Behavioural strategies to self‐manage low‐potassium diets in chronic kidney disease

Background

Dietary potassium restrictions may be challenging to follow, due in part to the restrictive nature of recommendations on foods people enjoy. Little is known how people incorporate low‐potassium diets into their lifestyles.
Objective

To examine the self‐directed behavioural strategies people employ to follow low‐potassium advice.
Design

Qualitative methodology.
Participants

Thirty‐four adults with chronic kidney disease.
Approach

Semistructured interviews were undertaken in an outpatient department. Thematic analysis was undertaken on transcribed interviews.
Findings

Analysis identified three themes: 'Differing opinions of food'; 'Food generates positive emotions'; and 'Doing what works'. Participants described foods providing different levels of enjoyment. Favourite foods in their habitual diet held either a physiological or a psychological value to them. Five subthemes underpinned the 'Doing what works' theme that described the self‐management behaviours used by participants to follow low‐potassium dietary advice. These were positive reframing; reflection; self‐talk; social support; decisional balance; paradoxical instruction; and knowledge shaping. These techniques helped overcome the conflict between favourite food preferences and dietary restrictions. Dietary restrictions proved more challenging where an emotional connection to a favourite food existed. Restrictions on less preferred foods did not present participants with the same self‐management challenges.
Conclusions

Promoting behavioural change techniques such as decisional balance, and social support may be a useful strategy to empower people following dietary restrictions. Practitioners should understand whether suggested dietary restrictions include an individual's favourite food; the value attached to it, and explore specific ways to include favourite foods in some way when discussing a low‐potassium diet.