Perceived barriers to management of chronic kidney disease

Abstract

INTRODUCTION: The number of patients with chronic kidney disease (CKD) is gradually increasing in developing countries such as Rwanda. Barriers to the management of CKD from nurses' perspectives is not an area that has been well explored. This study aimed to assess the perceived barriers to CKD management from the perspective of nurses working at the referral hospitals in Rwanda.
METHODS: The study used a cross-sectional research design. The study setting was selected referral hospitals in Kigali. A convenience sample of 55 nurses was obtained and data was collected using a self-administered questionnaire. Analyses were done using descriptive and inferential statistics in the SPSS application.
RESULTS: Respondents identified the most barriers to management of CKD as: limited knowledge of CKD (96%) and its risk factor of glomerulonephritis (93%), limited information of dialysis (98%) and fluid restriction (95%) treatment as well as a lack of further training on nephrology nursing (93%). Shortage of nephrologists and nurses (98%) and a multidisciplinary care team (95%) were resource barriers. Other barriers were limited knowledge of CKD risk factors: hypertension (78%) and HIV/AIDS (80%), limited in-service training (69%), and non-adherence (86%). The experience of respondents was associated with limited knowledge of CKD risk factors: hypertension (P =0.001), diabetes (P=0.001) and HIV/AIDS (P=0.040). The level of nursing obtained by the respondents was associated with a lack of further special training (p=0. 001), limited in-service training (P=0.028) and non-adherence of CKD patients (P=0.017).
CONCLUSION: Barriers to CKD management in Rwanda are evident. There is a need for in-service training for nurses in order to improve the proper treatment of the CKD population.