Qualitative Study Of The Compliance Of Peritoneal Dialysis Patients With Hyperphosphatism

ObjectiveThe purpose of this study was to explore the cognition of peritoneal dialysis patients with hyperphosphatemia to antiphosphate drugs by qualitative research method from the inner feelings of patients and the difficulties of practitioners and the reasons affecting their compliance with hypophosphatemic drugs.To explore the strategies to improve the compliance of patients with peritoneal dialysis with hyperphosphorus.In order to improve the compliance of peritoneal dialysis patients with hyperphosphatism and provide evidence for rational use of phosphorus-lowering drugs and to reduce the incidence of hyperphosphorus in peritoneal dialysis patients.MethodThe researchers selected peritoneal dialysis patients with hyperphosphatemia who were followed up regularly from May 2018 to June 2019 in the outpatient or inpatient department of Guangdong Provincial Hospital of Traditional Chinese Medicine.Using the qualitative research method of grounded theory.To study patients who meet inclusion and exclusion criteria by convenient and objective sampling.Semi-structured interviews were used to conduct in-depth and face-to-face personal interviews with patients until the information was saturated.Finally,15 subjects were included.After the interview,the researcher sorted out the recording materials and notes as soon as possible.Researchers themselves listen to the recordings repeatedly and transcribe them verbatim into the text,labeling pauses,tones,tones,etc.After transcription,the researcher invited another competent nurse to check the correctness and form the final transcript.Transcription Data Using QRS Nvivo 11.0 plus Software,through three levels of coding,and then refine the theme.ResultsTo analyze the reasons that affect the compliance of 15 peritoneal dialysis patients with hyperphosphatism.Fifty codes were obtained in the open coding stage;23 secondary codes were obtained after comparison and induction.At the stage of spindle coding,five generic were obtained:lack of knowledge,factors hindering correct medication,emotional,economic burden,social and family support.In selective coding,through in-depth analysis and Reflection on the category of coding.Finally,the core category is defined as the interaction between subjective initiative of taking medicine and social and family economic support.ConclusionThrough interviews,it was found that the lack of knowledge of patients was mainly manifested in the ignorance of drug types,the method of taking medicine(mode,dosage,timing)is unknown,unclear efficacy of drugs,missing medication but not aware of the impact on the condition.The main reasons for the lack of knowledge are poor memory caused by diseases,inadequate training of medical staff or training methods that make patients not fully understand the training contently.The main factors that hinder correct medication include poor memory,drug efficacy,rejection of medication,bad teeth affecting medication,side effects of medication,poor taste of medication.the efficacy of medication,rejection of medication and side effects of medication are related to lack of knowledge,which shows the urgency of improving patients' knowledge of medication for hyperphosphorus.In the study,it was found that the curative effect of drugs had a bidirectional effect on drug compliance.Poor taste of drugs is the main reason that affects the compliance of patients.Emotional aspects include:negative attitude(muddle through,pessimism,self-abandonment,etc.),expectation,image change.Some patients suffer from self-abandonment,muddle through or pessimistic psychology because of long-term chronic diseases and poor therapeutic effect,which reduces their compliance with medication.Another part of patients are eager to acquire new knowledge,improve their external image,facilitate the prescription of drugs and external reminders,urge them to take drugs on time,in order to increase the compliance of patients.The heavy economic burden mainly includes high cost,reimbursement policy,high economic pressure and few preferences.In the interview,it was found that there was no positive correlation between the financial burden and the patient' s medication compliance.Social and family support was positively correlated with patients' medication compliance,and patients with good social and family support had good medication compliance.