{"doi":"10.1111/jorc.70064","title":"From Impact to Meaning Reconstruction: A Qualitative Study of the Illness Trajectory in Chronic Kidney Disease Without Kidney Replacement Therapy","abstract":"<jats:title>ABSTRACT</jats:title>\n                  <jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Living with non‐dialysis chronic kidney disease is a complex experience that extends beyond clinical markers. While the physical aspects of the disease are well‐documented, a deeper understanding of the patient's subjective journey is needed to inform person‐centered care.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>This study aimed to develop a conceptual understanding of the lived trajectory of patients with non‐dialysis chronic kidney disease to identify specific psychological shifts and management challenges.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Design</jats:title>\n                    <jats:p>This is an interview‐based qualitative study.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants</jats:title>\n                    <jats:p>A purposive sample of 13 patients with non‐dialysis chronic kidney disease was recruited from a tertiary hospital in Shenzhen, China.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach</jats:title>\n                    <jats:p>Data were collected using in‐depth, semi‐structured interviews and were analyzed using content analysis, guided by the Illness Trajectory Framework.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings</jats:title>\n                    <jats:p>The analysis generated three central themes that defined the patient's illness trajectory: (1) Cognitive and Emotional Impact, an initial phase characterized by confusion, negative emotions, and identity conflict following diagnosis; (2) Dilemmas in Disease Management, a protracted period of struggle with treatment adherence, conflicting medical advice, and a lack of support; and (3) Adaptation and Meaning Reconstruction, an emergent phase wherein patients began to accept their condition and rebuild a purposeful life.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>The illness experience in non‐dialysis chronic kidney disease is a dynamic trajectory composed of distinct, identifiable phases. The resulting three‐phase framework offers a valuable conceptual tool for practitioners to better anticipate and address the evolving psychosocial and practical needs of their patients. Implementing phase‐specific support strategies is critical for improving patient adaptation and long‐term outcomes.</jats:p>\n                  </jats:sec>","journal":"Journal of Renal Care","year":2026,"id":635167,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1647775,"name":"Shengcai Zhu","orcid":null,"position":1,"is_corresponding":false},{"id":1647776,"name":"Kunqi Ma","orcid":null,"position":2,"is_corresponding":false},{"id":1647778,"name":"Junze Yan","orcid":null,"position":3,"is_corresponding":false},{"id":681768,"name":"Xiaoqin Zhong","orcid":"0000-0001-6964-7185","position":4,"is_corresponding":false},{"id":1647779,"name":"Shenglang Zhu","orcid":"0009-0001-2632-6450","position":5,"is_corresponding":false},{"id":346834,"name":"Li Wang","orcid":"0000-0003-4959-0729","position":6,"is_corresponding":false},{"id":806812,"name":"Jiaojiao Hu","orcid":"0000-0003-3875-2868","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"From Impact to Meaning Reconstruction: A Qualitative Study of the Illness Trajectory in Chronic Kidney Disease Without Kidney Replacement Therapy","abstract":"<jats:title>ABSTRACT</jats:title>\n                  <jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Living with non‐dialysis chronic kidney disease is a complex experience that extends beyond clinical markers. While the physical aspects of the disease are well‐documented, a deeper understanding of the patient's subjective journey is needed to inform person‐centered care.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>This study aimed to develop a conceptual understanding of the lived trajectory of patients with non‐dialysis chronic kidney disease to identify specific psychological shifts and management challenges.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Design</jats:title>\n                    <jats:p>This is an interview‐based qualitative study.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants</jats:title>\n                    <jats:p>A purposive sample of 13 patients with non‐dialysis chronic kidney disease was recruited from a tertiary hospital in Shenzhen, China.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach</jats:title>\n                    <jats:p>Data were collected using in‐depth, semi‐structured interviews and were analyzed using content analysis, guided by the Illness Trajectory Framework.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings</jats:title>\n                    <jats:p>The analysis generated three central themes that defined the patient's illness trajectory: (1) Cognitive and Emotional Impact, an initial phase characterized by confusion, negative emotions, and identity conflict following diagnosis; (2) Dilemmas in Disease Management, a protracted period of struggle with treatment adherence, conflicting medical advice, and a lack of support; and (3) Adaptation and Meaning Reconstruction, an emergent phase wherein patients began to accept their condition and rebuild a purposeful life.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>The illness experience in non‐dialysis chronic kidney disease is a dynamic trajectory composed of distinct, identifiable phases. The resulting three‐phase framework offers a valuable conceptual tool for practitioners to better anticipate and address the evolving psychosocial and practical needs of their patients. Implementing phase‐specific support strategies is critical for improving patient adaptation and long‐term outcomes.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"42223048","pmcid":null,"openalex_id":"https://openalex.org/W7163035976","authors":[],"funders":[{"funder_name":"Shenzhen Science and Technology Innovation Commission Fund of 2023","grant_id":"JCYJ20230807115904009","title":null}],"total_grants":1,"fwci":0.0,"citation_percentile":0.66559041,"influential_citations":0,"citation_trend":[],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://doi.org/10.1111/jorc.70064","host_type":"journal"},{"url":"https://doi.org/10.1111/jorc.70064","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/jorc.70064","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/jorc.70064","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/42223048","host_type":"repository"}],"fields_of_study":["Dialysis and Renal Disease Management","Chronic Kidney Disease and Diabetes","Patient-Provider Communication in Healthcare","Humans","Qualitative Research","Female","Renal Insufficiency, Chronic","Male","Adaptation, Psychological","Middle Aged","China","Aged","Adult","Interviews as Topic","Renal Replacement Therapy","Quality of Life"],"mesh_terms":["Adaptation, Psychological","Adult","Aged","China","Female","Humans","Interviews as Topic","Male","Middle Aged","Quality of Life","Renal Replacement Therapy","Qualitative Research","Renal Insufficiency, Chronic"],"keywords":["Kidney disease","Psychosocial","Qualitative research","Meaning (existential)","Disease","Grounded theory","Identity (music)","Adaptation (eye)","Lived Experience","Illness Trajectory","Meaning Reconstruction","Chronic Kidney Disease Without Kidney Replacement Therapy"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T14:44:28.608991Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}