Stigma and Medical Professional Support in the Conservative Phase of Chronic Kidney Disease Treatment

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Stigma and Medical Professional Support in the Conservative Phase of Chronic Kidney Disease Treatment

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Co-author 1

Saori Kuroda pcrgt497@gmail.com Kaishokai Medical Corporation, Shizuoka Division shizuoka Japan *

Co-author 2

Nana Suzuki skuroda@kaishou. Kaishokai Medical Corporation Shizuoka Kyoritsu Clinic shizuoka Japan -

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Introduction

This study examined the stigma experienced by patients with chronic kidney disease (CKD) and the ideal support provided by healthcare professionals. Approval was obtained from the Ethics Committee of the Kaishokai Medical Association (24015_01SH).

Methods

The study subjects were patients undergoing dialysis. They were asked to reflect on the support provided by healthcare professionals and their feelings during conservative treatment visits. A questionnaire was administered using Google Forms. The survey consisted of five questions about patient information, seven questions about actual treatment support, five questions about perceptions of treatment life, and four questions about the image of words. The survey questions addressed the perceptions of the support provided during the conservative treatment phase and a sense of control over the treatment. The analysis was performed using chi-square tests or Fisher’s exact tests, with a significance level of p<0.05.

Results

Thirty patients responded. The patients had been on dialysis for 5 to less than 15 years (36.7%), and the most common underlying disease was diabetic nephropathy (34.5%). Almost all the patients had received nutritional guidance. In terms of the perception of support, support materials (p<0.05) and healthcare provider encouragement (p<0.01) tended to lead to more positive perceptions. Patients who felt less in control of their treatment tended to have more unpleasant impressions of the commonly used terms in treatment support (dialysis prevention and lifestyle-related diseases) (p<0.05). The attitude of healthcare providers who indicated a favorable perception of support and a sense of control over the treatment was that the treatment was focused on protecting the kidneys rather than on dialysis prevention (p<0.05).

Conclusion

In patients with conservative CKD, “stigma” is not only a common term but also has the potential to be internalized through the attitudes and self-perceptions of those around them. Therefore, “stigma” is thought to affect patients’ acceptance of their disease and their sense of control over the treatment. Providing consistent information using support materials likely leads to a sense of fulfillment in patients receiving support. Meanwhile, patients perceived both “encouragement” and “blame” through healthcare provider support. Furthermore, encouragement that focused on preventing the progression of symptoms rather than avoiding dialysis prevention treatment was more effective. However, some patients felt encouraged and blamed by medical professionals’ support. The effectiveness of support varies depending on the timing, expression, and relationship of the medical professionals with the patients. Medical professionals are believed to contribute to reducing stigma by providing individualized interventions that enable them to support patients in their recovery.The results suggest that the stigma experienced by patients with chronic kidney disease (CKD) is easily internalized. Furthermore, not only verbal stigma, but also the perception of support and a sense of control over treatment had an impact.

Kewords