A phenomenological study to explore patient experience of fluid and dietary restrictions imposed by hemodialysis

Background: Noncompliance with fluid restrictions and diet is a major problem among hemodialysis patients. This can lead to fluid overload in the interdialytic phase and the accumulation of metabolic waste. This study aims to explore the life experience of patients undergoing hemodialysis and their compliance with fluid restrictions and diet. Method: The design of this study was qualitative with a phenomenological approach. It involved 15 patients undergoing hemodialysis interviewed using semistructured interview guidelines. The data were collected and then transcribed and analyzed using the Van Mannen method. The coding analysis used Nvivo 12 software. Results: Patients ranged from 24 to 64 years old. More than half of the patients were not compliant with the fluid restrictions based on the IDWG score (60%, n=15). Five themes emerged: fluid restrictions and understanding related to diet (health education, fluid and diet restriction, information provider, and experience), personal motivation (activity, side effects, need, and lack of motivation), social support (family), compliance (motivation and attitude), and disease management (management of fluid and diet restriction). Conclusion: Hemodialysis patients expressed a number of concerns that caused them not to comply with diet and fluid restrictions. Several issues identified were patient-related and potentially modifiable using the correct information or health education related to diet and fluid restriction. Nurses should be more aware of identifying these problems to address compliance issues. Future research should aim to understand nurses’ perceptions and practices that may guide interventions to resolve this urgent compliance issue.