Prevention of recurrent urinary stones: insights on diet management from patients' and healthcare professionals' perspectives for nursing care planning [EMBARGOED]

Abstract

Dietary modifications have been acknowledged as one of the most effective methods in preventing the recurrence of urinary stone. However, knowledge is sparse regarding the experiences of patients in self-managing their diet and the role of healthcare professionals (HCPs) in providing efficient dietary care to this segment of the population. Objectives: This study explored the experiences of both patients and HCPs in dietary management for the prevention of urinary stone recurrence in Malaysia. Methodology: By deploying the interpretive qualitative method and the constructivist paradigm, the Social Cognitive Theory (SCT) was used to examine the experiences of both participant groups. After conducting the purposive sampling technique, 41 participants were selected to carry out face-to-face semi-structured interview sessions. The participants, who comprised of 20 patients diagnosed with urinary stone disease and 21 HCPs from diverse professional backgrounds (i.e., urologists, doctors, nurses, dietitian, and medical assistants) in a primary care team, were recruited from a tertiary general hospital located in Kuantan, Malaysia. The framework analysis was used for data analyses in this study. Results: Experiences captured from the patients were narrowed to three main themes. Theme one describes the determinants in view of the participants regarding their dietary transition (initiating the behavioural changes). Theme two explains the ways the participants adhered to dietary recommendations (dealing with behavioural adherence). Theme three delineates the struggles faced by the participants in maintaining dietary compliance (sustaining motivation). The findings derived from the HCPs also were categorised into three primary themes. Theme one highlights factors that influenced the integration of dietary advice in patients’ care plans by HCPs. Theme two sheds light on the channels used by HCPs in providing dietary advice to patients. Theme three explores factors that influenced the efficacy of dietary. Conclusion: The study uncovers multifaceted challenges in dietary management for urinary stone prevention. This including misconceptions and knowledge gaps concerning stone diet, overlooked psychological factors, compliance and motivation difficulties, a lack of multidisciplinary support, and insufficient informational resources concerning diet related to urinary stone recurrence prevention management in both patients and HCPs. Key issues hightlighted in this study showed the complexities of dietary management in urinary stone disease, prompting the need for more comprehensive approaches in education, health policy or dietary guideline support and practice for dietary care provision that involve both patients and HCPs.