Justin Oveyssi1, Karine E Manera2,3, Amanda Baumgart2,3, Yeoungjee Cho4,5,6, Derek Forfang7, Anjali Saxena8, Jonathan C Craig2,3,9, Samuel Ks Fung10, David Harris11, David W Johnson4,5,6, Peter G Kerr12, Achilles Lee13, Lorena Ruiz14, Matthew Tong15, Angela Yee-Moon Wang16, Terence Yip17, Allison Tong2,3, Jenny I Shen14,18. 1. St. Mary's Medical Center, Long Beach, CA, USA. 2. Sydney School of Public Health, 4334The University of Sydney, New South Wales, Australia. 3. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. 4. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia. 5. Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia. 6. Australasian Kidney Trials Network at the University of Queensland, Brisbane, Australia. 7. National Forum of ESRD Networks, San Pablo, CA, USA. 8. Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. 9. College of Medicine and Public Health, Flinders University, Adelaide, Australia. 10. Division of Nephrology, Department of Medicine and Geriatrics, Jockey Club Nephrology and Urology Centre, Princess Margaret Hospital, Kowloon, Hong Kong, China. 11. Sydney Medical School, 4334The University of Sydney, Australia. 12. Department of Nephrology, Monash Health, Victoria, Australia. 13. Department of Medicine and Geriatrics, 36658Tuen Mun Hospital, Hong Kong, China. 14. Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA. 15. Department of Medicine and Geriatrics, 260246Pok Oi Hospital, Yuen Long, Hong Kong, China. 16. Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China. 17. Department of Medicine, Tung Wah Hospital, Hong Kong, China. 18. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Abstract
BACKGROUND: Peritoneal dialysis (PD) can offer patients more autonomy and flexibility compared with in-center hemodialysis (HD). However, burnout - defined as mental, emotional, or physical exhaustion that leads to thoughts of discontinuing PD - is associated with an increased risk of transfer to HD. We aimed to describe the perspectives of burnout among patients on PD and their caregivers. METHODS: In this focus group study, 81 patients and 45 caregivers participated in 14 focus groups from 9 dialysis units in Australia, Hong Kong, and the United States. Transcripts were analyzed thematically. RESULTS: We identified two themes. Suffering an unrelenting responsibility contributed to burnout, as patients and caregivers felt overwhelmed by the daily regimen, perceived their life to be coming to a halt, tolerated the PD regimen for survival, and had to bear the burden and uncertainty of what to expect from PD alone. Adapting and building resilience against burnout encompassed establishing a new normal, drawing inspiration and support from family, relying on faith and hope for motivation, and finding meaning in other activities. CONCLUSIONS: For patients on PD and their caregivers, burnout was intensified by perceiving PD as an unrelenting, isolating responsibility that they had no choice but to endure, even if it held them back from doing other activities in life. More emphasis on developing strategies to adapt and build resilience could prevent or minimize burnout.
BACKGROUND: Peritoneal dialysis (PD) can offer patients more autonomy and flexibility compared with in-center hemodialysis (HD). However, burnout - defined as mental, emotional, or physical exhaustion that leads to thoughts of discontinuing PD - is associated with an increased risk of transfer to HD. We aimed to describe the perspectives of burnout among patients on PD and their caregivers. METHODS: In this focus group study, 81 patients and 45 caregivers participated in 14 focus groups from 9 dialysis units in Australia, Hong Kong, and the United States. Transcripts were analyzed thematically. RESULTS: We identified two themes. Suffering an unrelenting responsibility contributed to burnout, as patients and caregivers felt overwhelmed by the daily regimen, perceived their life to be coming to a halt, tolerated the PD regimen for survival, and had to bear the burden and uncertainty of what to expect from PD alone. Adapting and building resilience against burnout encompassed establishing a new normal, drawing inspiration and support from family, relying on faith and hope for motivation, and finding meaning in other activities. CONCLUSIONS: For patients on PD and their caregivers, burnout was intensified by perceiving PD as an unrelenting, isolating responsibility that they had no choice but to endure, even if it held them back from doing other activities in life. More emphasis on developing strategies to adapt and build resilience could prevent or minimize burnout.
Authors: Lindsey A Jones; Elisa J Gordon; Timothy P Hogan; Cindi A Fiandaca; Bridget M Smith; Kevin T Stroupe; Michael J Fischer Journal: Kidney360 Date: 2021-09-22
Authors: Aminu K Bello; Ikechi G Okpechi; Mohamed A Osman; Yeoungjee Cho; Brett Cullis; Htay Htay; Vivekanand Jha; Muhammad A Makusidi; Mignon McCulloch; Nikhil Shah; Marina Wainstein; David W Johnson Journal: Nat Rev Nephrol Date: 2022-09-16 Impact factor: 42.439