Behavioural research in patients with end-stage renal disease: A review and research agenda

Abstract 

Objective

To suggest a behavioural research agenda for patients with end-stage renal disease (ESRD) based on a concise review of seven stages of psychosocial research, a literature review, and current behavioural research in other chronic somatic diseases.

Methods

Historical behavioural ESRD research was classified. The specialized register of the Cochrane Behavioral Medicine Field was also checked, and additional papers were selected by screening reference lists and related behavioural science journals, to identify promising areas for future research.

Results

The top-five topics identified via the literature search pertain to (1) psychological aspects and interventions, (2) adaptation, coping, and depression, (3) exercise, (4) counseling and education, and (5) compliance. ‘Illness and treatment beliefs’, ‘sexuality’, ‘suicide’, ‘family support’, and ‘self-management interventions’, were identified on the basis of research in other chronic illnesses as topics for future research. Regarding theory, the Common-Sense Model (CSM) was judged to offer useful theoretical perspectives; regarding methods, qualitative methods can be a valuable addition to quantitative research methods.

Conclusion

Illness beliefs, treatment beliefs, and self-management behaviours are promising concepts in the assessment and clinical care of ESRD-patients. Cognitive–behavioural treatments appear to have potential and should be specified and elaborated for specific categories and problems of ESRD-patients.

Practice Implications

This research agenda is in line with moves towards patient-centred disease-management to improve the quality of medical care for ESRD-patients.

Keywords: End-stage renal disease, Review, Research agenda, Psychosocial research, Evidence-based behavioural medicine, Disease-management