A formative research as the groundwork for designing evidence-based adherence promotion campaigns for patients on peritoneal dialysis

Abstract

Background: Peritonitis is a leading, fatal complication of bacterial infection with significant health and social consequences to end-stage kidney disease patients on peritoneal dialysis (PD). Adherence to a therapeutic regimen is crucial to prevent peritonitis. Therefore, to develop an evidence-based and patient-centered communication campaign to improve patients' adherence, a formative research is essential to understand patients' beliefs.

Objective: The authors used the health belief model (HBM) as the framework to examine Hong Kong PD patients' risk perception of peritonitis and the factors that accounted for their adherence to the therapeutic regimen.

Method: Thirty-four PD patients in Hong Kong participated in focus group discussions to investigate patients' perceived susceptibility and severity of peritonitis, perceived barriers and benefits associated with adherence, their self-efficacy to perform PD-related regimens, their motivational cues to adhere, and potential persuasive strategy and communication channels for adherence promotion.

Results: The findings revealed that perceived susceptibility varied across patients' peritonitis experience, and that they perceived peritonitis to be associated with physical, psychological, and social consequences. Patients considered maintaining their independence and minimizing their sense of guilt as the benefits of adherence. Perceived barriers to adherence included social activities and work, treatment expenses, fatigue, and environmental constraints. Since adaptation to PD treatment and imitation of other patients' practices appeared to influence patients' self-efficacy, narrative communication was identified as a potential persuasive strategy for guiding the development of campaign messages.

Conclusion: The HBM-guided formative research has provided useful insights into designing evidence-based adherence communication campaigns.

Keywords:

• Behavior change communication
• End-stage renal disease
• Focus groups
• Health belief model
• Health communication
• Patient adherence
• Peritoneal dialysis
• Persuasive communication

Disclaimer statements

Contributors Dr Fung led the study, research design, data collection, analysis, and manuscript writing. Dr Lee assisted data collection and review of the manuscript. Dr Lam contributed to obtain the ethics approval and data collection. All authors contributed to interpretation of findings.

Funding This study was supported by faculty research grant from Hong Kong Baptist University.

Conflict of interest None

Ethics approval The study was approved by the institutional review boards of Hong Kong Baptist University and Hospital Authority Hong Kong

ORCID

Timothy K. F. Fung http://orcid.org/0000-0003-2710-0282

Additional information

Notes on contributors

Timothy K. F. Fung

Author information

Timothy K. F. Fung is an Assistant Professor in the Department of Communication Studies at Hong Kong Baptist University. He received his doctoral degree in mass communications from the University of Wisconsin-Madison in 2010. He is interested in how health issues are represented in the media and how people process health messages. His work is published in Journal of Health Communication, and Mass Communication & Society.

Kelvin K. W. Lee

Kelvin K. W. Lee is a senior lecturer in the Academy of Film at Hong Kong Baptist University. He received his doctoral degree in computer science from the University of Hong Kong. His area of interest is using animation for health communication and promotion.

Man Fai Lam

Man Fai Lam, M.D. is a specialist in nephrology and honorary clinical assistant professor in the Faculty of Medicine at the University of Hong Kong. He is a fellow of Royal College of Physicians of Edinburgh, Hong Kong Academy of Medicine (FHKAM), and Hong Kong College of Physicians (FHKCP).