Adaptation of patients to continuous ambulatoty peritoneal dialysis (CAPD)

Abstract

Research shows that treatment with continuous ambulatory peritoneal dialysis (CAPD) provides comparable long-term survival rates for patients with end stage renal disease (ESRD) (Trbojevic, Nesic, & Stojimirovic, 2001; Lok, 1996; Carey et al., 1990; Ross & Rutsky, 1990). However patients need to adapt to stressful permanent procedures and drug therapy that may influence their quality of life. Patients tend to use coping mechanisms to deal with their stressors (Lindqvist & Sjoden, 1998; Lok, 1996). The aim of this study was to explore adaptation of patients to CAPD. Roy's Adaptation Model (1984) provided the framework for the study. This small-scale qualitative study used semi-structured, face-to-face interviews, with a convenience sample of 10 patients undergoing CAPD in the local general hospital. Interviews were audio-taped, transcribed and thematic analysis was carried out. The findings were grouped under 4 themes, namely, biological, psychological, social and spiritual modes of adaptation. Moreover, these findings identified various factors which enhanced and inhibited participants' adaptation to CAPD. Lack of independence appeared to hinder most patients' adaptation. Social life events, work, swimming, exercise and fatigue were the major inhibiting factors. On the other hand, support from the family, the renal unit, and spiritual coping were the most adaptive modes used to adapt to CAPD. Adaptation to changes in patients' lifestyle required effort and sacrifice on the part of the whole family. Following a discussion of the findings, several recommendations for clinical practice and education were made. Further research was suggested to explore more in depth ways of adaptation of patients on CAPD.