word chronic due to emotional distress.
Alternatively, the correct diagnosis
and prognosis may have taken
some time to determine. Therefore,
the information about the chronic
nature of an individual’s disease may
not have been available on initial visits.
While some participants would
have preferred more information
about their diagnosis, others
described a reluctance to accept the
diagnosis related to the absence of
symptoms. This marked divergence
in perception is important and points
to the need for individualized assessments
to determine readiness to
learn about the diagnosis and treatment
implications. As well, ongoing
evaluation of the clients’ understanding
of the nature of the illness and
treatment requirements may present
an opportunity to provide information
and clarify misconceptions.
Again, a collaborative approach
between those with early CKD and
health care providers is urgently
needed to meet the multifaceted
aspects of CKD. Such an approach
would allow for individualized plan
of care and support people with
early CKD as they develop their selfmanagement
skills. It would also
provide opportunities for education,
particularly around factors known to
slow CKD progression such as
hypertension.
As was seen in this study in CKD,
previous researchers have described
the need for more disease-specific
information for people with other
chronic illnesses. For example,
Rogers, Kennedy, Nelson, and
Robinson (2005) interviewed people
diagnosed with inflammatory bowel
disease (IBD) and found participants’
concerns regarding disease
prognosis, medications, side effects,
and diet were not addressed. Koch,
Jenkin, and Kralik (2004) conducted
a qualitative study with people with
asthma and discovered the importance
of framing disease-related
information within the context of
participants’ lives given the chronic
nature of the illness. We observed
similar problems in the CKD population.
Participants were