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Patient experience of non-malignant ascites and its treatment: a qualitative study.

BACKGROUND
Ascites is an accumulation of serous fluid in the abdominal cavity. It can be caused by both malignant and non-malignant conditions and produces distressing symptoms. There have been no qualitative studies looking at the experiences of patients with non-malignant ascites.


AIMS
To explore the experiences of patients living with non-malignant ascites and its management. Also, to explore the views of these patients about services available to them.


METHOD
Phenomenological qualitative research study using digitally recorded semi-structured interviews.


SETTING AND PARTICIPANTS
Six adult patients with non-malignant ascites who were receiving paracentesis to manage their symptoms in an acute hospital day unit.


RESULTS
Participants experienced a wide variety of physical symptoms. They discussed how the ascites impacted on their social lives. They had views on diuretics, low sodium diet and paracentesis as methods of symptom management. Participants' confidence in staff performing paracentesis was a common finding, particularly as ultrasound was rarely used. While only some were suitable for liver transplant, all discussed their future care needs.


CONCLUSION
Participants' experiences of non-malignant ascites are that it has a considerable effect on their quality of life. Patients like the system of day case admission for drainage, but question whether this is sustainable. Advanced practitioners can successfully provide a paracentesis service for these patients in hospitals and potentially this is transferable to hospices. Patients seemed happy to consider the option of semi-permanent drains and pumps as methods of managing ascites.