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Compliance in peritoneal dialysis: A qualitative study of renal nurses

Authors

  • Alexandra McCarthy RN BNg MNsg PhD,

    Corresponding author
    1. Senior Lecturer, School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
      Alexandra McCarthy, School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia. Email: al.mccarthy@qut.edu.au
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  • Peta S Cook BPhoto BSocSc(Hons) PhD,

    1. Lecturer, School of Sociology and Social Work, University of Tasmania, Launceston, Tasmania, Australia
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  • Carrie Fairweather RN BNsg(Hons) PhD(Candidate),

    1. Deputy Head, School of Nursing and Midwifery El Ain Campus, Faculty of Health, Griffith University, El Ain, United Arab Emirates
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  • Ramon Shaban RN EMT-P PhD(Candidate),

    1. Lecturer, Griffith University Research Centre for Clinical and Community Practice Innovation and the Princess Alexandra Hospital, Brisbane, Australia
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  • Kristine Martin-McDonald RN MEd PhD

    1. Head, School of Nursing, Victoria University, Melbourne, Victoria, Australia
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Alexandra McCarthy, School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia. Email: al.mccarthy@qut.edu.au

Abstract

End-stage renal failure is a life-threatening condition, often treated with home-based peritoneal dialysis (PD). PD is a demanding regimen, and the patients who practise it must make numerous lifestyle changes and learn complicated biomedical techniques. In our experience, the renal nurses who provide most PD education frequently express concerns that patient compliance with their teaching is poor. These concerns are mirrored in the renal literature. It has been argued that the perceived failure of health professionals to improve compliance rates with PD regimens is because ‘compliance’ itself has never been adequately conceptualized or defined; thus, it is difficult to operationalize and quantify. This paper examines how a group of Australian renal nurses construct patient compliance with PD therapy. These empirical data illuminate how PD compliance operates in one practice setting; how it is characterized by multiple and often competing energies; and how ultimately it might be pointless to try to tame ‘compliance’ through rigid definitions and measurement, or to rigidly enforce it in PD patients. The energies involved are too fractious and might be better spent, as many of the more experienced nurses in this study argue, in augmenting the energies that do work well together to improve patient outcomes.

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