{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:31:16Z","timestamp":1777944676287,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009727","name":"Hospital Research Foundation","doi-asserted-by":"publisher","award":["My IP 19251"],"award-info":[{"award-number":["My IP 19251"]}],"id":[{"id":"10.13039\/100009727","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2042383"],"award-info":[{"award-number":["GNT2042383"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Renal Care"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although self\u2010management is essential for slowing the progression of chronic kidney disease and improving quality of life, patients continue to face substantial and varied challenges in managing their condition. Existing research has identified barriers to self\u2010management but less is known about the barriers and facilitators experienced by patients with advanced chronic kidney disease not yet receiving kidney replacement therapy (dialysis and transplantation). Furthermore, few studies have been consumer\u2010led or have integrated clinician and patient perspectives in a shared discussion environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore the barriers to, and facilitators of, chronic kidney disease self\u2010management from the perspectives of key stakeholders, using a consumer\u2010led qualitative approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with chronic kidney disease and clinicians were purposively sampled from a large renal service in South Australia to participate in a focus group interview, co\u2010facilitated by a person living with chronic kidney disease. Three, 2\u2010h focus group interviews involving 11 renal consumers and six renal clinicians were undertaken following a semi\u2010structured interview guide that was co\u2010developed with renal consumers and transcribed verbatim. Transcripts were coded and analysed using inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six themes emerged: patient individuality, information and education resources, disease and treatment burden, healthcare team services, patient\u2010clinician relationships, and teaching and learning strategies. Identified barriers included patient passivity, limited chronic kidney disease awareness, fragmented care, impersonal clinical approaches, and physical\/emotional distress. Facilitators included positive attitudes, goal setting, trust and satisfaction with clinicians, effective communication, shared decision\u2010making, person\u2010centred care and caregiver support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study identified that chronic kidney disease self\u2010management is influenced by interacting personal factors, relational factors and systemic factors. These qualitative insights demonstrate that patients' ability to self\u2010manage is shaped not only by knowledge, but by emotional burden, confidence, and the quality of relationships within the healthcare system. Consumer\u2010led approaches that reflect these lived experiences may enhance the relevance and acceptability of future self\u2010management support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jorc.70055","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:44:25Z","timestamp":1772970265000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cUnderstanding Chronic Kidney Disease Self\u2010Management Barriers and Facilitators: A Consumer\u2010Led Qualitative Study\u201d"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0689-3300","authenticated-orcid":false,"given":"Laura E.","family":"Lunardi","sequence":"first","affiliation":[{"name":"Central Northern Adelaide Renal and Transplantation Service, Central Northern Adelaide Renal and Transplantation Service (CNARTS) Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"College of Health Adelaide University Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa A.","family":"Matricciani","sequence":"additional","affiliation":[{"name":"College of Health Adelaide University Adelaide South Australia Australia"},{"name":"Alliance for Research in Exercise Nutrition and Activity (ARENA), College of Health Adelaide University Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4704-4943","authenticated-orcid":false,"given":"Richard K.","family":"Le Leu","sequence":"additional","affiliation":[{"name":"Central Northern Adelaide Renal and Transplantation Service, Central Northern Adelaide Renal and Transplantation Service (CNARTS) Royal Adelaide Hospital Adelaide South Australia Australia"},{"name":"School of Psychology, College of Education, Behavioural and Social Sciences Adelaide University Adelaide South 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Group Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhanee","family":"Lester","sequence":"additional","affiliation":[{"name":"Central Adelaide Local Health Network (CALHN) CNARTS, Consumer Reference Group Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Effie","family":"Johns","sequence":"additional","affiliation":[{"name":"Central Adelaide Local Health Network (CALHN) CNARTS, Consumer Reference Group Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Britton","sequence":"additional","affiliation":[{"name":"Central Northern Adelaide Renal and Transplantation Service, Central Northern Adelaide Renal and Transplantation Service (CNARTS) Royal Adelaide Hospital Adelaide South Australia 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