The experiences of people starting haemodialysis: A qualitative study

IF 1.5 4区 医学 Q3 NURSING
Kshama Mehta PhD, Wael F. Hussein MRCPI, Kerstin K. Leuther PhD, Alexandra Fegler BA, Brigitte Schiller MD, Paul N. Bennett PhD
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Abstract

Background and Objective

Starting dialysis is a life-changing transition for people living with kidney disease. People feel overwhelmed with diet changes, medications and surgical interventions, and often experience high levels of anxiety, depression and hospital admissions. The objective of this study was to explore and describe the experiences and perspectives of people starting dialysis.

Study Design

Observational qualitative study using audio-recorded, individual, semi-structured interviews.

Participants

We conducted 20 semi-structured interviews with English-speaking adults who were within 90 days of starting in-centre haemodialysis at centres of a nonprofit dialysis provider in Northern California.

Approach

Trained qualitative researchers conducted interviews that were deidentified and transcribed verbatim before being inductively coded into codes, categories, and themes.

Results

Three overarching themes emerged from the interviews. Being overwhelmed when starting dialysis, realises the emotional unpreparedness of patients starting dialysis and how the centre's environment (waiting and treatment areas) and staff behaviour impact the dialysis start experience. Making sense of it all, covers how the patient's symptoms, behaviour, and dialysis-related experiences impact the dialysis start. Moving forward, describes how education informed optimal decision-making, and can provide hope for a longer and better life.

Limitations

Predominantly college-educated participants were recruited from a single dialysis organisation which may limit the transferability of results.

Conclusion

Understanding the life-changing experiences that patients encounter when starting dialysis assist dialysis clinicians to help patients adjust and develop long-term coping strategies.

开始血液透析者的经历:定性研究。
背景和目的:对于肾病患者来说,开始透析是一个改变生活的过渡。人们对饮食改变、药物治疗和手术干预感到不知所措,经常会出现高度焦虑、抑郁和入院治疗的情况。本研究旨在探讨和描述开始透析的患者的经历和观点:研究设计:观察性定性研究,采用录音、个人半结构式访谈:我们对北加州一家非营利性透析服务提供商的中心开始中心内血液透析 90 天内的英语成年人进行了 20 次半结构化访谈:方法:训练有素的定性研究人员对访谈内容进行了去身份化处理和逐字记录,然后归纳编码为代码、类别和主题:结果:访谈中出现了三大主题。开始透析时不知所措,认识到患者开始透析时情绪上的不适应,以及透析中心的环境(等待区和治疗区)和工作人员的行为如何影响患者开始透析的体验。理清头绪,包括患者的症状、行为和透析相关经历如何影响透析的开始。展望未来,阐述了教育如何为最佳决策提供信息,并为更长、更美好的生活带来希望:局限性:参与者主要接受过大学教育,是从一家透析机构招募的,这可能会限制结果的可移植性:了解患者在开始透析时遇到的改变生活的经历有助于透析临床医生帮助患者调整并制定长期应对策略。
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来源期刊
Journal of renal care
Journal of renal care Nursing-Advanced and Specialized Nursing
CiteScore
3.50
自引率
5.30%
发文量
36
期刊介绍: The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.
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