Discussion Summary: Challenges in Renal Disease Self-Management

This report provides a comprehensive summary of challenges in self-management for patients with renal diseases, drawing from multiple online discussion posts. The report identifies key barriers such as short durations of self-management education, lack of health literacy, challenges related to hyperkalemia management, cost of care, and communication difficulties. It then proposes evidence-based strategies to overcome these barriers, including enhanced patient education through various methods like smartphone-based teaching and teach-back methods, improved health literacy through staff training and accessible healthcare, incorporation of motivational interviewing, government subsidies for medication, and utilization of mobile health trucks and telehealth facilities. The report also addresses language barriers by suggesting the use of translation technology and language-appropriate materials, ultimately aiming to improve patient outcomes through effective self-management practices.

Running head: DISCUSSION SUMMARY
Discussion summary
Name of the student:
Name of the university:
Author note:

1DISCUSSION SUMMARY
Introduction:
Renal diseases are is one of the most commonly discovered chronic health adversities
which involves a number of concerns that are associated with not just pharmacological care
but also demands considerable self-management activities (Kramer et al. 2018). It causes
gradual loss of function of the kidney of the patient, hence, there is need for acute self-care or
self-management that emerge for such patients due to the lack of the kidneys being able to
complete their daily functionality. This summary essay will attempt to discuss the challenges
identified by three online discussion posts and suggest strategies to overcome the barriers.
Discussion of challenges and strategies to overcome:
With respect to the appendix 1, it discussed the fact that the challenges in the self-
management priorities and along with that, the self-management education plans given to the
patients with kidney damage has considerable barriers. The extremely short duration of the
self-management education and training is the main contributing factor for the challenges in
patients or their family carers not clearly understanding the need for lifestyle modifications,
dietary habits and fitness regime. The discussion post provided the strategy of offering
steering promotion platforms to the suitable target group, although there are other possible
strategies as well (Reid et al. 2011). Enhancing the duration of the clinical interaction
between the patients and their care providers during patient educational session or discharge
planning with smartphone based teaching can be effective (Hayashi et al. 2017). Another
strategy, as discussed by Dinh et al. (2016), is the teach back method, which will encompass
asking the patients or their family members to repeat back the content of the education plan
which will ensure clear demarcation of whether the patients have understood it completely.
As per the appendix 2, the lack of health literacy among the populace, especially those
belonging to the lower socio-economic gradient, has limited access to health care and health

2DISCUSSION SUMMARY
promotion, and I completely agree with the school of thought. In order for the self-
management planning and training to work effectively for the patients in consideration, it is
very important for the target group to at least have a basic idea of preventative or health
promotional behaviours (Joboshi and Oka 2017). Along with that, the discussion post of
appendix 2 has also mentioned that the hyperkalaemia is a health concern which is not given
enough prioritization in the health promotional planning. Both of these factors act
cumulatively against proper self-management activities being integrated in the patents with
hyperkalaemia or kidney disorders (Fried, Kovesdy and Palmer 2017). First and foremost
strategy is adequate training of the health care staff on the importance of hyperkalaemia to
improve health literacy of the populace. It is crucial for the local and global health authorities
to focus on enhancing the accessibility of health care as well to ensure better accessibility,
better literacy and better self-management of the diseases (Kazawa et al. 2015).
With respect to the discussion post appendix 3, the small set patient centred
conferences based on self-care activities around the home care based self-management can be
difficult. The collective decision making, the effective and impartial participation from both
the patient nd the collaborating care providers is important which is often not taken into
consideration which impacts their self-management abilities as well. In this case, a very
important strategy that can be incorporated in this context is incorporating different
motivational interviewing and collective decision making that encourage self-care modalities
(Crown and Vogel 2017).
As discussed in the appendix 4, Cinacalcet being withdrawn from the pharmaceutical
benefit scheme has enhanced the cost of care for the patients immensely. Which has led to
reluctance to continuing the medication or taking the alternative surgical option which is
associated with greater risks. There is need for local and national government action on
making the medicine subsidized on the basis of demand supply statistics, although the there

3DISCUSSION SUMMARY
are other strategies that can be taken as well, along with more cost-effective management of
the disease is mandate. There is need for more emphasis of the care services to encourage the
patients to engage in non-pharmacological self-management activities such as controlled
water intake as per the discussion post (Burnier et al. 2014). As discussed by Kramer et al.
(2018), other potassium lowering therapies can be also considered in management of
hyperkalaemia. Dietary modification that limit the daily intake of potassium has also been
proven as a considerably important strategy for hyperkalaemia self-management (Clark-
Cutaia 2018).
Appendix 5 discusses the impact of communication and transport related difficulties
in accessing the care facilities and self-management of the renal disorders of the patients. The
transportation barrier acts like considerable restriction for the health care staff to carry out
community education due to the lack of resources availability and the complication in
reaching the patient populations, which affects the patient population residing in remote and
rural areas. One very important strategy as discussed in the post with respect to Shahady
(2006) can be the incorporation of mobile health trucks in the patient education and self-
management training facilities along with community education as per the discussion post.
Although, the aid of tele-health facilities can also be taken to improve the health literacy of
remote patient populations (Toh, Pawlovich and Grzybowski 2016).
Appendix 6 discusses a very important aspect associated with self-management of
chronic diseases, which is the language barrier. Summarizing the discussion post, it has to be
mentioned that for the Australian migrant population the language barrier restricts the
effective communication between the patients and the care providers. I would like to add that
this challenge is also pertinent for the first people of Australia, where the cultural
appropriateness and language barrier is a very important challenge for implementing health
literacy and self-management. In this case, the strategy discussed in the post had been taking

4DISCUSSION SUMMARY
the aid of advanced technology in the mobile phones and Google translator (Jungner et al.
2018). Along with that, taking the assistance of technology to develop language appropriate
instruction pamphlets can also prove to be beneficial (Hawley and Morris, 2017).
Reflection and conclusion:
On a concluding note, I would like to mention that this had been an extremely
beneficial experience for me which has not only helped me identify the challenges
predominating the lack of adequate self-management for patients with renal disorders; but
this exercise has also helped me evaluate the analyse the challenges, link them with my own
best understanding of the scenario and suggest evidence based strategies that can be easily
implemented in practice to overcome these barriers. I sincerely hope that the knowledge and
expertise gained from this activity will help me implement safe and effective evidence based
practice in future.

5DISCUSSION SUMMARY
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6DISCUSSION SUMMARY
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