Please download and print the PDF file below:

Rebecca L. Amato, BSN, RN,

Rebecca L. Amato, BSN, RN, works for DaVita as the Area Clinical Educator and Quality Manager in the Washington state area. She is a past president of her ANNA Greater Puget Sound Chapter 503, and currently volunteers with the chapter coordinating vendor sponsorship for educational events. Rebecca has also acted as the chair of the Corporate/Government Special Interest Group of ANNA. Rebecca sat on the AAMI Renal Disease and Detoxification board from 1995-2002. She has 21 years in the nephrology field.

This exploratory-descriptive study identifies dimensions of self-management demonstrated by patients with end stage renal disease (ESRD) who have been successfully treated with peritoneal dialysis (PD) for more than 4 years (range = 4.1 to 13.1 years, mean=7.5 years). After IRB review, semi-structured interviews were conducted with 18 individuals, 10 male and 8 female; 11 Caucasian, 6 African-American, and 1 Hispanic. Respondents ranged in age from 33 to 86 years (mean = 54.4 years). Interviews were audio-recorded and verbatim transcriptions were analyzed according to a content analytic procedure, with movement from specific to general. Two broad domains of self-management were identified: autonomy/control in health care and normality in everyday life. Autonomy/control was comprised of three specific dimensions: partnership in care, self-care, and self-care self-efficacy. Normality in everyday life included the dimensions of flexibility/freedom, interpretation of illness severity, and perception of body image. Although the small sample size and methodology limit generalizability, insights into the lived self- management experience on PD were identified. Such insights lay the groundwork for development of interventions to facilitate informed decision-making regarding dialysis modality, to teach tactics for effective self-management on PD, and to help health care professionals to support the self-management efforts of patients on PD.