Living with End-State Renal Disease

The current ANS featured article is titled “Existential Contradictions in
Living With End-Stage Renal Disease: A Qualitative Metasynthesis” authored by Ingrid Villadsen Kristensen, MScN; Jette Henriksen, PhD, MScN;
Regner Birkelund, PhD, Dr Phil, MScN; Annelise Norlyk, PhD, MScN. Here is a message the Ms. Kristensen sent about this work!

This article presents a study, which is a part of a phd study, that encompasses the entity of investigating the existential experiences of living with end-stage renal disease and undergoing a kidney transplantation with a living donor.

The title of the phd dissertation is “Living with ambivalence while facing the future: The existential experiences of patients living with end-stage renal disease before and after a kidney transplantation with a living donor”. Besides the qualitative metasynthesis, the phd study includes two empirical studies conducted in the tradition of Ricoeur’s theory of narration and interpretation. The dissertation has been accepted for defense by the Faculty of Health at Aarhus University, Denmark, and defended May 27, 2020.

My supervisors during my phd studies are co-authors in this article: Main supervisor Annelise Norlyk, RN, Associate professor, Study Director, PhD, MScN, Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University; Co-supervisor Regner Birkelund, RN, Professor, PhD, dr. Phil, MScN, Lillebaelt Hospital, Vejle & Institute of Regional Health Research, University of Southern Denmark and Co-supervisor Jette Henriksen, RN, Senior lecturer, PhD, MScN, VIA Nursing, VIA University College.

The qualitative metasynthesis conducted in this article follows parts of ‘Handbook for Synthesizing Qualitative Research’, where qualitative metasynthesis is amplified by two American nursing researchers, Margarete Sandelowski & Julie Barroso. Living with end-stage renal disease is anchored in complexity, and to reach profound knowledge concerning the experiences of living with end-stage renal disease, we conducted this qualitative metasynthesis.

Kidney transplantation is a well-established treatment for end-stage renal disease. Simultaneously, kidney transplantations with a living donor are increasing in number. However, patients experience challenging existential aspects concerning kidney transplantation. Furthermore, some patients have the possibility to undergo transplantation with a living donor, while others may have to wait for a deceased donor for several years. As not all patients living with end-stage renal disease are eligible for a kidney transplantation, some patients will be in need of dialysis. This qualitative metasynthesis following Sandelowski and Barroso’s method, therefore investigates the existential experiences of living with end-stage renal diasease.

The key findings of the study show that living with end-stage renal disease challenges patients existentially; as the lives of patients consist of existential contradictions characterized by different types of oscillations. ‘Oscillation’ symbolises moving back and forth without getting anywhere, passing from one condition to another. Hereby, being in a state of oscillation is challenging for patients, and it highlights the existential characteristics of living with end-stage renal disease:

The findings in the qualitative metasynthesis show that technology plays a major part in the lives of patients living with end-stage renal disease. Time is an important issue. Besides, we found that dialysis treatment is an uncertain condition and a long-lasting reminder that life is time-limited. The metasynthesis contributes with new knowledge about how these oscillations are experienced by patients, and illustrates the need to move beyond providing only treatment by prioritizing the existential dimensions experienced by patients.