Abstract
Aims: To understand the lived experience of frailty in the advanced chronic kidney disease (CKD) context and how this impacts interac-tions with healthcare providers and medical decision-making.
Background: Frailty has been characterised as a state of accelerated aging with increased vulnerability to adverse outcomes and non-rou-tine recovery from relatively minor insults. To date, the lived experi-ence of individuals with CKD and frailty have yet to be examined. Methods: Participants with advanced CKD and Fried Frailty pheno-type and their caregivers were invited to participate in in-depth inter-views or focus group workshops to gain a rich description of key informants' experiences of frailty. Interviews were recorded, tran-scribed and coded for meaningful concepts and analysed using inductive thematic analysis using a constant comparative method of data analysis employing Social Cognitive Theory.
Results: Two focus groups( N = 4, N = 2), seven individual semi-structured interviews and three caregiver semi-structured interviews were analysed prior to saturation of themes. Experiences of frailty were described across four domains: the self, the body, the mind and impact on relationships; yielding themes of: the normative influence of capacity, the defining feature of reliance on help (personal or equip-ment), the dynamic state of frailty, erosion of identity, unresolved symptom burden, non-routine recovery, contracted social sphere, the mind-body continuum, and proximity to death. Experiences of frailty were punctuated by falls, comorbidity and prolonged hospitalisations.
Conclusions: Frailty is a pejorative, personal, subjective experience defined by deterioration from a previous normative baseline and reli-ance on aids and carers. Patients and their carers strive to maintain the status quo, experiencing life “day by day”, and “taking baby steps”. The dynamic state of frailty needs to be considered in deci-sion-making and future planning.
Background: Frailty has been characterised as a state of accelerated aging with increased vulnerability to adverse outcomes and non-rou-tine recovery from relatively minor insults. To date, the lived experi-ence of individuals with CKD and frailty have yet to be examined. Methods: Participants with advanced CKD and Fried Frailty pheno-type and their caregivers were invited to participate in in-depth inter-views or focus group workshops to gain a rich description of key informants' experiences of frailty. Interviews were recorded, tran-scribed and coded for meaningful concepts and analysed using inductive thematic analysis using a constant comparative method of data analysis employing Social Cognitive Theory.
Results: Two focus groups( N = 4, N = 2), seven individual semi-structured interviews and three caregiver semi-structured interviews were analysed prior to saturation of themes. Experiences of frailty were described across four domains: the self, the body, the mind and impact on relationships; yielding themes of: the normative influence of capacity, the defining feature of reliance on help (personal or equip-ment), the dynamic state of frailty, erosion of identity, unresolved symptom burden, non-routine recovery, contracted social sphere, the mind-body continuum, and proximity to death. Experiences of frailty were punctuated by falls, comorbidity and prolonged hospitalisations.
Conclusions: Frailty is a pejorative, personal, subjective experience defined by deterioration from a previous normative baseline and reli-ance on aids and carers. Patients and their carers strive to maintain the status quo, experiencing life “day by day”, and “taking baby steps”. The dynamic state of frailty needs to be considered in deci-sion-making and future planning.
| Original language | English |
|---|---|
| Pages (from-to) | 88-89 |
| Number of pages | 2 |
| Journal | Nephrology |
| Volume | 28 |
| Issue number | S2 |
| DOIs | |
| Publication status | Published - Aug 2023 |
| Event | 58th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology (ANZSN) 4–6 September 2023 - Te Pae Christchurch Convention Centre, Ōtautahi Christchurch, New Zealand Duration: 4 Sept 2023 → 6 Sept 2023 Conference number: 58 https://onlinelibrary.wiley.com/toc/14401797/2023/28/S2 |