Illness representations and coping processes of Taiwanese patients with early-stage chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) is a public health problem worldwide with an increasing incidence and prevalence and high cost. The role of illness perceptions in understanding health-related behavior has received little attention in patients with early-stage CKD. PURPOSE: This qualitative study aimed to describe the illness representation and coping process experience of patients with early-stage CKD in Taiwan. METHODS: A qualitative content analysis approach was used to analyze semistructured, open-ended, one-on-one interviews with 15 patients with early-stage CKD. Purposive sampling was used to recruit patients diagnosed with early-stage CKD from the nephrology departments of two medical centers in Taiwan. Trustworthiness of the study was evaluated using four criteria suggested by Lincoln and Guba. RESULTS: Six themes emerged from the analysis: experiencing early symptoms, self-interpreting the causes of having CKD, realizing CKD as a long-term disease, believing CKD could be controlled by following doctors' orders, anticipating the consequences of having CKD, and adopting coping strategies to delay the progress of CKD. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Findings from this study compared with previous studies reveal that education can effectively change patient illness representations as an approach to improve coping behavior. This finding offers healthcare professionals insight into the health education necessary to assess patient illness representation to provide culturally sensitive interventions.

[Nurse's experience of using music therapy to relieve acute pain in a post-orthopedic surgery patient].

This article describes the experience of a nurse who used music therapy as the intervention to reduce a patient's pain during wound care after orthopedic surgery. The intervention was applied between April 8th and April 29th 2008. The nurse applied Roy's adaptation model as the assessment tool. The major and primary health problem identified was acute pain accelerated by wound care. The pain of this client not only triggered negative feelings, but also affected negatively on his daily life and feelings of self-belongingness. Through an individual-tailored music therapy, the client's pain during wound care was greatly reduced and even completely disappeared. The ultimate outcome of decrease in pain included reductions in negative feelings and increased positive spiritual strength. It is recommended that nurses who are responsible for wound care use this simple and economical music intervention to reduce acute postoperative pain.