The Lived Experience of In-Center Hemodialysis Patients Receiving Treatment in DeKalb County PDF
Preview The Lived Experience of In-Center Hemodialysis Patients Receiving Treatment in DeKalb County
Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2017 Te Lived Experience of In-Center Hemodialysis Patients Receiving Treatment in DeKalb County, Georgia Stacey Deniese Cooper Walden University Follow this and additional works at: htps://scholarworks.waldenu.edu/dissertations Part of the African American Studies Commons, and the Public Health Education and Promotion Commons Tis Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact Walden University College of Health Sciences This is to certify that the doctoral dissertation by Stacey Cooper has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Frazier Beatty, Committee Chairperson, Public Health Faculty Dr. Kimberly Dixon-Lawson, Committee Member, Public Health Faculty Dr. Magdeline Aagard, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2017 Abstract The Lived Experience of In-Center Hemodialysis Patients Receiving Treatment in DeKalb County, Georgia by Stacey D. Cooper MBA, Health Care Management, University of Phoenix, 2009 BSN, Albany State University, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2017 Abstract Chronic kidney disease (CKD) is preventable and reversible in the early stages with upstream strategies; however, the number of individuals diagnosed with end-stage renal disease (ESRD) is increasing annually. Although researchers have documented the physiological and psychological stressors associated with hemodialysis (HD), little is known about the effects of in-center HD on the recipients in DeKalb County, Georgia. This study described the experiences of 10 African American HD patients who dialyze in DeKalb County. Using a phenomenological approach, the interviews were transcribed and then analyzed for significant quotes and recurrent themes relevant to receiving HD in DeKalb County. The health belief model was used to identify the perceptions and susceptibilities that formed the lived experiences of the participants. Results showed that 70% of the patients had been diagnosed with hypertension and/or diabetes and that 50% had never heard of ESRD prior to diagnosis. All 10 patients reported never knowing that hypertension and/or diabetes was a major cause of ESRD. The study sought to find common themes related to the perceived threat of ESRD by the participants. This study can be used to implement positive social change by instituting upstream strategies to decrease the prevalence of ESRD or slow the progression of CKD in this population, heightening awareness of this disease in minority communities, and implementing a sustainable health behavior plan to decrease the prevalence of the disease. The Lived Experience of In-Center Hemodialysis Patients Receiving Treatment in DeKalb County, Georgia by Stacey D. Cooper MBA, Health Care Management, University of Phoenix, 2009 BSN, Albany State University, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2017 Acknowledgments I would like to take this opportunity to thank Julia Taylor, regional operations director at Davita, for providing the avenue for me to complete this project. Without her okay, this might not have been possible. I will be forever grateful for your generosity and optimism. Carolyn Mitchell and Tamika Etienne, thank you for your support and allowing me into your facilities to speak to the patients that your care for and protect every day. I would like to thank my family (Diamond, Emerald, and Melvin) for allowing me to finish this project while I missed family time and put you on the back burner. I appreciate your relentless patience during this critical time. I know that it has not been easy. I would like to thank my parents, Larice and Aniese Cooper, for being my biggest cheerleaders. Also, I thank my brother, Gary, and my sister, Shawnta, for always encouraging me to continue to move forward. Table of Contents List of Tables ..................................................................................................................... iv Chapter 1: Introduction to the Study ....................................................................................1 Statement of the Problem ...............................................................................................8 Research Questions ......................................................................................................10 Purpose of the Study ....................................................................................................10 Theoretical Framework ................................................................................................11 Nature of the Study ......................................................................................................12 Operational Definitions ................................................................................................12 Assumptions, Limitations, Scope, and Delimitations ..................................................14 Significance of the Study .............................................................................................14 Summary ......................................................................................................................15 Chapter 2: Review of the Literature ...................................................................................17 Introduction ..................................................................................................................17 Research Strategy.........................................................................................................19 Review of Literature ....................................................................................................20 Primary Care ......................................................................................................... 21 Racial Disparities in Care ..................................................................................... 27 Defining PD and HD ............................................................................................. 30 Conceptualizing PD and HD Experiences ............................................................ 34 Race-Based Variations in Dialysis Experience..................................................... 42 Health Belief Model .............................................................................................. 45 i Summary ......................................................................................................................47 Chapter 3: Research Method ..............................................................................................49 Introduction ..................................................................................................................49 Research Design...........................................................................................................49 Role of the Researcher .................................................................................................50 Research Methodology ................................................................................................51 Participants ............................................................................................................ 51 Measures ............................................................................................................... 52 Ethical Protection of Participants.......................................................................... 53 Procedures ....................................................................................................................54 Data Collection ............................................................................................................55 Expert Panel .................................................................................................................57 Data Analysis ...............................................................................................................58 Verification of Findings ...............................................................................................58 Summary ......................................................................................................................60 Chapter 4: Results ..............................................................................................................61 Introduction ..................................................................................................................61 Recruitment of Participants..........................................................................................61 Data Analysis ...............................................................................................................63 Validity ................................................................................................................. 67 Demographic Characteristics ................................................................................ 68 Qualitative Data Analysis ............................................................................................68 ii Theme 1: Lifestyle Changes ................................................................................. 69 Theme 2: Lack of Education ................................................................................. 73 Summary ......................................................................................................................79 Chapter 5: Discussion, Conclusion, and Recommendations .............................................80 Introduction ..................................................................................................................80 Interpretation of the Findings.......................................................................................81 Theme 1: Lifestyle Changes ................................................................................. 82 Theme 2: Lack of Education ................................................................................. 85 Theoretical Considerations ..........................................................................................90 Implications for Social Change ....................................................................................91 Recommendations ........................................................................................................92 Reflections on the Research Experience ......................................................................94 Conclusion ...................................................................................................................95 References ..........................................................................................................................97 Appendix A: The Kidneys ...............................................................................................107 Appendix B: Peritoneal Dialysis Solution Infusion .........................................................108 Appendix C: Needle Placement for Hemodialysis ..........................................................109 Appendix D: Protocols for Interview Questions ..............................................................110 iii List of Tables Table 1. Demographic Information of the Participants .................................................... 65 iv
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