A qualitative investigation of experiences of care and illness perceptions related to self-management behaviors in chronic kidney disease.

Background: Chronic kidney disease (CKD) requires active self-management to slow progression, yet adherence is often low. To inform intervention development, this qualitative study explored CKD patients' illness perceptions and care experiences, and examined how these factors may interact to shape self-management. Methods: Eighteen adults with CKD stages 2-5 were recruited from a nephrology clinic and interviewed immediately after routine care encounters. Semi-structured interviews were analyzed using both inductive and deductive reflexive thematic analysis (informed by the Common-Sense Model of Self-Regulation). Results: Patients generally perceived CKD as chronic but controllable, with few noticeable symptoms and limited immediate consequences. Low symptom burden often reduced the perceived importance of self-management in daily life, whereas understanding the reasons for treatment and lifestyle changes increased motivation. Patients described treatment and control beliefs as moderate, but patients struggled to perceive the effects of dietary changes. Access to clear information, continuity of care, and trust in healthcare and practitioners were highlighted as important for coherence and confidence in self-management. Emotional responses were often alleviated through increased knowledge and supportive interactions with healthcare staff. Conclusion: Mapping experiences to illness perceptions revealed multiple pathways through which care processes may support or hinder CKD self-management.