Middle-range theory of the existential dimension of being-in-the-world of chronic kidney disease: Grounded Theory.
Carolina Giordani da Silva, Maria da Graça Oliveira Crossetti, Maravilla Giménez Fernández and 1 others
PMID 39319965WHAT IT FOUND
Patients on dialysis or transplant described fear, sadness, hopelessness, anger, and loss of autonomy; nurses' presence, concern, and empathy were framed as helping acceptance and coping.
Key findings
01Patients with chronic kidney disease receiving renal replacement therapy described fear, sadness, hopelessness, anger, mourning, and suffering linked to loss of autonomy and living close to death.
02The proposed nursing theory frames nurses' presence, concern, and empathy as ways to help patients accept chronic kidney disease and find coping strategies.
03The care environment was framed as a living space built through relationships and time, not just physical space.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 7 nurses, 3 nursing technicians, and 10 patients from one nephrology service in Brazil were included, so the theory may not fit other settings. Participants were selected by convenience and theoretical sampling, not by random or representative sampling. The study developed a theory from interviews and coding; it did not test the theory or its assumptions against patient outcomes. The authors state that the design does not support external validity.
The easy way to misread this
Do not read this as evidence that the proposed theory improves adherence, coping, or quality of life. It was built from interviews with 7 nurses, 3 nursing technicians, and 10 patients, and its assumptions are not tested empirically.