Family caregivers perception, strategies and challenges in meeting nutritional needs of patients attending maintenance Hemodialysis at Iringa Regional Referral Hospital

Abstract

ABSTRACT Background Malnutrition is common in patients with chronic kidney disease (CKD). A higher risk of infection, cardiovascular disease, and metabolic changes, all of which raise morbidity and mortality are linked to malnutrition. Family caregiver help patients prepare food and support their adherence to the prescribed diet. Thus, it is crucial to investigate family caregivers' experience in providing nutritional care to hemodialysis patients. Aim This study aims to explore family caregivers' perception, strategies and challenges in meeting nutritional needs of hemodialysis patients at Iringa Regional Referral Hospital. Methods An explorative qualitative study design was used to explore the caregivers experience in providing nutritional support to the patients undergoing maintenance hemodialysis. Family caregivers were selected using non-probability purposeful technique guided by saturation principle. In-depth interview was carried out, the interviews were audio recorded and transcribed. The data was analyzed using thematic approach that is familiarizing with data, generating initial codes, searching for themes, reviewing themes, naming themes and report writing. Results Family caregivers reported to provide nutritional support to patients undergoing maintenance hemodialysis based on their common experience and by using different printouts and posters given to the patients. On perception participants reported dietary recommended, diet restricted, fluid modification and benefits of adhering recommended food, participants reported to utilize four strategies in nutritional care including meal preparation techniques, eating of produced food, handling communal eating and drinking, assessing adherence to dietary recommendation. Additionally, caregivers reported to face four barriers in providing nutritional care. These barriers are inadequate understanding, financial constraints, and overzealous restriction during supportive nutritional practices. They expressed the need for government support, nutritional education, and reduced cost of treatment. Conclusion and recommendation Family caregivers play great role in provision of nutritional support to patients attending maintenance hemodialysis. Caregivers are resourceful as a link to provide nutritional care as they spend much time with patients and they directly involve with provision of care. Additionally, caregivers are the bridges to link patient’s problem directly without errors to the health care providers like doctors, nurses and dietitians to meet patient’s needs. Health care providers need to provide the family caregivers with knowledge concerning kidney diseases in nutrition care to improve the quality of hemodialysis patients.