needs of their patients. Implementing phase-specific support strategies is critical for improving patient adaptation and long-term outcomes.