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Identifying barriers and enablers in the dietary management of chronic kidney disease using the PEN-3 cultural model

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Morris, A., Biggerstaff, Deborah, Krishnan, N. and Lycett, D. (2018) Identifying barriers and enablers in the dietary management of chronic kidney disease using the PEN-3 cultural model. In: 2017 BDA Research Symposium, Birmingham, UK, 6 Dec 2017. Published in: Journal of Human Nutrition and Dietetics, 31 (1). pp. 11-12. ISSN 0952-3871. doi:10.1111/jhn.12534

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Official URL: http://doi.org/10.1111/jhn.12534

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Abstract

Background

Non-compliance with renal dietary restrictions increases morbidity and mortality (1) and has been attributed to an individual's poor motivation to change behaviour. (2) However the social and cultural environment within which people follow this dietetic advice is not well understood (3). The aim of this research was to identify the social and cultural barriers to self-management of a renal diet to better understand renal dietary compliance in chronic kidney disease (CKD).

Method

Participants underwent individual semi-structured interviews. Interviews explored the barriers and enablers to following dietary advice and lasted between 38–94 minutes. All were recorded and transcribed verbatim. Data was explored until saturation and findings interpreted using the PEN-3 cultural model.(4) This model situates culture at the centre of determinants of health behaviour. It consists of three areas each under the acronym PEN: Person, Extended family, Neighbourhood (cultural Identity domain); Perceptions, Enablers, and Nurturers (relationship and expectation domain); Positive, Existential and Negative (cultural Empowerment domain). Thematic analysis identified emergent themes. UHCW NHS Trust gave ethical approval.

Results

18 adults with CKD stage 5 (12 Caucasian men, 2 Asian men, 2 Asian women and 8 Caucasian women) took part. Themes in the table below reflected ways that society and culture affected adherence to individualised dietary advice. Enablers reflected how participants dealt with these perceived barriers.

Item Type: Conference Item (Paper)
Divisions: Faculty of Medicine > Warwick Medical School > Biomedical Sciences
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: Journal of Human Nutrition and Dietetics
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 0952-3871
Official Date: 9 February 2018
Dates:
DateEvent
9 February 2018Published
Volume: 31
Number: 1
Page Range: pp. 11-12
DOI: 10.1111/jhn.12534
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Conference Paper Type: Paper
Title of Event: 2017 BDA Research Symposium
Type of Event: Conference
Location of Event: Birmingham, UK
Date(s) of Event: 6 Dec 2017
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