Perceptions of rural Australian adults with chronic kidney disease stages 3 and 4 about the role of dietary intervention in their health and access to dietetic care.

Background: Dietary modification is an important component of chronic kidney disease (CKD) management. The aim of this study was to explore the perceptions of people with earlier-stage CKD living in rural Australia about the role of dietary intervention in their health and access to dietetic care.

Methods: Semi-structured interviews were conducted with 14 people with stage 3-4 CKD living in a rural Australian health district. Interview questions were guided by the principles of the appreciative inquiry study methodology. The thematic analysis involved inductive coding of data, discussions of emerging themes between co-researchers as coding proceeded and thematic memoing to finalise the transformation of data into distinct themes.

Results: Three predominant themes were evident from the data. First, people with CKD expressed that 'Dietary change empowers' them in self-management. Second, 'Dietetics is valued' in achieving dietary change. Third, it was clear that nephrologists had a key role in determining service access through 'Awareness and advocacy' of renal dietetic services.

Conclusions: People with CKD living in rural Australia desire early, specialised renal dietetic care. The unexpectedly high acceptability of less resource-intensive technology for dietetic intervention suggests that there is an opportunity for service reorientation. Access to dietetic care could be enhanced by building on the key role of nephrologists in dietetic referral, service awareness and perception of value.