Pictures and perspectives: a unique reflection on interdialytic weight gain.

The purpose of this study was to explore the perspectives of managing interdialytic weight gain for individuals on hemodialysis. A qualitative design was used to elicit patients' stories with some participants using images to support their story telling. Data were analyzed using an iterative theming process. Themes that arose from preliminary data analysis include magnitude of loss, constant struggle, and transition to acceptance. Transition to acceptance is not a linear progression to understanding and compliance but a multifaceted, tortuous struggle unique to individuals and largely dependent upon support, belief in a life worth living, and willingness to engage in surveillance and maintenance of behavior. Appreciating the impact and meaning of fluid restriction for individuals on hemodialysis will assist health professionals to identify support strategies that facilitate healthy fluid gain behaviors.