Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form


Clark, Maya (2012) EXPERIENCE OF MANAGING ESRD DIETARY MODIFICATIONS. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

Primary Text

Download (584kB) | Preview


Aims: The purpose of this mixed-methods study is to explore the impact of participant characteristics on dietary patterns, adherence, perceived problems, and self-efficacy; identify characteristics of hemodialysis patients most likely to experience difficulty adhering to restrictions; and to explore perceived dietary related barriers experienced in this patient population.

Methods: A secondary analysis using data of 122 participants from an ongoing randomized clinical trial examining the effects of a technology supported behavioral intervention on dietary sodium intake in hemodialysis patients was performed. Semi-structured interviews were conducted on a subset of 30 participants to complete the qualitative analysis.

Results: Younger participants were more likely to report problems managing the hemodialysis diet and low self-efficacy for restricting sodium intake. Consistent with these findings, younger participants had a higher median sodium intake and average daily weight gain. Females reported more problems managing the diet. Race and perceived income adequacy did not appear to influence outcome measures. Barriers included time and convenience, cost, and content of nutritional counseling. Participants were satisfied with efforts made by dialysis center staff to disseminate information.

Conclusions: Our findings suggest that there may not be a need to customize interventions in regard to race or income adequacy. There may, however, be a need to customize counseling and interventions for younger adults and females. Further investigation is needed to understand the independent effects of age and gender on variations in hemodialysis dietary recommendations and problems and self-efficacy. Additionally, while participants were satisfied with nutritional counseling efforts, interventions which improve food choices and decision making in real time would be helpful.


Social Networking:
Share |


Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Clark, MayaMNC27@Pitt.eduMNC27
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHoffman, LeslieLhof@pitt.eduLHOF
Committee CoChairSevick, Mary Annsevick@pitt.eduSEVICK
Committee MemberBurke, Loralbu100@pitt.eduLBU100
Committee MemberRen, Dianxudir8@pitt.eduDIR8
Committee MemberZickmund,
Date: 13 August 2012
Date Type: Publication
Defense Date: 30 July 2012
Approval Date: 13 August 2012
Submission Date: 6 August 2012
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 120
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: End stage renal disease, behavioral research, dietary behavior, health care disparities
Date Deposited: 13 Aug 2012 14:15
Last Modified: 15 Nov 2016 14:01


Monthly Views for the past 3 years

Plum Analytics

Actions (login required)

View Item View Item