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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.
 

Roberta Braun Curtin, PhD, RN, Research Director of the Medical Education Institute, Madison, WI; and serves as a research consultant for the Life Options Rehabilitation Program.

H. Keith Johnson, MD, is in private practice with Renal Consultants, P.C., Nashville, TN; and serves as Chairman of the Board of Dialysis Clinic, Inc.

Dorian Schatell, MS,is Executive Director at the Medical Education Institute, Madison, WI; and Program Director of the Life Options Rehabilitation Program.

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