Conservative management of end-stage kidney disease at Cape Coast Teaching Hospital

Abstract

More often, patients have no option but to begin dialysis when their chronic kidney disease progresses. The purpose of this study was to examine nurses, doctors and patients’ knowledge and understanding of conservative management of end-stage kidney disease at Cape Coast Teaching Hospital in Ghana. The study adopted mixed methods. A census was used to select nurses, while purposive sampling technique was used to select doctors and patients for the qualitative arm of the study. Interviews were conducted with doctors and patients, whereas questionnaires were administered to nurses. Overall, 146 nurses responded to the questionnaire, while five doctors and 18 patients were interviewed to reach saturation. The quantitative data collected from the questionnaire was analysed using mean, standard deviation and one-sample t-test of IBM SPSS for windows, version 23; while the data collected from the semi-structured interview guide were organised and analysed thematically. The study found that patients with end-stage kidney disease were saddled with unhappiness and sadness, resulting from their current condition. While some of the patients declared that the dialysis procedure was time consuming, and painful and tiresome; another group of patients stated that the dialysis procedure was user-friendly. Moreover, unlike renal replacement therapy which functions as a kidney, conservative management does not: it only reduces that speed at which the kidney disease progresses. Also, conservative management does not help a patient who is at stage 5 of the kidney disease. Finally, the lack of trained nephrology nurses and doctors in the hospital was a barrier to the practice of conservative management in patients with end-stage kidney disease.