Experiencing "the gift of life" : holistic contribution of health education and counselling in end-stage renal disease

Abstract

This qualitative study explores the contribution of health education and counselling toward rehabilitation and quality of life among end-stage renal disease (ESRD) patients who have undergone living related kidney transplantation in Malaysia. Biopsychosocial (BPS) model of health is used as theoretical framework to clarify the variables of this study, and a road-map for data analysis. To give direction of the study, conceptual framework is developed based on the understanding of the relationship and problems of ESRD and its treatment. A total of thirty-two semi-structured interview questions reflecting the five research questions were formulated to use in face-to-face in-depth interview among the three kidney transplant recipients after informed consents were obtained. The three respective kidney donors consented to be interviewed separately for data triangulation. Hospital checklists on health education and counselling to be given by the health care professionals to kidney recipient and donor were collected for partial data verification. Content analysis was used as analytic technique to process and interpret data for the three study participants. Findings in this study yielded six themes that contribute to the rehabilitation and quality of life among kidney transplant recipients. They are family and societal support, health education and counselling, peer group information, socio-cultural values, spiritual belief, and freedom of life. Of the six themes: freedom of life, spiritual belief, and peer group information were found to be the new themes from this study. This study supported the adoption of BPS model of health in the holistic care of ESRD patients keeping in mind of the additional consideration of the spiritual dimension. As the findings revealed in this study, the initial conceptual framework was also revised.